Flabbergasted…Chemo Update

The news: We just saw the oncologist Dr. Atluri at Leo Jenkins Cancer Center for the second time. When we saw her last week she was waiting on more information from the Oncologist we saw in Rocky Mount. Once she reviewed Casey’s case more thoroughly, and discussed it with her colleagues they decided that chemotherapy would be too aggressive for his Stage 1A diagnosis. She pulled up the National Cancer Network guidelines for us and showed us what our options were. One would be surveillance, the second would be a surgery called RPLND. Surveillance was not an option for us, not only because of high cost of CT scans but more than 44% of patients have a relapse and have to have chemo anyway.

So, what is RPLND? Retroperitoneal Lymph Node Dissection is a procedure to remove abdominal lymph nodes to treat testicular cancer. Basically they go in and remove some lymph nodes and basically check out the lymphatic system by sight and feel to make sure that no cancer remains in his body that did not show up on the CT scan. There are two options that can happen after the surgery.

One – Casey could be considered cured. He would go through surveillance of CT Scans every 6 months for the first two years and one per year for three years afterward (This would be the same as if he had actually had chemo). He would then be considered cured. Dr. Atluri feels that this is a very good outcome for Casey since his CT scans showed no cancer spread and his tumor markers are normal.

Two – They could find additional cancer cells and if they were at a level of n1 or higher he would still have two rounds of Chemotherapy. So, we’d be back at the beginning of the process.

So, what do we have to gain from the surgery? Casey could be cured by the surgery and never have to have chemo. He wouldn’t have to put all the toxicity from the chemo drugs in his body. However, this is surgery with a long healing period approximately 4 weeks. There’s still a slight chance of becoming infertile because of retrograde ejaculation, where basically during operation they can hit a nerve that causes the ejaculation to go into the bladder instead of coming out of the body. Plus, there’s a lingering chance that he’s still need chemo anyway.

Right now, I think we’re very confused. My brain feels like one of those justice scales trying to weigh the options of each option. We’re thinking about both and we will meet with the new urologist next Friday. It’s going to be a long wait until then…and waiting is one of the worst parts of your loved one having cancer. You want answers now, but there’s nothing you can do but wait.

Tagged as: Cancer, chemo, Retroperitoneal Lymph Node Dissection, RPLND, testicular cancer