My cancer diary:
Monday - May 7, 2001
[total: day 92]

"It has been quite some time since I have last update the dairy pages. We have booked the hotels in Heidelberg in the meantime. -

Today is the big day: the first consilium to discuss the CT scans and the x-ray pictures. Although it's just a ten minutes drive I am pushing Andrea that we leave early. If waiting for results after the second CT scan was similar to seeing Fate rolling dice, this today feels at least like hearing a jury's verdict in a death trial. The appointment is between Andrea and me plus A. and B. plus the radiologist M. It's scheduled for 19:15 at M.'s office.
It turns out that M. is well prepared. He has read the CT reports and looked at the pictures. I give him the x-ray of the lungs of 1999 taken by my family doctor. It turns out that the x-ray of my lungs of 1996 is not available. As A. and B. haven't arrived yet he asks for a few minutes privacy. When A. and B. arrive we all meet in M.'s office.

Did the jury reach a verdict?

M. attaches the x-ray slide of 1999 to the light panel at the wall and summarizes the results of the CT scans. In his opinion the x-ray proves that the suspicious metastasis at the base of the left lung is not a metastasis at all, thus not due to cancer, but a swelling that has decreased in size and was due to a scar from a former pneumonia. Jabadabadoo!
He then comes back to the CT pictures and explains the small subpictures of a few CT slides. The retroperitoneal lymph nodes have decreased in size. But there are still some of 5 mm in size. A. and M. start a discussion about the location of these lymph nodes and the probability that a tumor in the right testicle spreads to the area right or left of the aorta.

I still can't believe it, so M. replies to my hesitation very convinced and convincing: There is no doubt about the lung location for him.
A. recommends to do the retroperitoneal lymph node dissection (RPLND) as the next step. According to him there are three possibles results of that operation: a) there is no tumor mass found in the lymph nodes, b) there is just mature teratom or c) there is still vital tumor mass existing. Just alternative c) would mean another chemo-cycle, a) and b) would end up in the wait and see strategy.

I am given all the pictures for our visit in Heidelberg. I add that I would need a few copies of some reports from my file for the visit to Heidelberg. No problem, the file is at the accounting department at the moment. It should be back Wednesday afternoon. I will get the copies then.

When we are leaving the hospital Andrea seems very relieved. I need some distraction. We decide to go to a restaurant - the first time since February.
When we are back home I am still not relieved. I keep thinking about the next logical step. As I know from my own research and from A.'s words: this RPLND surgery. I haven't yet fully understood what it means so I search the Internet for more detailled information.

RPLND means a serious operation, lasting three to six hours, some say to ten and twelve hours if there are complications. Basically they open your belly from just below the sternum to the area below your belly button, pull out everything that is inside and in the way, dissect the lymph nodes where the cancer sits, put everything back in and staple the skin together again.
Sounds interesting! I learn from a Dutch study report that is available online about the risks: paralytic ileus, urinary tract infection, lymphocele, retrograde ejaculation...

That's tough! I am totally nervous, like a maniac, and scared to death because of the side effects..."

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PS: This diary reflects just my very own opinion. - You might be also interested to read further details in doerings.net general section about testicular cancer.