Learning About Testicular Cancer
- Rob K., a college student from Delaware, dismissed his back pain as from a gym-related injury, but he was later diagnosed with stage 3C testicular cancer at age 20. Now, 21, and in remission after undergoing chemotherapy, an orchiectomy [testicle removal], and retroperitoneal lymph node dissection (RPLND), he’s hopes his story will inspire others not to ignore symptoms and to stay positive through adversity.
- Symptoms of testicular cancer can be subtle. Some people may even confuse the early symptoms such as a small mass in their testicle as an injury. But when these signs are dismissed, the cancer can grow and become worse.
- Self examinations are incredibly important when it comes to screening for testicular cancer. Men aged 15 to 55 should perform a monthly self-examination to find any changes in the testes that might indicate cancer at an early stage.
- According to the National Cancer Institute, testicular cancer is often diagnosed in men between the ages of 20 to 39 years and it’s a disease that can usually be cured.
Now, 21, and in remission after undergoing chemotherapy, an orchiectomy [testicle removal], and retroperitoneal lymph node dissection (RPLND), Rob is encouraging others to always listen to your body and push for answers when something doesn’t feel right.
Read MoreRELATED: What You Need to Know About Testicular Cancer
He then recounted having a loss of appetite, which he also suspected was due to the pain. However, it wasn’t until he began throwing up “blood and bile” that he underwent blood tests and a CT scan.
When he was diagnosed, he recalled, “One of the doctors had walked in and asked if I had ever noticed anything funky going on with my testicles and I was like ‘I guess so .. probably for a couple of years.”
He said his right testicle had felt “more firm” for about five years, but he didn’t think anything of it.
He then learned his treatment plan would be chemotherapy, surgery to remove one of his testicles, and surgical removal of lymph nodes in his abdominal area.
Rob explained, “My diagnosis was a lot further along. I had stage3C … which is the furthest along stage, so I was not able to get any surgeries or anything first.
“I had to go the chemo route first, so I had opted of four rounds of VIP chemo five days in, and then 21 days at home, and then I’d go back in to get chemo for five days and then off.”
He noted how he didn’t enjoy having PICC line, an IV, put in throughout the time he underwent chemotherapy and the treatment led him to lose hair and feel sick.
“I did lose my hair and I think that was one of the more challenging things for me … I just wanted to stay in my house, I didn’t want anyone to see me,” Rob added. “That was definitely a huge mental battle for me.”
However, despite losing a testicle during his cancer fight, he did opt to get a prosthetic testicle to help him cope with the loss.
Looking back on his struggle with his identity and “feeling like a man” after surgery, Rob offered some positive insight into his cancer journey, explaining, “The chemo that I had … and the surgery, I don’t feel the same like I used to. It can be hard but you just have to give everything time.
“The body is resilient. You just have to give it time and it will heal, which I’ve been grateful to see my body get back to normal in every aspect.”
For anyone dealing with a cancer diagnosis, Rob advises others, “Try to never get ahead of yourself because it’s never a good thing. There’s so many things to worry about and think about, like endless things, so if you keep going down that path it’s never going to go in your favor, you’re just going to keep thinking negatively.
“It’s also a really good time to realize how many people you have around you. If you’ve ever felt lonely before it’s a really good time to realize how any people really do love and care about you. And realizing and being appreciative of how many people feel that way about you and wanting you to thrive and do better.”
Understanding Testicular Cancer
A testicular cancer diagnosis is rare, but it is the most common form of cancer diagnosed in young men. Depending on the stage, the disease is considered extremely treatable. Treatment options can include chemotherapy and radiation, but often the first line of treatment is surgery to remove the testicle which contains the cancerous cells.
Symptoms of testicular cancer can be subtle. Some people may even confuse the early symptoms such as a small mass in their testicle as an injury. But when these signs are dismissed, the cancer can grow and become worse.
Expert Resources On Testicular Cancer
- April Is Testicular Cancer Awareness Month; Here’s What You Should Know About The Rare Disease
- Black Eyed Peas Rapper Taboo Says He Felt ‘Embarrassed’ After Testicular Cancer Diagnosis, Highlights Disparities in Health Care for Native Communities
- Dealing With the Shame That May Come With Testicular Cancer
- Smoking Marijuana May Increase Testicular Cancer Risk: Study
- 5 Important Facts About Testicular Cancer, Including How to Screen for the Disease
“It’s not uncommon to see men come in with masses on their scrotum and have inflammation of the scrotal wall; they develop pain as a result. A lump is the most common symptom of testicular cancer,” Dr. Edwin Posadas, the medical director of the Urologic Oncology Program at Cedars-Sinai Cancer, previously told SurvivorNet.
Dealing With the Shame That May Come With Testicular Cancer
Dr. Posadas says some men may even notice blood in their ejaculate as a result of testicular cancer. “This symptom is less common, but always bad,” he said.
Other symptoms can include:
- Breast growth or soreness
- Early puberty in boys
- Low back pain (a potential symptom of advanced testicular cancer)
- Shortness of breath, chest pain, or a cough (a potential symptom of advanced testicular cancer)
- Belly pain (a potential symptom of advanced testicular cancer)
- Headaches or confusion (a potential symptom of advanced testicular cancer)
Dr. Posadas urges young men to seek medical care if they are having symptoms. “Most men under the age of 40 tend not to think about seeing a doctor they need to know to advocate for themselves,” he said.
