k4txz

I had my last treatment of chemo for my cancer on January 14, 2003. I
have been having follow-up CT's, bloodwork and chest Xrays. This last
CT scan showed a enlarged lymph node of a little over 1cm. My blood
work and Chest Xray all came back normal. My oncologist wants to do
surgery if in a month the lymph node has stayed the same or enlarged.
I asked her about doing a pet scan to see it was actually cancer and
she responded that the pet scan probably would not pick something that
small up. I personally do not want to have the surgery if my marker
levels are all normal. does anyone know if lymph nodes can enlarge and
be cancerous without the marker levels elevating? Also what else could
cause enlarged lymph nodes?
Thanks,
J Clark
k4txz@k4txz.com

steph

Testicular cancer can certainly grow without the markers elevating.
But the likeliest thing is that the repeat scan will not show any growth, in
which case surgery is a judgement call

down

Lymph nodes can also be enlarged due to infection or inflammation,
experienced radiologists can sometimes tell the diff between large
metastatic and inflamed nodes. A 1cm node (depending where its located)
is borderline, a repeat scan is sensible -perhaps a month or two later.
If it keeps growing and you can rule out an infection at or below that
level then surgery is the way to go. As Steph says, markers aren't too
reliable in testicular cancer. Were they were raised before treatment
began?

--
madiba

j c

My markers were elevated before the treatment began. after the first cycle
they went back to normal. I continued on with 2 more cycles of chemo. The
enlarged lymph node is in the same spot that was cancerous before. Thanks
for the followups.

J Clark

paul collins

JC,

Here is my real life experience with your situation:

I had the exact same scenario 12 years ago, but back then my doc wanted to
remove all my lymph nodes throughout my whole torso. I refused. My cancer
just came back 2 years ago and I'm still fighting it. My doc this time was
getting advice from Dr. Lawrence Einhorn, Lance Armstrong's saving doc, who
now is exclusively my doc. Anyway, the tumor grew back in the original lymph
node and I went through 7 1/2 months of chemo when they decided to do
surgery. But now they are able to do a more precise removal of only the key
lymph nodes associated with network the caner is in. I had my surgery at U
of M by a very good urologist and things were looking pretty good. He was a
specialist in this type of surgery and that is all he does, so he was very
experienced at this type of surgery. But despite all that my cancer
persists. Believe-you-me, I wish I had that lymph node removed 12 years ago!

My advice to you would be to go see Dr. Einhorn at Indiana University Cancer
Center and get his opinion, after all, he is THE top testicular cancer
doctor in the world. He has the best reputation for pulling people from the
grave! I just hope he can save me!

PTC

steph

If disease is recurrent after treatment, it sometimes becomes marker neg
even though it was initially marker pos.
Nonetheless, the likeliest thing is that yours is NOT recurrent.....

j

I'm not a doctor but knowing where all the lymph nodes are in the torso, that's
physically and practically impossible to do. The patient would have to be cut
open from the neck down to the pelvis and even under the armpits. (perhaps a misunderstanding?)

best wishes with your treatment.
J

steph

Retroperitoneal lymph node dissection is a pretty extensive surgery, with
quite significant side-effects.

j

Yes, I see that, thank you.
http://urology.jhu.edu/MIS/RPLND.html

J

paul collins

Well, what the doctor "exactly" said to me was all the lymph nodes were to
be removed throughout my chest and abdomen. Much like the procedure for
Hodgkins Disease.