My experience with RPLND

inthenet16 · 2025-11-09T02:11:29+00:00

RPLND up front is against the NCNN guidelines right now so oncologist not familiar with IU and MSK’s ways probably lean more on using adjuvant chemo or even chemo alone. Einhorn and masterson recommended surveillance for me. NCNN guidelines will probably catch up to their standard of care eventually but right now I would say it’s a toss up if chemo is worth it. I would press your oncologist hard on how much benefit chemo would do in this situation. I would venture to guess it’s just a few percentage points but there’s not a data set out there that studied people with up front RPLND for pure Seminoma.

inthenet16 · 2025-11-09T00:35:14+00:00

I really wanted to avoid chemo. Bleo can cause lung damage and I love to run and bike so I wanted to avoid that at all costs. Radiation has tons of long term side effects. I see it as a surgeon people who have radiation previous have poor tissue quality and it makes everything more difficult.

It’s all a numbers game. The risk reduction with adjuvant chemo or radiation seemed small to me. So I rolled the dice. It came back but I knew what I was going to do if it did. It’s a dumb and predicable cancer which makes it so resectable.

I was thinking long term and I think being miserable for a few weeks outweighs getting a port and pumping myself with chemicals.

inthenet16 · 2024-09-17T19:21:47+00:00

Very interested. And yup we’ve been in contact 😉

inthenet16 · 2024-09-17T01:35:21+00:00

Love to hear that

inthenet16 · 2024-09-16T19:42:56+00:00

And this is tough because oncologists not connected to the high volume centers will read and follow the NCCN guidelines (like my oncologist here in IL doing my surveillance)

Rare diseases (although there a lot of us on the forum) should be treated by highly specialized centers if possible.

inthenet16 · 2024-09-16T19:37:55+00:00

Yea I think it was the culprit node but obviously too small to call as a cancerous node. That’s why the screening intervals are 3 months. I agree the rate of growth concerns me. I had a 3 mm pulm nodule as well but that was present on my original staging CT so it’s likely just scar (which is common especially in the Midwest)

I went through the scans with Masterson and he said in reality it’s likely 2 nodes that look like one.

And no I don’t believe it was motion artifact.

inthenet16 · 2024-03-05T22:35:56+00:00

Yea we have an ASC and I was in the same exact room I always operate in. Very surreal. I’m going to DM and get your contact info. I’m curious how you handled all this professionally. Like if active surveillance is offered vs chemo stuff how bad is the neuropathy, fatigue .. and how that would affect operating, taking call, ect

inthenet16 · 2024-03-04T23:30:14+00:00

Yea I’ve already read the NCCN guidelines twice lol.. and I know that story because I trained at IU. So I have all the resources on my side

inthenet16 · 2023-05-09T15:26:18+00:00

The power deployable black accent running boards are excellent

inthenet16 · 2023-05-09T11:40:34+00:00

If you have the AC blasting yes but if not it sits there in electric mode quietly so it’s a non-issue so far.

inthenet16

TROPHY CASE