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Testicular Cancer

Surveillance after teratoma

After an operation to remove a testicle for cancer it is important that men are seen regularly for blood tests, x-rays and other checks (see 'Follow-up'), at least for the first few years.

Men diagnosed with a teratoma, with no evidence of metastases (spread of the disease), either have two courses of adjuvant chemotherapy to prevent any spread, or they may be monitored (surveillance), with frequent blood tests and x-rays. With a teratoma the blood tests are very reliable in detecting recurrence. The overall survival rate is very good with either approach.

One man initially had blood tests every two weeks after his orchidectomy, followed by monthly blood tests and x-rays. Another man assumed that surveillance was the normal route for men in his situation. He was shocked four weeks later by the manner in which he was informed that the tumour markers in his blood had started to rise again, which indicated that the cancer had spread. A nurse casually gave him the news when taking his blood.

 

Says that he was glad to have surveillance and no further treatment.

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Age at interview: 42
Sex: Male
Age at diagnosis: 41
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When the consultant came in, he very quickly assured me that there was no indication that it had spread to anywhere else in the body. The scan was clear, the blood tests certainly didn't indicate there were any traces which would suggest that it had spread, but that I needed to be under very close observation for the coming months and years. 

I would go immediately be on to a sequence of blood tests, monthly blood tests or monthly check, or two weekly initially blood tests followed by monthly blood tests, and then monthly check-ups, which involved a chest x-ray. That would last at that interval for the first year. I would then go on to two-monthly and then go on to quarterly, six-monthly, annually until I got to ten years and'

Were you given any choice at that stage, whether you should just have surveillance or whether you should have any other sort of treatment at all?

Not really I mean there was no need for, for any other treatment, or I was assured there was no need and I, I don't see why I would need to. So there was no, you know there is no choice there, it was just a case of saying, 'What we need to do is for you to come in regularly and, and check.'
 
 

Explains that he assumed that surveillance was the best option for him and that he was shocked to...

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Age at interview: 32
Sex: Male
Age at diagnosis: 27
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Were you a given a choice of whether to follow this surveillance route or whether to have some chemotherapy straight away?

No my specialist at the time, my oncologist said this is the route they take. Now I was told that that's what they did and I assumed that that was what they did with all patients in my case. I would assume unless it was obvious that the tumour had spread to other areas, which I think after the surgery if they take your blood levels and they're high they know that the tumour is somewhere else in your body as well

Right.

So with me they took my bloods after my, before my surgery which were high. I had the surgery and then after surgery they were normal again. So that's why they adopted a 'wait and see' policy with me. Now I did that for four weeks and on the fourth week I found out in a very, er '., one of the few occasions throughout my illness that I was not very happy with the treatment that I received. The fourth week I was in the cancer ward, getting my bloods taken and I was on the chair with a lead in my arm and one of the nurses was drawing the blood. She'd just finished drawing the blood and I was holding a piece of cotton wool on the area of the needle and standing up sort of just about to put my coat on and walk away and I said, "So when am I going to go monthly or is it going to keep going weekly for another week?" and one of the nurses turned round and said, "Oh, it's definitely weekly because your bloods are starting to go up," you know, and that's how I was told that my tumour marker levels had started to rise, was by a nurse inadvertently saying "Oh your bloods have started to go up." Now that to me was a very wrong way of breaking the news to somebody because instantly it's just shock and worry.

Awful.

Now I, I can't remember what I, when I saw my oncologist after being told that, was it the same day or was it the next, a couple of days later. I think it may have been a couple of days later that I got an appointment to see my oncologist who explained to me that my tumour marker levels were starting to rise again which means that the cancer had spread to somewhere else. 

Last reviewed December 2017.

 
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