Testicular cancer treatable

The lump in John Doe’s right testicle wouldn’t go
away. He didn’t tell his parents or doctors. He
couldn’t tell anybody because it was so embarrassing; he was
so ashamed of it. For two years, John let the lump grow and still
didn’t have the courage to tell anyone. He was only 16
and thought, “˜how can a young guy like me who plays sports,
eats healthy, and goes to church get cancer?’ One night John
started spitting out blood. He started to get tired. He
lost his appetite. His testicle started to get big and heavy.
Rarely would he change in front of the guys in gym class. John told
his parents about the problem of spitting up blood but not about
his testicle. John’s father brought him to the hospital for
X-rays. He was diagnosed with a lung disease, but the doctors
were having a hard time determining where the lung disease came
from. After three days, John gave in and finally told them that
there was something wrong with his testicle. John Doe died in
December of 1996 from testicular cancer. Many young men are
reluctant to talk about testicular cancer due to embarrassment,
which can lead to denial of even having the disease. Because of
this embarrassment, treatment is often not received when it is
needed. This is unfortunate because the cure rate for testicular
cancer is high, with a five-year overall survival rate of 92
percent. While testicular cancer is rare ““ only one percent
of all cancers seen in men ““ compared to prostate cancer,
over the past 50 years, the number of cases for testicular cancer
has doubled. In the United States today, testicular cancer is the
most common cancer of young men 15 to 34 years of age. With
knowledge of testicular cancer and the motivation to perform
regular testicular examinations, men can literally save their own
lives with early detection. The exact cause of the cancer is
unknown. Abnormal growth of cells in the testicle eventually
causes the testicle to enlarge. A patient with a history of an
undescended testicle, whether or not the condition was surgically
corrected, has an increased chance of developing cancer. Other
risks have been linked to previous cancer in the other testicle, a
history of mumps that affected the testicles, inguinal hernia and
high socioeconomic status. Fortunately, most lumps or testicular
pains are due to causes other than cancer. Because testicular
cancer can spread throughout the body, early detection by a
testicular self examination is paramount. Men know their own bodies
better than anyone and are most likely to detect changes that might
be the source of cancer. To evaluate testicular cancer, a doctor
will first perform a physical exam of the suspicious area and
usually order an ultrasound test. During a testicular ultrasound,
gel is applied to the area and an instrument is passed over the
scrotum. An image is produced using high frequency sound
waves. This test is short and painless. Other possible tests
include a chest X-ray, CT scan and/or MRI (all painless
techniques). Blood tests may also be helpful in making a diagnosis
because testicular cancer causes the level of certain proteins in
the blood to increase. One possible treatment for testicular cancer
is removal of the affected testicle. Removing only the cancerous
portion of the testicle is out of the question because doing so may
allow the cancer to spread elsewhere. It is rare for both testicles
to be affected, which means the remaining testicle can supply the
body with enough hormones and produce sperm. If the cancer has
spread, it can often be treated with further surgery, radiation
therapy and anti-cancer drugs. Even when it does not appear that
cancer has spread, doctors may recommend short courses of these
therapies in order to make sure the cancer is completely gone.
These drugs carry a risk of infertility, but many men continue to
be fertile after treatment. Men who have had testicular cancer have
an increased likelihood of developing cancer in the remaining
testicle. They also have an increased risk of certain types of
leukemia as well as developing other types of cancers. Regular
follow-up care ensures that any changes in health are discussed and
any recurrent cancer can be treated as soon as possible.

Baback Gabbay is a third-year medical student at the UCLA
David Geffen School of Medicine and a writer for The Diagnosis, an
organization comprised of UCLA medical students. The Diagnosis was
started by second-year medical student Ronney Shantouf. Send
questions, comments and topics you’d like addressed to
[email protected]. “Your Health” will publish every
even week during Winter quarter.