Stage 1 Group 2 Immature Teratoma

[jamieee]

I just turned 22, and underwent surgery a week ago to remove cysts from my ovaries, the two largest being 30cm and 10cm in my left and right ovaries respectively. My ovaries were left intact, but the biopsy report revealed that the 10cm cyst was a mature teratoma but the 30cm cyst was an immature teratoma at Stage 1 Group 2. Apparently, this form of immature teratoma is pretty rare.

My doctors say they removed all visible cancer during the surgery, but are now advising me to undergo chemotherapy to reduce the chances of recurrence. My family is more interested in adopting a wait-and-see approach through close surveillance and frequent blood tests and scans.

Could anyone with experience or medical knowledge advise me on which way I should go? Personally, I'm quite freaked out at the possibility of acquiring fatal infections through chemo than anything else.

Thanks! :)

[jamieee]

Hi guys,

It's me again.

I went to another onco who said I should start on chemo immediately. To be honest, I really don't know if chemo is an overkill for my condition (IA Group 2 immature teratoma), but my loved ones just want me to be healthy and well.

Therefore, I suppose I should be more open to the idea of chemo. Could anyone tell me the short/long term side effects of chemo? Did your eyebrows/eyelashes fall off too? How did you deal with it? Fertility wise, how many of you got pregnant?

Thanks!

[jamieee]

Hi all,

Thanks for your replies. I'm currently residing in Singapore, and have a gyn/onco as my surgeon/specialist. My grading is Group II, which is in the middle of well and poorly differentiated. The only thing stopping me from chemo is the possibility of catching worse infections, and not knowing if chemo is an overkill.  

[kcd86]

So sorry to hear that you are dealing with so much at such a young age! There a varying forms of "Ovarian Germ Cell Tumors" most are benign but a few are malignant, to which some are a aggressive form. The decision to wait before any treatment should be discussed with your GYN/Oncologost. I hope you have a gyn/oncologist as your surgeon. Also I would advise that you go to a large cancer medical center i.e. Sloan Kettering in NYC as they deal with rare forms of gyn cancers much more frquently than most centers. I took my wife to Sloan as she also had a rare form of OVCA. Your gyn/oncologist based on the pathology report will be able to tell you how aggressive this immatre teratoms is.
Immature teratomas are the only ovarian germ cell tumor that are histologically graded. That is based on what they see under the microscope determines how aggressive they may be. The grade of aggressiveness (ranging from I [well differentiated] to III [poorly differentiated]) is based upon the proportion of tissue containing the immature elements . Tumor grade is an important indicator of the risk for spread ouside the ovary. The presence of foci of yolk sac tumor in immature teratomas generally reflects more aggressive tumor behavior.
It is very scary to think of the whole big picture at once especially at such a young age, but the appropriate treatment will mean a currative course and a long life. Yes you can get infections after chemo but you will be told what to look out for to catch it early if you have to have chemo. The wait and see approach is very dangerous especially if you have an agreesive form of this cancer but again get to a large medical center and get their opinions.
I wish you all the best.
Good Luck
Kevin

[biochemgrl]

Hi Jamie,

So sorry to hear that you are dealing with so much at such a young age!  My experience shares a few similarities with yours, however your best recommendations would come from a doctor you may want to consult for a second opinion.

I have stage 1c/2 epithelial ovarian cancer and like you my doctor removed all visible cancer during surgery, but wants to follow up with chemo. My mother also wanted me to refuse chemo based on the notion that there certainly are natural, safer alternatives.

Since I'm quite a healthy living fanatic... exercise, take many supplements, eat very healthy, and never even take over the counter medications, my family was quite surprised I've chosen chemo. After countless hours looking for any credible evidence, I decided that there are just no easy natural cures.

Why not just wait and see? In my particular case, my 17cm tumor had a high probability of shedding cancer cells into the abdominal cavity. As my doctor explained, if I should have a relapse with a metastasized tumor, he will not be able to successfully treat it. I guess there's always a chance I'd be fine without chemo, but it's a gamble I just don't want to take.

I'm not aware that the chance of a fatal infection is a high risk with chemo. Your doctor would monitor your blood count throughout treatment and stop if your numbers get too low.With the carboplatin/taxol I will get, my blood count should drop to its lowest about day 21, I think, and then start to normalize. I plan to work, exercise, etc. all thru chemo.

I wish I had more experience with teratomas to offer you, but if one doctor suggests chemo, it would seem to be worth getting a second doctor's opinion before deciding against it. Wishing you all the best....