The Follow-Up

September 22, 2014

Follow-up appointment at the VA.  Healing just fine from surgery...yes, we already know that....now let's get down to the meat and potatoes of this visit.

Tumor was 2.7 centimeters at it's largest point.  The tumor had not spread outside of the testicle itself, which is great!  Type of tumor:  seminoma.  I'm not going to lie...I've researched seminoma vs. non-seminoma extensively and I just don't really understand the difference.  Google it for yourself, maybe you'll grasp it a little more than I did.

Prior to surgery, his tumor markers were up past 450.  That's too high....much too high.
After surgery, his tumor markers were less than 2.  You may be asking "so does that mean they got it all?  What about those swollen lymph nodes?  What's up with that?"

According to the doctors, it means there are still some cancer cells in those lymph nodes, but they are inactive right now.  GREAT! Let's kick them while they're down and get them the hell out of there!

And now you're asking yourself:  What's the next step? Lymph node removal surgery, radiation, or...God forbid... chemotherapy?

September 25, 2014

Follow-up appointment with the Hematology Oncologist (hereafter referred to as "chemo guy").
Treatment option of choice: Chemo.  2 types of drugs, given for 4 cycles.

Hold on now....what's wrong with the other two options?

According to Chemo guy, if they did surgery to the remove the lymph nodes, they could leave behind just ONE little cell.  One itty bitty, barely even viable cancer cell.  Well....given enough time and the space...that cell could do whatever it wanted and divide and conquer.  So that's not an option until something else has been tried first.

Radiation apparently melts testicular cancer away like butter on a hot Georgia day.  BUT, the kicker....radiation causes cancer.  Usually lymphoma.  Now, it generally takes 30-40 years before this happens, but it happens.  Radiation, as we've been told, is more reserved to older folks who, lets be honest, may not be around another 30-40 years.  Radiation, in Dave's case, is apparently the LAST thing they want to do.

So as you can see, chemo is the only logical choice.  They'll do the chemo, which should kick those remaining cancer cells in the ass.  If for some reason it doesn't, then removal of the lymph nodes ought to take care of it.

Dave's treatment plan is as follows:
4 straight days of chemo (drugs:  Cysplatin and Etoposide)
2 weeks of rest
repeat 3 more times
(FYI: the 4 treatment days followed by 2 weeks of rests comprise 1 cycle)

Assuming his labs all stay good and his health doesn't change, his last week of rest of his last cycle of chemo is the week of Christmas.  So....Merry Christmas to him, he'll be done with chemo!

Treatment will begin October 6.  I'm such a bad wife, I told the chemo guy about Dave's cold symptoms because Dave HADN'T told him....oooh I got a dirty look from that darling husband of mine because he wanted to start treatment right away on the 30th.  Oops :)

Cue 1 audiology test (because Cysplatin can cause long-term partial hearing loss and they needed a base line) and 1 week of agonizing waiting.

(We had a "Farwell nut" party the Friday before chemo....a lot of gag gifts and margaritas were had.  We also had a date night the Saturday before chemo....saw Gone Girl [oh my god, go see the movie AND read the book!] and then shared some appetizers and a bottle of wine at Olive Garden...super great night!)