Dear family and friends:
After my follow-up appointment late last week, it appears that I will need another surgery to wipe the cancer out completely. However, if the tumor markers in my bloodstream remain high, they will want me to begin chemotherapy instead of surgery.
I am grateful to our Lord for His hand of guidance in all of this, and if being cancer-free requires another surgery, then so be it. If I have to endure chemo, then fine. Thankfully, embryonal carcinoma, when it develops in the testicles, is rarely fatal and is usually cured in the long run (although it does recur in many patients). It has a history of spreading very quickly in men, heading north via the lymphatic system toward the liver, lungs, and brain. There is no way of knowing whether or not my lymph nodes are carrying the cancer unless they are removed and dissected.
The surgery is called an RPLND, or retriperitoneal lymphnode dissection. It is major surgery, taking 3-4 hours on the table, and 4-8 days of recovery in the hospital. It involves cutting the patient open from sternum to groin, and carefully removing the clusters of lymph nodes that are located in front of the spine, behind the kidneys, along the vena cava and aorta, etc.
This surgery, if it happens, will most likely not be for a few weeks. We have to wait for my bloodwork until at least two more weeks, which is the timeframe for the tumor markers to typically normalize. Again, if they are not normal, I will skip surgery and head straight to chemotherapy. If they are normal, then surgery.