More details and game plan

Heath had his appointment with his oncologist, Dr. Hui Wang on Friday.  I thought she was pretty nice and is looking out for his well-being as well.  She went over CT results and we discussed the treatment plan and many other topics.  The CT results showed bulky lymphadenopathy ('lymph node disease') involving the cervical, left axillary, mediastinal (sternum region), retrocrural (lower chest closer towards spine), retroperitoneal (abdominal) and proximal left iliac regions.  The pathology report final diagnosis is metastatic seminoma.  What we've learned about seminoma is that this type of cancer involves germ cells that originate from the testicles.  During embryonic development, these certain cells are left throughout the body.  This is why Heath can have this cancer and not have any involvement with the testicles.  However, he will still get an ultrasound of the testicles to make sure there isn't something small that the CT didn't pick up.  Dr. Wang had him do some more bloodwork to check the markers to determine staging.

Game plan:  First thing is for Heath to bank sperm next week.  Dr. Wang was really anxious for that to happen first and foremost.  He will also be getting a heart work-up (called a MUGA) and the ultrasound of the testicles on Tuesday (April 28th).  Once these things are completed, Dr. Wang will go over all the numbers and decide the exact course of treatment.  If he is in the 'good risk' category then he will have chemo with 2 drugs....if it is further along, then he will have to have 3 drugs.  She is hoping that he won't have to have the 3rd drug because this can be damaging to the lungs.  I really need to do more research on this drug and we need to find out if it is totally necessary to have this exact one if he "needs it".  

He is tentatively scheduled to start chemo on May 4th assuming all the other 'tasks' are completed.  He will have 3 days in a row of chemo...then will have 3 weeks until the next cycle....completing 4 cycles.  The drugs he will be receiving are Cisplatin and Etoposide....and hopefully NOT Bleomycin.  Dr. Wang would like him to be an inpatient at the hospital for the first treatment to monitor him and have him on fluids.  Cisplatin can cause kidney problems so he will be closely monitored with frequent kidney value checks.  After the 4 cycle treatment, he will have another CT scan to see how things are going.  If all goes well (and it will) then he will be done....if it is still persisting, then I believe he may get radiation at that time.

This type of cancer is slow-growing and very treatable.  Dr. Wang wasn't in a huge rush to get him started on chemo, but we wanted to get it going and start the inevitable.  Plus, the way the cycles work out we wanted to make sure his treatment was not during the same week as our Sunriver vacation.  

Heath has a friend who used to be in his men's counseling group (Dave) who is a radiation oncologist.  He has been talking to him quite a bit...and Dave will act as a liaison between Dr. Wang and Heath.  We will also keep our natropath on board and if need be we will use the natropath  oncologist at the office...having both natropaths communicate on stuff.

We are all doing well and are just ready to get the ball rolling!