Learning about Testicular Cancer
- Sal Gomez was 25 when he was diagnosed with stage two testicular cancer. His first sign of the disease arrived as a pain in his right testicle and lower back, but the medical student thought he likely just had a pulled muscle.
- Now, he wants others to learn about his story to erase the stigma surrounding testicular cancer and urge men to see their doctors when they need to,
- 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. Other signs can include breast growth or soreness, early puberty in boys, low back pain, shortness of breath, chest pain, a cough, belly pain, or headaches or confusion.
- 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.
- Testicular cancer survivors may come across issues with fertility after overcoming the disease, but this is not always the case. Either way, you should discuss possible side effects and fertility preservation options with your doctor before starting treatment.
Gomez, 26, noticed a pain in his right testicle and lower back last year. Being a busy medical student working in a surgical rotation and studying all night, he thought he must have pulled a muscle.Read More
But given Gomez’s busy schedule, he decided to put off his ultrasound since he started to feel better and he didn’t seem to have the standard signs of testicular cancer.
“When you learn about testicular cancer, you learn symptoms like a lump,” he explained. “You really don’t think about cancer being painful. You usually think of a pea-sized lump (on) a testicle that’s not painful but maybe has some kind of enlargement.”
His pain eventually returned, however, so he eventually decided to have the ultrasound.
“Pain really shouldn’t be coming and going,” Gomez said. “I did another exam, and at the time, I didn’t feel a lot there.”
Shockingly enough, the ultrasound did find a mass that “looked particularly cancerous.”
“A couple of days later, I got a CT scan of my abdomen and my (pelvis) that revealed what the back pain was,” Gomez said. “I had these very enlarged lymph nodes in my lower back area, up around where my kidneys are.”
It wasn’t until about a week later that doctors confirmed he had stage 2 testicular cancer after removing his testicle. He was just 25 at the time. From there, he underwent chemotherapy.
“I did nine weeks of chemotherapy after having the primary tumor removed. It was pretty brutal,” Gomez said.
Follow-up scans showed his lymph nodes were somewhat responsive to his chemo, but they were still large enough for Gomez’s doctors to be worried about cancer being there despite earlier scans revealing that his cancer hadn’t spread.
He then had an an eight-hour lymph node dissection to remove them. And though that recovery was “tough,” a later pathology report showed “no viable cancer.”
Now, he wants others to hear his story in order erase the stigma surrounding testicular cancer and educate people about less common signs of the disease.
“I had to tell everybody that I’m going to lose my testicle, and on top of that I think the biggest thing is — and I’m an example of this — men don’t want to go to the doctor,” Gomez said. “If we don’t talk about it, how can we find these really dangerous things?”
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.
“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.
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.
“Testicular cancer commonly occurs from ages 20-45, but it can occur at any age,” Dr. McGregor continued. “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 risk of testicular cancer.”
Fertility after Testicular Cancer
Testicular cancer survivors may come across issues with fertility after overcoming the disease, but this is not always the case. Treatment for this cancer can “affect hormone levels and can also affect your ability to father children after treatment,” according to the American Cancer Society, so you should discuss the possible effects with your doctor before beginning treatment to understand all the options you have at hand.
One route people with the disease can take it to store sperm in a sperm bank before treatment starts. But testicular cancer can result in low sperm counts, so getting a good sample may be tricky. Also, if only one testicle is left after treatment, fertility returns following treatment – typically about two years following chemotherapy.
But it’s important to remember that testicular cancer does not mean fatherhood is out of the question by any means – and some people who’ve overcome testicular cancer might not see any issues at all.
Todd Rosenbluth, for example, became a father after having testicular cancer. But when he and his wife wanted to start a family following his cancer battle, things were difficult despite his cancer not being an issue.
Rosenbluth was diagnosed with testicular cancer in his late 20s after his wife urged him to go to his annual appointment with his doctor. He then had surgery to remove one testicle and overcame the disease, but fertility issues came later despite his doctor telling him the couple’s struggles to have a child were unrelated to his cancer.
“Unrelated to the testicular cancer, my wife and I did have fertility issues,” Rosenbluth previously told SurvivorNet. “We had been trying for four years to have a child. They tell you it’s not related to the fertility issues at all. But in your head, when you’re having all these troubles, and you did lose a testicle, you feel the blame.”
Eventually, though, everything did work out. He and his wife had a beautiful son, Milo, in March 2018. That’s when Rosenbluth finally felt free from his past cancer battle.
“The safest I felt with my testicular cancer was when my son was born,” he said.