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Personal stories about choosing RPLND, chemotherapy, or watchful waiting for stage I nonseminoma

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By Bets Davis, MFA

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These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

John, age 28: As a cyclist, I figured the swelling on my testicle was probably caused from over-training, but my wife made me go to the doctor to have it checked out. It's a good thing I did because the doctor told me I had a stage I nonseminoma. Since we found it at an early stage and my prognosis was good, I was given the options of chemotherapy, RPLND surgery, or watchful waiting. At the time, I was spending a lot of time traveling to races so I decided that I didn't really have the time for all the checkups and tests that go with watchful waiting and I wasn't comfortable with undergoing chemotherapy, so I chose RPLND. After the RPLND, I had some trouble with fluid retention in my legs and postoperative pain, both of which have since improved. I've been able to resume my cycling career and my doctor says I'm cancer-free, so I have no regrets.

Lorenzo, age 37: After I got over the shock of my diagnosis, we talked about my treatment choices. My doctor told me that because we caught the cancer at an early stage, I had to decide on which treatment option was best for me. After discussing it with my wife, we decided on the RPLND. We also felt the stress of watchful waiting would be just too much for us, especially since we have a young child and would like to have another. While my doctor says that I'm still cancer-free after two years, the surgery did cause me to become infertile. Although I did bank sperm before the surgery, part of me wishes I had given more thought to watchful waiting.

Michael, age 31: When my doctor told me I had testicular cancer, I was devastated. I decided that I would do everything in my power to beat this disease. After discussing it with my doctor I decided to go ahead with chemotherapy. I knew there was a chance that I didn't need it but I wanted to get it over with as soon as possible so I could continue with my life. Because my cancer was early-stage, the chemotherapy program wasn't very intensive and the side effects were barely noticeable. That was a year ago and I feel great. I know I made the right decision for me.

Sam, age 20: At first I couldn't believe what the doctor was telling me. How could I have cancer? I thought I was too young for something like that. After going through a period of denial and anger, I decided I was going to do whatever I could to beat it. My doctor said I was fortunate because we had caught it at an early stage. After orchiectomy, I was told I could either go for surgery to remove lymph nodes in my pelvis, have chemotherapy, or try watchful waiting. I decided to wait and see if my cancer was gone before undergoing other treatment. I'm young and don't like the idea of having major surgery or chemotherapy if I don't have to, especially since they can cause other problems later on. The follow-up schedule has been hard to stick to at times, but it's been over a year and the doctor says I'm still cancer-free, so I think it's been worth it.

David, age 33: After being diagnosed with a stage I nonseminoma, I decided to try a watchful waiting program after my orchiectomy. I made all of my follow-up appointments and felt confident that my cancer was gone for good. Well, about 8 months after starting the program, we found out that my cancer had spread to the lymph nodes in my pelvis. Now, my doctor tells me that I'm going to need the surgery anyway and may also need chemotherapy to cure my cancer.

Credits

Author Bets Davis, MFA
Editor Susan Van Houten, RN, BSN, MBA
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Christopher G. Wood, MD, FACS - Urology/Oncology
Last Updated January 26, 2009
Last Updated: 01/26/2009

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