Testicular cancer is a cancer that starts in the testicles (testes), the organs that produce male sex hormones and sperm. Compared to other cancers, testicular cancer is rare; however, it is the most common cancer in American males between the ages of 15 and 35. Fortunately, it is highly treatable and the outcome for most men diagnosed with testicular cancer is favorable with fewer than 400 dying each year from the disease.
In the below Q&A, Dr. Adnan Danish, Summit Medical Group Radiation Oncologist and testicular cancer survivor shares some very important information based on clinical expertise and first-hand experience with the disease. Dr. Danish has had the unique experience of being both a patient and caregiver in the field of oncology. As a high school senior, both he and his father were diagnosed with cancer and received their treatments together. During that time, he witnessed the true workings of modern medicine and realized the critical role a caregiver plays in not only providing treatment, but compassion and empathy as well. This experience, along with his avid interest in the sciences, inspired him to pursue a degree in molecular biology and biochemistry, psychology, and ultimately led him to his medical studies.
Q&A with Adnan Danish, MD
What are the symptoms of testicular cancer?
Signs and symptoms may include a painless lump or swelling in the scrotum, hardness, pain or discomfort in the testicle, and a dull ache in the lower abdomen, back or groin area.
How is testicular cancer diagnosed?
Sometimes testicular cancer is found by the patient during a self-exam. It can also be found by a doctor during a routine physical or by a urologist who you are seeing for symptom relief. For me, testicular cancer was found after I sought medical care for a groin injury which I acquired while working out during my senior year of high school. My school nurse recommended a urologist and ultimately, a surgeon.
How is testicular cancer treated by type and stage?
If caught in the early stages, testicular cancer is generally treated with surgery. Depending on the pathologic type (seminoma vs. non-seminoma), surgery is followed by chemotherapy or radiation therapy. If the cancer is caught early enough, surgery may be all that is needed. I was diagnosed with a non-seminoma tumor, a type that typically grows and spreads quickly. I had to undergo additional surgery to remove lymph nodes. A couple months after my initial surgeries, my surveillance scan unfortunately revealed lung nodules and I had to undergo four rounds of chemotherapy.
Luckily, with the various treatment options available testicular cancer is one of the most curable types of cancers.
Who treats testicular cancer?
Testicular cancer is treated by urologists, medical oncologists, and radiation oncologists depending on the type and stage.
Are there side effects of treatment or surgery?
Side effects vary depending on the treatment.
Side effects depend on the dose but include fatigue, nausea, diarrhea, loss of appetite, and skin changes at the radiation site. It also can interfere with sperm production and may affect fertility.
Side effects are dependent on the drugs and dose, but common side effects include nausea, hair loss, fatigue, diarrhea, vomiting, chills, fever, coughing, shortness of breath, mouth sores or skin rash. Other side effects are dizziness, numbness, loss of reflexes and difficulty hearing. Men who receive very high doses of chemotherapy may experience destruction of bone marrow and require a bone marrow transplant. Some cancer drugs reduce sperm count. Most patients recover their fertility, but it can be permanent for some patients. This should be discussed with a doctor. For me, chemotherapy was tough. I lost hair, lost weight, and experienced extreme fatigue—all during my first semester at college.
Sometimes, the cancer can be removed through small incisions in the abdomen. However, depending on the type and stage, a radical inguinal orchiectomy—removal of the tumor through an opening made just above the pubic area—may be necessary. Short-term risks would include anesthesia reactions, excess bleeding and clots, or infection. Losing a testicle will not affect sexual activity or chances of reproduction, but if both testicles are removed, sex drive decreases and a man becomes infertile.
“Although testicular cancer can affect fertility outcomes, many survivors, myself included, are able to maintain fertility. I had to have a minor surgery performed by a fertility specialist, but now I have three happy and healthy boys. Information is key, and you should always talk to your doctor about all possible options and outcomes, but I am proof that it can be possible to father a child after overcoming this disease.”
Can testicular cancer come back after treatment?
Over 95% of men treated with testicular cancer are cancer-free at 5 years. I was lucky. My post therapy scans were clear, and my cancer did not return. However, for some people, the cancer may come back. Therefore, surveillance is critical. Depending upon how it presents the second time, treatment such as chemotherapy or localized radiation may be prescribed. It’s possible that surgery would be needed.
Summit Medical Group Care
At Summit Medical Group, we use a multidisciplinary approach to care that is individualized to each patient’s stage of cancer. We offer a variety of treatment options including standard and minimally invasive surgery, as well as chemotherapy and radiation therapy. “As a testicular cancer survivor, I fully understand the impact that cancer can have on not just the individual, but the entire family. It’s a very difficult time for everyone involved, but I am living proof that there is hope. My main advice for males of all ages would be to not dismiss any pain, lumps, or changes in the testicles and seek immediate professional care if you have any concerns. I’m forever grateful for the care I received and proud to be able to use my experience to help others,” says Dr. Danish.