From the first moment my wife discovered
she had breast cancer, there was a deafening silence from the men I know. Even
ones whose wives, mothers or girlfriends had breast cancer seemed to have
received a gag order from some Central Cancer Command and did little more than
mumble about the experience. Not one to shut up for any known reason, I started
this blog…(Sorry this is late today, but my new granddaughter was born on
Thursday and we just moved the newly expanded family home this afternoon!)
My old friend who
had a radical orchiectomy (http://breastcancerreaper.blogspot.com/2011/12/man-cancer-and-orchiectomy.html)
faces a second operation next week. The procedure is a real mouthful so to
speak because it doesn’t have a “common name”. He will be undergoing a
retroperitoneal lymph node dissection or an RPLND – which really doesn’t do
anything to make it easier to remember, because the letters might make up the
word “ResPLeNDent”, but that’s not helpful and I doubt very much that it’s
particularly descriptive of how my old friend will feel AFTER the procedure.
Not even
Wikipedia has a simple explanation, so as I am wont to do, let’s see about
translating the doctors:
Retro (= behind) peritoneal (= a sack that lines the area below the lungs
and above the bladder that holds the kidneys, liver, parts of the large and
small colon, most of the pancreas and the stomach) is surgery that tries to get
at and remove abdominal
lymph nodes.
The nodes are
outside of the sack that holds all the abdominal organs and lie against the
INSIDE part of the spine. Lymph nodes are usually found at “bending points”
like knees, ankles, arms, elbows, etc. Humans bend at the waist as well and a
node in the abdomen pumps lymph through the body just as the others do. But it
is close to the testicles and the nodes are the first to be attacked by cancer
cells if they metastasize from there. Testicular cancer spreads in a well-known
pattern, and these nodes are a primary landing site during spread of
the disease.
Doctors need to remove the nodes in order to
treat testicular cancer, as well as help establish its exact stage and
type. This has been done in the past by surgery so invasive that it required cutting
a man open from the bottom of the sternum (middle of the rib cage) to below the
belly button! There are dangers in this as well that I prefer not to go into.
But several
doctors do the same surgery laparoscopically and while some surgeons consider
it “less effective” others, it is less painful, runs fewer risks and joins the
ranks of laparoscopic surgeries for repairing knees, shoulders, hernias and
prostrates. It’s more expensive and detractors point out that not “all hospitals”
have the capability of doing this, but it is far less incapacitating than the
invasive older surgery.
Once the nodes
are removed, an oncologist can examine the tissue to determine the extent of
spread of the cancer. If no malignant tissue is found, the cancer may be more
accurately considered as a stage I cancer, limited to the testicle and the
orchiectomy may either be considered the “final solution” or they can follow it
with chemotherapy or possibly radiation therapy. The low mortality and relapse
rate with this procedure, as compared with the alternative, which is
observation is the main reason my old friend has considered this as an
alternative to the invasive surgery.
If you have
testicular cancer – and any of us with testicles are susceptible. Warning signs
are NOT LIMITED TO but may include: a
lump or mass in either testicle, any enlargement or swelling of a testicle, a collection of fluid in the scrotum, a dull ache in the lower abdomen, back, or in
the groin, a feeling of
heaviness in the scrotum, discomfort or pain in a testicle or in the scrotum,
enlargement or tenderness of the
breasts. If you’re worried, go to your doctor! If you’re wondering, try the
link below.
