Background – Monitoring

A few weeks after surgery, in November 2018, I had my first appointment with the Germ Cell Oncology team at the Bristol Haematology and Oncology Centre. They are the specialist unit for testicular cancer in the south-west of the UK.

I was finally given my official diagnosis, based on my CT Scan and the pathology of the tumour that had been removed. My diagnosis was: pT1 stage I combined germ cell tumour (90% classical seminoma, 10% urea ectodermal tumour). My tumour measured 80 mm in length and had grown from the inside of the testicle. The only real testicular tissue that was left was in a thin layer around the tumour. The good news was that my CT scan was clear and no cancer cells had been found in the tissue of any of the surrounding blood vessels.

So it looked like the surgery had done the job. None-the-less, I was to be monitored for the next five years, just to be sure. This would mean monthly visits to the clinic for the first year or so, then progressively less frequent check-ups for the remaining four years.

A monthly check-up would involve a short consultation with either an oncologist or a specialist nurse. I would also have blood taken to check on tumour markers. Chest x-rays and CT scans would be taken every three months.

The tumour markers that are regularly checked for testicular cancer patients are:

AFP: alpha-fetoprotein
HCG: Human Chorionic Gonadotropin
LDH: Lactate Dehydrogenase

For me, HCG had been notably heightened prior to surgery, with a reading of up to around 180 IU/L. The normal range for HCG is from 0-5 IU/L. The other markers remained largely normal for me both prior to surgery and all three have stayed mostly within normal range since. The only exception to this was LDH, which has shown to be above normal at times, but it is well known that a high LDH reading can be triggered by a number of things that are not tumour-related, which means that it is only a reliable marker if it shows consistent readings.

As a side note, I’d made some changes to how I’d been living since my first visit to the GP in September. I’d stopped drinking coffee and alcohol. I’d also started detoxing using the Dr Morse method, something that I’d been meaning to do for a couple of years but hadn’t previously gotten around to. This meant that I was eating a lot of fruit and vegetables, most of it raw, and I was taking a number of herbal supplements to support the body during detoxification. I continued with this until January 2019, at which point I stopped the herbs and broadened my diet a little. I continued to avoid caffeine and alcohol.