Testicular Cancer Presentation at WHRHS Alex Hohmann February 21-22, 2012.

Testicular CancerTesticular CancerPresentation at WHRHSAlex HohmannFebruary 21-22, 2012

Alex’s testicular cancerAlex’s testicular cancerFirst in 1996 (age 30): surgery & radiotherapySecond in 2008: surgery and surveillance

Alex’s post-diagnosis Alex’s post-diagnosis goalsgoalsHealthy lifestyle and surviving cancer wellAdvocacy, fund raising and education

2009 LIVESTRONG 5K 2010 LIVESTRONG 45-mile ride

2011 LIVESTRONG 5K

Basic facts about TCBasic facts about TCTesticular cancer includes different cancer

cell types (seminoma vs non-seminoma) that typically appear first in the testes

TC does not have any clearly identified causes

Men with TC were most likely born predisposed to it

TC rates seem to be higher in men born with an undescended testicle and are highest among Caucasian men

TC by the numbers*TC by the numbers*8300 men diagnosed with TC in US in 2011Most common cancer in men ages 15 to 40Overall 5-year survival rate of 95%Localized (confined to testes) survival of

99%Almost 400 men die each year as from TCEarly detection is critical to survivalIf TC is caught early and treated correctly,

survivors live full and healthy lives

* All figures from the Sean Kimerling Testicular Cancer Foundation, National Cancer Institute, and American Cancer Society

Structure of the testesStructure of the testes

http://nurse-practitioners-and-physician-assistants.advanceweb.com

Early detection of TCEarly detection of TCExamine testicles at least once a monthLook for presence of a pea-sized mass

attached to testes or for scrotal enlargement

Other symptoms may include feeling of heaviness in scrotum, severe and worsening back ache, breast tenderness

See a urologist at the first sign of any of these symptoms. Do not delay.

Diagnosis of TCDiagnosis of TCUrologist will examine testicle and, if

indicated, order a scrotal ultrasound to be done right away

The ultrasound is quick and painlessUltrasound images are examined by a

radiologist who will report back to the urologist if there are signs of a tumor

Urologist will draw blood and order a CT scan to be done right away

Treatment of TC: first Treatment of TC: first stepsstepsEntire testicle must be removed in a

short procedure called an inguinal orchiectomy, usually down outpatient

Biopsy of the testicle, as well as CT scan and blood tests determine type (seminoma vs non-seminoma) and staging (1, 2, 3)

Post-orchiectomy treatment and follow-up vary according to type and stage and are done under the care of an oncologist

Treatment of TC: next Treatment of TC: next stepsstepsDepending on cell type, stage 1 TC may

require only follow-up testingNon-seminoma may require further

surgery (RPLND) for biopsy or treatmentSome patients elect adjuvant radio- or

chemotherapy to reduce relapse riskRelapse (cancer shows up again, often in

lymph nodes) must be treated immediately with chemo- or radiotherapy

Effects of TC and Effects of TC and treatmenttreatmentLoss of one testicle does not usually impair

testosterone and sperm productionRadio- or chemotherapy can impair sperm

production so some men bank spermA second TC is very rare, resulting in loss of

fertility and need for hormone replacementProperly treated and followed up by a

doctor, majority of TC survivors have normal sexual performance and live a fully and healthy life

Alex’s treatmentAlex’s treatmentFirst TC (‘96) stage 1 seminoma:

surgery, radiotherapy, 5 years of surveillance

Second TC (‘08) also stage 1 seminoma:surgery, prostheses installed, up to 20 years of surveillance, lifetime testosteronereplacement

Bilateral TC (2x) isextremely rare

Healthier than ever Memorial Sloan-Kettering Cancer Center, New York

Alex’s lessons from cancerAlex’s lessons from cancerThere was no way of avoiding TCThere are others facing the same thingKeep a sense of humor

Alex’s lessons from cancerAlex’s lessons from cancerDon’t take health for grantedBe grateful for life by giving back to

othersDon’t be shy about speaking up

Points to rememberPoints to rememberKnow your bodyLive a healthy lifestyleGet a complete physical regularlySee a doctor ASAP at any sign of troubleHave someone (e.g. loved ones) with youAsk questions and take good notesReach out for supportDon’t be shy about discussing health

issuesAbove all, don’t die of embarrassment!

Other disorders of the Other disorders of the testestestesVaricocele: swelling of testicular blood

vesselsHydrocele: accumulation of fluid in scrotumEpididymitis: inflammation of the epididymisOrchitis: inflammation of the testiclesPrimary hypogonadism: low testosterone

due to failure of testes to produce itCryptorchidism: undescended testicleTesticular torsion: interruption of blood

supply due to twisting of spermatic chordTesticular rupture due to blunt force