Divided By A Common Language

Divided By A Common Language

After being diagnosed with a relapse I went to see the oncologist to talk through my options. The main / standard protocol was to follow three rounds of BEP chemotherapy over nine weeks. This is the protocol discovered / pioneered by the great Dr Lawrence Einhorn and very much at the centre of testicular cancer management for stage 2 and beyond.

I won’t go into the actual treatment at this time, that will be for another post. Rather this time I want to focus on a mild / major panic I had at the start and during my first round.

What was the panic?

The question – was BEP the right protocol and treatment for the type of cancer I had? An important question, and not based out of total ignorance nor completely from Dr Google (you know him?).

The real issue was the type of cancer I was being treated for, in this case embryonal carcinoma (EC for short). If I calmed down a bit, then 1) I would have read a bit more and 2) I would have had more faith in the process and those nice people at The Christie. Yes, I know they do all sorts of cancer treatment, including testicular cancer. But what if they were wrong this time around? What if they were subjecting me to chemotherapy that just wasn’t going to work?

Big panics. And the reasoning for the panic… some words I read on the Internet. Not just a random Dr Google site, but actually a site I could / can trust (have a look at
https://www.cancerresearchuk.org/about-cancer/testicular-cancer/types)

As of 26th April 2019, the above page has the following gem of information on it. The information is correct – but can lead to palpitations (at least in me):

There are 2 main types of testicular cancer:
* seminoma
* non seminoma (some doctors may call these teratomas)

And here’s the kicker…


(Some doctors may call these TERATOMAS)

The problem is that there is a sub category of non seminoma cancer that is called Teratoma. And it is very chemo-resistant!

My panic, having read a lot on the Internet about testicular cancer, I was suddenly confronted with the possibility that I was being provided with the wrong treatment protocol – because I had a teratoma.

Happily I was wrong, and whilst undergoing my first round of treatment I found an article explaining / forewarning of my panic… Because in the UK, as CRUK said, some doctors use the term teratoma as a generic for non seminoma.

Embryonal carinoma is a non seminoma, and so in the UK is sometimes called “teratoma” – but not as in the sub-type. (Phew).

So the take away from this:

  • Ask your oncologist what type of cancer you are being treated for
  • If the oncologist says “teratoma” – ask again, whether it is the non seminoma subtype teratoma, of the “generic” (sic) name. And if the later, ask the first question again – “what type do I have?”

For those interested the sub type teratoma, is more slowly growing than the other types (which is why, I think, it is chemo resistant) and us usually treated through surgery (removal).