Screening for Testicular Cancer
Testicular self-examination is one way to screen for this disease, Dr. Posadas says.
“It takes less than a minute,” Dr. Posadas previously told SurvivorNet. “Rub testicles through your fingers looking for any sore areas. Rub the top of the testicle, particularly the delicate epididymis. (The epididymis is a tube at the back of the testicles which stores and carries sperm.)
“Don’t squeeze real hard on there. [You should] look for a smoother feel; if you feel a hard nodule on there, you may require blood work from a urologist. [Testicular cancer] is highly curable, even when it’s advanced.”
In a previous interview with SurvivorNet, Dr. Bradley McGregor, clinical director of the Lank Center for Genitourinary Oncology at the Dana-Farber Cancer Institute, also emphasized the importance of self-examinations.
“It is recommended that men aged 15 to 55 perform a monthly self-examination to find any changes to help find the cancer at an early stage,” Dr. McGregor said. And if someone spots any of the early symptoms, “he should visit his doctor immediately.” It’s important to be aware of your body and get in touch with a doctor if you notice anything unusual.
Dr. McGregor continued, “Testicular cancer commonly occurs from ages 20-45, but it can occur at any age. The highest risk factor for testicular cancer is a history of cryptorchidism, an undescended testicle, where the testicle does not move down into the scrotum before birth.
“Men with a family history of testicular cancer are at increased risk as well. No lifestyle changes have been shown to definitively reduce the risk of testicular cancer.”
What Life May Look Like After Treatment
If patients have not experienced too many complications from their chemotherapy, “they are often able to go back to many of the same things that they did before they had their diagnosis of cancer and are able to live full and complete lives,” Dr. Michael Jain, medical oncologist at Moffitt Cancer Center, told SurvivorNet in an earlier interview.
If the cancer does return at some point, any future treatment you get will depend on:
- The type of cancer you had
- The type of treatment you received for it
- How long it has been since you finished your treatment
- Your overall health
Making a Survivorship Care Plan
So what comes after successful treatment? “At that point we often focus on the survivorship issues that they may have, preventing second cancers, and properly following them,” Dr. Jain explains.
A survivorship plan will include a schedule for follow-up exams and tests, plus a schedule for tests to check for any long-term health impacts from your cancer or treatment, and screening for any new cancers.
Your doctor will likely tell you what to look out for in terms of side effects that could show up late or over the long term. Your care team will provide you with diet and physical activity recommendations as part of your survivorship plan.
Moving On From Treatment
It’s natural to feel continuing mental health effects, such as depression and anxiety, even after your treatment ends. This is where you can benefit from a supportive community. Look to strengthen your relationships with friends and family, faith groups, support groups, and mental health professionals to buoy you as you move on from treatment.
In addition to caring for their mental health, people who finish treatment and are in complete remission will want to move on from cancer with a physically healthy lifestyle. Eating nutritious foods, exercising regularly, staying at a healthy weight, and not smoking are all lifestyle practices that generally contribute to a healthy quality of life.
Indeed, cancer and its treatment might naturally point survivors in the direction of such practices. “Mostly [we’re] trying to maximize the quality of life that people have, because once you have a cancer diagnosis, I think it is an important time in someone’s life where they can take stock and really understand what’s important,” Dr. Jain adds.
Cancer’s Impact on Male Fertility
Cancer treatments like chemotherapy can damage sperm in men, and hormone therapy can decrease sperm production, according to the National Cancer Institute. Radiation treatment can also lead to lower sperm count and testosterone levels, impacting fertility.
These possible side effects of cancer treatment should be discussed with your doctor before starting treatment. Men may have the option to store their sperm in a sperm bank before treatment to preserve their fertility.
This sperm can then be used later as part of in vitro fertilization (IVF), a procedure in which a woman’s egg is fertilized with sperm in a lab. The embryo is then transferred to a woman’s uterus to develop.
WATCH: Dr. Terri Woodard explains fertility preservation options patients have when going through cancer treatment.
Fertility struggles are also a genuine concern among cancer patients, as certain cancer treatments can cause infertility. Fortunately, in many cases, efforts can be made before beginning treatment to help preserve fertility.
Many couples, at one point or another, experience infertility. The Centers for Disease Control and Prevention (CDC) says within the U.S., “about one in five” married women between the ages of 15 to 49 with no prior births are unable to get pregnant after trying for a year. Additionally, “one in four” of women in this group struggle to get pregnant or carry the pregnancy to term.
Infertility may affect many cancer patients undergoing treatment due to cancer treatment’s impacts on the body. Various cancer treatments, including chemotherapy and radiation, can affect both men’s and women’s fertility. Before undergoing cancer treatment, patients should speak to their doctors about fertility preservation if they wish to have a family in the future.
The American Psychological Association said in its Monitor on Psychology Magazine, “A diagnosis of infertility–the inability to get pregnant after a year or more of trying–can lead to depression, anxiety, and other psychological problems, trigger feelings of shame and failure to live up to traditional gender expectations and strain relationships, say psychologists specializing in infertility.”
Among men, infertility can “cut into a man’s feelings of masculinity” and “can lead to issues of shame and embarrassment.” psychologist William D. Petok said.
Contributing: SurvivorNet Staff
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