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Living with cancer· Appointment prep

Appointment sheet: Non-seminomatous germ cell tumour

One page to bring and write on: your details, the questions for Non-seminomatous germ cell tumour plus your own, the words you may hear, what to bring, the treatments the standard of care names, and room for the answers and agreed next steps. What you type stays in this browser. Print it or save it as a PDF. New to all this? Start with the first 60 days. Orientation, not medical advice.

Tick the questions to print

All of this cancer's questions start ticked. Untick what does not apply; ticks are kept in this browser. .

Your own questions

Shared with the prep pack, so questions you add there appear here too.

Print or save as PDF

Use (or Ctrl+P, Cmd+P on a Mac). To keep a copy, choose Save as PDF as the destination in the print dialog. Only the sheet prints; the controls stay on screen. Your typed notes print where you typed them; empty fields print as ruled lines to write on.

Appointment sheet

Non-seminomatous germ cell tumour

Prepared with OnCo (onco.cc/prep/non-seminoma/). Orientation, not medical advice; your team knows your case.

My details

Name
Date of appointment
Hospital and clinician
Who is coming with me

What I know, what is unclear, changes to discuss

Saved in this browser
What I know so far
What is unclear to me
Changes since last time

My questions

18 on the sheet
Newly diagnosed
  1. 1.What is my exact diagnosis, stage, and grade, and which tests established them?
  2. 2.Which biomarkers have been tested on my tumour (for example AFP, hCG and LDH, Lymphovascular invasion, Marker decline during chemotherapy, Chromosome 12p gainon pathology), and what were the results?
  3. 3.Which subtype is my cancer, and does that change the recommended treatment?
  4. 4.Is germline (inherited) genetic testing recommended for me or my family?
Stage I
  1. 5.For my situation (stage i), which of the standard options do you recommend and why?
  2. 6.Am I a candidate for Bleomycin, Etoposide, Cisplatin, and what side effects should I expect?
Metastatic, good risk
  1. 7.For my situation (metastatic, good risk), which of the standard options do you recommend and why?
  2. 8.Am I a candidate for Bleomycin, Etoposide, Cisplatin, and what side effects should I expect?
Metastatic, intermediate and poor risk
  1. 9.For my situation (metastatic, intermediate and poor risk), which of the standard options do you recommend and why?
  2. 10.Am I a candidate for Cisplatin, Etoposide, and what side effects should I expect?
Residual masses after chemotherapy
  1. 11.For my situation (residual masses after chemotherapy), which of the standard options do you recommend and why?
Relapse
  1. 12.For my situation (relapse), which of the standard options do you recommend and why?
  2. 13.Am I a candidate for Cisplatin, and what side effects should I expect?
Any stage
  1. 14.Are there clinical trials I could join, for example of TIGER: standard-dose TIP versus high-dose TI-CE with stem cell transplant as first salvage for relapsed germ cell tumours, Autologous stem cell transplant (high-dose therapy)?
  2. 15.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 16.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 17.I read that “Poor-risk disease still kills about half of those affected”. How does that affect my plan?
  5. 18.I read that “Whether high-dose chemotherapy is better than conventional salvage (TIGER)”. How does that affect my plan?

Tests and results to bring

Biomarker results to ask for: AFP, hCG and LDH (IGCCCG risk grouping), Lymphovascular invasion (stage I relapse risk), Marker decline during chemotherapy, Chromosome 12p gain (i12p) on pathology.

Scans and tests linked to this cancer: Active surveillance, AFP, hCG and LDH in germ cell tumours (IGCCCG risk groups).

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

The treatments I may be offered

  • Stage I: Orchidectomy then surveillance; one cycle of adjuvant BEP for men with lymphovascular invasion who choose it; nerve-sparing retroperitoneal dissection in selected cases. (Bleomycin, Etoposide, Cisplatin, Active surveillance)
  • Metastatic, good risk: Three cycles of BEP (or four of EP if bleomycin is contraindicated). (Bleomycin, Etoposide, Cisplatin)
  • Metastatic, intermediate and poor risk: Four cycles of BEP, or VIP; poor-risk patients with slow marker decline are switched to intensified therapy (GETUG 13); treatment in high-volume centres. (Cisplatin, Etoposide)
  • Residual masses after chemotherapy: Retroperitoneal lymph node dissection and resection of other residual masses when markers have normalised. (Testicular germ cell tumours)
  • Relapse: Conventional (TIP) or high-dose chemotherapy with stem cell support, as compared in the TIGER trial; late relapse treated surgically where possible. (Cisplatin, Autologous stem cell transplant (high-dose therapy))

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.

Answers and next steps

Saved in this browser
What I was told
Agreed next steps, dates and who to call