Doctors Lounge - Oncology Answers
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Forum Name: Testicular Cancer
|mh006720 - Tue Jul 24, 2007 3:10 am||
I'm a 28 y/o male with 10 year history of embroynal cell carcinoma & teratoma that was initially staged as greater than stage I and eventually stage II testicular carcinoma. I've had orchiectomy (with persistently elevated post-operative tumor markers), 3 rounds of bleomycin, etoposide, and cisplatin based chemotherapy, bilateral RPLND, and right-sided pyleoplasty (in that order). Pyleoplasty is for chronically obstructed UPJ following scarring due to RPLND. Currently diagnosed with hypertension (presumed to be due to the RPLND).
Family history of colon cancer, adenocarcinoma, cancer of the larynx, hypertension (all grandparents, and all diagnosed within 6 months of my diagnoses). I'm currently diagnosed with and managed by a nephrologist for hypertension.
Current medications: Metoprolol & Hyzaar (for blood pressure and tachycardia), Cymbalta (for depression and nerve pain) and trazodone (for sleeping & pain I suppose).
Since my last round of Chemotherapy almost 9 years ago, my AFP level has been consistently rising slowly. It's outside the normal range.,.which is why I suppose I'm still being monitored. bHCG is below detectable leves. CT scans of Chest/Abdomen/Pelvis show no marked interval change over the past few years.
Over the past few months I've had a persistent cough and decrease in energy. It's been about 6 months since my last checkup and I've got another one scheduled for next tuesday. My question is this -- how worried should I be, and what is the risk of recurrence after 10 years? (I assume that my Dr. is still worried, at least a little bit, seeing as how he's still seeing me almost 10 yrs after initial diagnosis, and he's cheif of staff at a major university hospital). What are your thoughts? Please ease my mind.
|Dr. Chan Lowe - Fri Jul 27, 2007 5:52 pm||
I probably am not going to give you the answer you were hoping for. In general, recurrence risk with stage 2 testicular cancer is low; however, there are many factors that contribute to risk. Unfortunately, your risk will never be zero. The longer it has been, the lower the risk.
The big problem with statistics is that no matter what the risk, if recurrence occurs, your rate of recurrence is 100%. Many cancers result in lifelong monitoring so I would not say you are at increased risk simply because you are still being followed. Your rising AFP is a little concerning. The undetectable HCG is a good sign.
I wish I could give you a more solid answer on your risk but I simply can't based on the limitations of the internet. Seeing your oncologist again will be very helpful and you'll likely get a better answer.
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