Testicular Cancer Treatments and Survival

According to recent estimates, approximately 9,000 new cases of testicular cancer were diagnosed in United States in the year 2014 (1). Despite brilliant advancements in the field of science and technology, the testicular malignancy claimed approximately 400 lives.Fortunately, testicular cancer is not very common in the general population. Based on latest estimates, the lifetime risk of developing testicular cancer in an average male is 1 in 270 (1).

Treatment Options for Testicular Cancer

There are a number of treatment options that may help in prolonging the survival in testicular cancer patients. According to the research conducted by Richardson and colleagues (2), with proper and timely treatment, more than 95% patients have a survival rate of more than 10 years.

Surgery:

Surgical resection of the tumor mass is often the first choice in majority of the cases. There are a variety of surgical procedures, depending upon the size, histological variety and other parameters of the tumor mass; such as:

• Surgical Removal of Testes or Radical Inguinal Orchiectomy: It is the most common procedure that is performed for all the histological varieties of testicular cancer. The procedure is an excellent choice in early as well as advanced malignancies. In radical inguinal orchiectomy, a scalpel is used to introduce an incision in the groin region for the excision of diseased or malignant testicular tissue (with surrounding normal tissue). In complete excision or removal of the diseased testicle, artificial implant can also be inserted (depending upon the patient’s desire).
• Surgical Removal of Adjacent Lymph Nodes or Retroperitoneal Lymph Node Dissection: This procedure is recommended in 21% of all the cases to minimize the risk of recurrence (3). In this procedure, an abdominal cut is made to safely extract the lymph node from the overlapping nerves. But sometimes, it becomes inevitable to preserve the nerve function while excising the nodes. In all such cases, ejaculation disorder is a common adverse post-procedure side effect. Erectile function of the penis is usually preserved in most of the cases (3).

If a cancer is diagnosed at a very early stage, surgical procedure remains the mainstay of treatment.Patients are advised secondary treatments (such as chemotherapy or radiotherapy) depending upon the extent or severity of the lesion. Most patients are required to see a primary care physician for follow-up visits to ensure cancer-free survival.These follow-up visits are scheduled once in two months for the first few years and then the number of visits is gradually decreased. A series of tests like blood samples, CT scan and other tests are also advised periodically to ensure cancer-free existence.

Radiation Therapy:

Radiotherapy is usually advised to patients who are diagnosed with early-staged seminomas (a histological variety of testicular cancer). Radiation therapy is recommended after the surgical reception of primary tumor mass. The radiation treatment kill cancer cells by exposing the malignant cells to high energy rays like x-rays on localized points of the body.Depending upon the age, overall health status and dose of radiotherapy, a number of adverse effects are reported by patients; such as easy tiredness, irritation and soreness over the abdomen and groin. These rays are spermicidal and can cause sterility therefore, it is advised to explore and discuss alternative options of sperm preservation prior to the treatment, with your physician.

Chemotherapy:

In advanced cases of testicular cancer, the malignant cells breaks away from the tumor ass and metastasize to distant sites via blood vessels and lymphatics. These cells are targeted by chemotherapeutic drugs circulating in the blood. Like radiotherapy, this treatment modality is also used to kill cancer cells after primary resection of tumor mass.Chemotherapy is also associated with varying degrees of adverse effects such as hair loss, nausea, gastrointestinal discomfort, weight loss and fatigue; however these symptoms can be controlled with drugs. Chemotherapy is also spermicidal and thus methods of sperm preservation should be discussed with the primary doctor before treatment begins.

Coping and Support:

Testicular cancer (like any other malignancy) can severely affect the emotional aspects of the individual’s life. Young males fear for their physical health and are also skeptical about the sexual and reproductive aspects of their life.Here are a few steps that you should take to strengthen your emotions:Educate Yourself About Your Condition and Disease: It is very important to learn about the malignancy you are suffering from. Although there are a number of credible sources on the internet, it is always a better idea to rely on the information (and sources) shared by your primary care provider.Look After Yourself: Consume a healthy and balanced diet with plenty of vegetables and fruits. Give your body adequate rest and free your mind from unwanted and unnecessary stress. Try to work out daily and ask for professional help if you are unable to quit smoking.Join a Support Group: Talking to other cancer survivors is helpful in keeping yourself motivated and focused. Check online for support groups in your locality (5).Stay in Touch With Family & Friends: Accept whatever help your friends or family has to offer. They are concerned about you and your disease. Confide in them whenever you need someone to talk to or when you’re feeling depressed.References:

1. http://www.cancer.org/cancer/testicularcancer/detailedguide/testicular-cancer-key-statistics
2. Richardson, L. C., Neri, A. J., Tai, E., & Glenn, J. D. (2012, February). Testicular cancer: a narrative review of the role of socioeconomic position from risk to survivorship. In Urologic Oncology: Seminars and Original Investigations (Vol. 30, No. 1, pp. 95-101). Elsevier.
3. Siegel, R., DeSantis, C., Virgo, K., Stein, K., Mariotto, A., Smith, T., ... & Ward, E. (2012). Cancer treatment and survivorship statistics, 2012. CA: a cancer journal for clinicians, 62(4), 220-241.
4. Tandstad, T., Smaaland, R., Solberg, A., Bremnes, R. M., Langberg, C. W., Laurell, A., ... & Cohn-Cedermark, G. (2011). Management of seminomatous testicular cancer: a binational prospective population-based study from the Swedish norwegian testicular cancer study group. Journal of clinical oncology, 29(6), 719-725.
5. Bender, J. L., Wiljer, D., To, M. J., Bedard, P. L., Chung, P., Jewett, M. A., ... & Gospodarowicz, M. (2012). Testicular cancer survivors' supportive care needs and use of online support: a cross-sectional survey. Supportive Care in Cancer, 20(11), 2737-2746.