What’s the most common type of cancer in young men? Here’s a hint: Lance Armstrong.
At age 25, the famous cyclist was diagnosed with testicular cancer. He was among the approximately 8,000 men, mostly between the ages of 15 and 35, who receive the diagnosis each year. Armstrong ignored warning signs, assuming his youth and physical condition couldn’t possibly allow for cancer. As a result, by the time his cancer was detected, it had spread to his lungs and brain. Aggressive treatment saved his life.
Testicular cancer tends to be virulent and fast-growing, so early detection is especially beneficial, says Dr. Micheal Chehval, director of urologic surgery at Saint Louis University Cancer Center. Yet the cancer’s very virulence makes it a prime target for effective chemotherapy, explaining Armstrong’s cure despite his cancer’s metastasis. “Not all testicular cancers can be cured, but certainly a large majority of them can, especially if caught early,” Chehval says.
In many cases, a testicular lump or mass is detected by the patient or his sexual partner. Other symptoms are either non-existent or extremely vague, making the presence of a lump the chief complaint among those who seek a medical opinion. Chehval is a proponent of monthly self-exams for all males from the mid-teens through mid-30s. Diagnosis is based on blood tests that measure specific tumor markers and ultrasound imaging of the mass.
If cancer is suspected, standard treatment involves the surgical removal of the testicle. Radiation and chemotherapy, if indicated, depend on the specific subtype of cancer and whether metastasis has occurred.
The effectiveness of testicular cancer treatment is “one of the pinnacles of success” in the field of oncology, says Dr. Elliot Abbey, an oncologist at St. Luke’s Hospital. He points to the development of the drug cisplatin, which, when combined with other drugs, creates chemotherapeutic regimens with a 90 percent cure rate.
There is no known way to prevent testicular cancer; however, “there are some known causes that predispose to this cancer,” says Dr. Som Bandi, an oncologist with the St. Louis Cancer and Breast Institute at St. John’s Mercy Medical Center. He lists an undescended testis at birth, family history, cancer in the opposite testis and HIV infection among the known risk factors. “Vasectomy is not a risk factor, contrary to popular belief,” he adds.
Infertility occurs in as many as 25 percent of patients at the time of diagnosis, even before any treatment, Bandi says. “Chemo effects are usually reversible over one to two years, and adequate sperm count would return in half to two-thirds of men over five years. I would recommend sperm banking prior to treatment in every patient who intends to have children in the future.”
Men also need to be aware that a prosthetic testis can be implanted during an outpatient procedure following treatment. However, Chehval notes that this procedure is not usually covered by insurance, unlike reconstruction for breast cancer patients.
Lance Armstrong successfully returned to cycling after his bout with testicular cancer. And with proper diagnosis and treatment, most men can be winners in the fight against this disease.