Initial Stage 1 Seminoma Relapse After 4 Years - Guidance on Chemo

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Hi All,

Unfortunately after nearly 4 years (3 years 11 months) of clear CT scans and blood tests, an enlarged abdominal lymph node and tumour marker level increase (6 - 9) at my most recent surveillance check has warranted an assumed relapse. I will be starting a 12 week chemo program of 4, 5 consecutive day sessions every three weeks. I am advised that only Cisplatin and Etoposide will be used. The exclusion of Bleomycin is intentional because (as per my oncologist) at my age (34) the possibility of Bleomycin creating lung complications later in life is unnecessarily high. 

The above said, accepting that chemo is the next step and grateful that testicular cancer is a highly curative cancer, I’m interested in understanding if there is any guidance on preparing for chemo. Physically, are side effects less if one is fitter, healthier? Is there anything recommended to keep fatigue, nausea at bay? I recognise I don’t know how I will respond to chemo but I expect it will be as per most and so if I can prepare now, I’d like to. 

Thank you in advance.

  • Good luck Maa13. Sounds like you are quite a strong person so I'm sure your positivity will help! I had one dose of Carboplatin so you are well beyond me already. For what it's worth I was pretty much back to normal after 6 weeks. I do get tired more these days (maybe my age 49) and get tinnitus occasionally but these are small prices to pay. Hope all goes well for you. 

  • the main side affects were the affect of cold on my fingers and toes - wearing gloves to get milk out of the fridge ! Also it affects your voice box in cold weather which makes you feel like you can’t breath - a nice cup of tea will sort this. During chemo through the hand it would affect the rest of my arm giving me a pins and needles sensation - this lasted a couple days. Other than that , normal effects of chemo - mainly tiredness for the first week and then seemed to improve .

  • I am sorry to hear this. I had 9 weeks BEP chemo last summer. You will need to dig deep and stay positive. Stay hydrated and ginger helps with the nausea. The issue is not sitting in the chemo suite receiving treatment; it’s the after effects when you go home. After 9 weeks chemo, my ct scan showed an enlarged lymph node and I had to undergo RPLND, which was debilitating and equivalent to weeks of chemo in terms of trauma.

    I am astounded to hear that you have potential relapse after 4 years! It shows how precious and unpredictable life is. I pray for you.

  • Hi, thank you for your well wishes. I start my second cycle on Monday and have enjoyed a great week 3. I feel at peace now knowing what to expect in the week following the chemo. My veins have healed therefore ready for this. Here’s to your continued without cancer journey.

  • Thanks Sub. I’m in South Africa so cold won’t be a problem but will be conscious of sensitivity to fingers and toes. Hope all remains positive with you.

  • Hi, sorry to hear about your post chemo discovery.  Thank you for the tips. I have found hydration, ginger and good healthy food as key to getting through this. I’m grateful my appetite remains so getting food in has not been a problem. I was equally upset with the recurrence but I was wrong for not attending to my initial tumour for as long as I did. 

    If you don’t mind sharing, how do you fair post op? Are you back on chemo or surveillance? I will pray for continued healing and the eradication of cancer.

  • After cycle 2, I was admitted into hospital with sepsis for a week. Then I was determined to finish my cycle of treatments. I forgot to mention mouth hygiene is ultra important- I got mucositis and struggled to eat.

    Post op it took me around 6 weeks to get back to normal. I had complications with the large wound dehissing and had to regularly attend the wound clinic. I began surveillance last week. Now I treat each day as a bonus! Thanks for asking.

    If you get bored during chemo, look up Daily Stoic on YouTube.

  • Thank you. Yea I had a big ridiculously painful ulcer develop on my lip in week 2 and started to feel some irritation in my back molars so now super pedantic on brushing, flossing and using an antiseptic mouthwash when needed. 

    Look hoping that this is the end of your battle and subsequent surveillance checks up remain clear.

  • Hi again. Cycle 2 complete. Halfway, in my mind. To those that recommended strapping up or in, you were right. The start to this recovery period has not been great. Same side effects but heightened. Fatigue and pain that I now assume is common with chemo. Unfortunately I do not have any tips or tricks, other than (I do not advocate for  this, it has merely helped me), purple lucozade. The carbonation assists with nausea and reflux. Tastes great and has given me the occasional boost to get me up to eat, move etc. Though I don’t want to eat, eating is the best. I feel as if I am healing my body. 

    One side effect that is bugging me is night sweats. If anyone has any thoughts on how to manage this, I’d be exceptionally grateful.

    Two consecutive blood tests (before cycle 1 and before cycle 2) indicate tumour markers back to normal so I believe I am winning. Have a great evening, day all.

  • Pleased to hear of your recent blood test results.  I can’t offer any thoughts about your night sweats, sorry!  Maybe someone else can offer some thoughts.  You sound like you are digging in, well done.  Keep at it.Muscle.  
    And keep eating , you need the fuel to recover.