Pediatric Hematology/Oncology

Genitourinary Cancers

Questions discussed in this category

How do you manage patients blood pressures while on anti-angiogenic TKIs?

Do you insist on ambulatory/home blood pressures to rule in/out white coat hypertension? Does your practice have a system to log patients' BPs to supp...

1 Answer available

What factors do you use when selecting which NGS platform to use for sequencing solid tumors?

For instance, do you factor availability of RNAseq, inclusion of normal blood controls, and QNS rates into your decision?

1 Answer available

How would you treat a stage IIIB recurrent seminoma with early recurrence following first-line treatment with VIP?

2 Answers available

Would you consider a cycle of EP in a patient with good risk stage IIIB seminoma on BEP but with bleomycin omitted for cycle 3?

Bleomycin omitted due to asymptomatic decline in DLCO

1 Answer available

What are best practices for oncologists during the national platinum shortage?

Please specify how your institution is allocating resources now or will be soon.

13 Answers available

How do you decide between RPLND vs. chemotherapy in patients with Stage IIA mixed germ cell tumor as primary treatment?

3 Answers available

What chemotherapy regimen would you use for a testicular cancer patient in need of BEPx3 but unable to use platinum based chemotherapy regimen due to cochlear implants?

2 Answers available

Which chemo regimen, if any, would you use as adjuvant treatment in a young patient with primary malignant thyroid teratoma?

Would surgical margins, evidence of angiolymphatic spread, number of lymph nodes removed during surgery inform your decision?

1 Answer available

When do you refer patients for germline testing when somatic tumor testing is negative for actionable mutations?

How reliable is somatic testing to detect an underlying germline predisposition?

2 Answers available

In a patient with stage 1 mixed germ cell tumor who cleared tumor markers post-orchiectomy but with subsequent rise to borderline abnormal within 6 weeks, would you treat with 3 cycles BEP as for S1 disease?

If serum markers were normal, how strongly do you consider 1 cycle of BEP for embryonal predominant pathology?

1 Answer available

For a young male with Stage III intermediate risk NSGCT with active 1 ppd smoking history but normal PFTs and DLCO results, would you still consider use of BEP x 4?

VIP can be considered, but given complex psychosocial issues and limited community cancer treatment resources, this question is being asked.

2 Answers available

Do you treat stage 1 non-seminoma differently if there is a component of embryonal carcinoma?

1 Answer available

Do you routinely check Pulmonary function testing prior to each cycle of BEP for young patients with testicular cancer with no pulmonary risk factors?

NCCN guidelines state check at baseline and then as clinically indicated. Some other sources state, can check prior to each cycle of BEP? What ...

2 Answers available

How do you approach therapy for a patient with stage IIIA NSGCT who received 4 cycles of EP followed by RPLND which revealed residual mixed teratoma and embryonal carcinoma?

Given persistent embryonal histology on RPLND, do you favor observation or TIP/VIP? What do you use to guide your decision?

1 Answer available

Would you change chemotherapy to VIP in a young patient with stage IIIB intermediate risk non-seminomatous germ cell tumor with borderline DLCO after one cycle of BEP?

2 Answers available

How would you manage asymptomatic brain metastases from testicular non-seminomatous germ cell tumor with a choriocarcinomatous component?

2 Answers available

Should special precautions be taken patients with Ehlers-Danlos syndrome receiving radiation therapy?

Would you have reservations in treating patients with breast, GI, or pelvic malignancies with radiation alone or concurrent chemoradiation?

2 Answers available

How do you manage a young patient with mediastinal nonseminomatous germ cell tumor that has relapsed after primary treatment with four cycles of VIP?

1 Answer available

What is your approach to unresectable metastatic rhabdomyosarcoma transformed from an embryonal cell germ cell tumor?

Should treatment be based on current histology (rhabdomyosarcoma) or origin (germ cell)?

1 Answer available

How do you treat a patient with a history of clinical stage IIb cN2, mixed germ cell embryonal carcinoma treated with BEP and RPLND five years ago, who now has signet ring cell adenocarcinoma with abdominal carcinomatosis with an unknown primary?

GI work up negative. NGS cancer type and isochromosome 12p ordered and pending. Pathology at RPLND was negative for cancer.

3 Answers available

In what situations do you utilize G-CSF in germ cell tumors or Hodgkin lymphoma patients receiving bleomycin?

There are conflicting reports of increased incidence of bleomycin-induced lung toxicity with G-CSF.

2 Answers available

Is there any consensus or guidance on how to manage germ cell tumor patients in the COVID-19 era?

1 Answer available

Do you routinely use tumor lysis prophylaxis when starting chemotherapy for germ cell tumors?

How do you assess risk of tumor lysis syndrome, and is hydration sufficient or should hypouricemic agents be used as well?

2 Answers available

Is it unusual to have isolated LDH elevation and normal HCG and AFP in non-seminomatous germ cell tumor (embryonal carcinoma)?

In a patient s/p orchiectomy and with pelvic lymphadenopathy, would you consider lymph node biopsy to confirm involvement by non-seminomatous germ cel...

2 Answers available

How do you manage a patient with a history of non-seminomatous germ cell tumor who has a rising AFP after primary chemotherapy without any imaging evidence of recurrence?

Given the non-specific nature of AFP and its elevation in various benign conditions, is there an AFP cutoff level or change over time for which you wo...

1 Answer available

For high risk, stage I, non-seminomatous testicular germ cell tumors, are there particular circumstances under which RPLND is clearly preferred over chemotherapy or surveillance?

Is any amount of teratoma or PNET an indication for surgery?

1 Answer available