Decisions, Decisions

If you had asked me last week what I was going to do for followup treatment, the answer would have been pretty clear cut: 2 cycles of chemotherapy, 3 weeks apart. Now the answer is less clear. Should I have radiation therapy? 1 cycle of chemotherapy? 2 cycles of chemotherapy? Do nothing but watch and wait? All of these suddenly seem possible.

Today we met with an oncologist team at MGH. This appointment was a little bit different than my last oncology appointment. First off, we met with a team instead of an individual medical oncologist. The team was a medical oncologist and a radiation oncologist, both who have treated testicular cancer before. I appreciated the multi-faceted approach: we got lots of detailed information about both possible treatments, from doctors who specialized in each area. Secondly, the office an environment was more welcoming and friendly. Finally, both doctors have treated testicular cancer before. Since testicular cancer is so rare (about 8000 cases / year in the US) it is not uncommon to find urologists or oncologists who have only rarely encountered the disease. It was comforting to know that this team has treated at least 10 cases over the last year or so -- not a lot of cases, but certainly more than you might expect given the statistics.

The doctors did not make a recommendation for treatment today, they are waiting on some additional imaging and blood work and I'll have a followup appointment on the 6th, but my impression was they are leaning towards radiation therapy. They did not rule out waiting or chemotherapy, but they have treated more people with testicular cancer using radiation. There is more data about the long term effects of radiation -- less so with Carboplatin (the chemotherapy drug). There are no long term studies of the effects of Carboplatin on 31 year old men so they can't say with any certainty how my quality of life will change. Hopefully, I'll learn more on the 6th.

Right now, I think I'm still leaning toward chemotherapy. Radiation treatment scares me because the radiation, while targeted, still reaches the stomach and pancreas. I don't know if I should be just as scared of chemotherapy or what is the quantifiable risk associated with radiation.

Anyways, things are up in the air and we have a lot of decisions to make.

Thanks for your love and support.