A testicular cancer diagnosis is a lot to take in. As you deal with your disease, emotions, and the process of treatment, you need to have honest and open discussions with your cancer care team. Therefore, it is important to ask several questions, no matter how small they may seem.
Here are nine questions you should consider asking your doctor:
How are you sure that I have testicular cancer?
You should undergo more than one type of test that shows primary cancer in the testicles and other parts of the body. A blood test identifies an increase in hormones produced by some cancer cells, which include alpha-fetoprotein, human chorionic gonadotropin (hCG), and lactate dehydrogenase. Although the presence of such hormones indicates cancer, the absence does not mean the opposite.
It is also crucial to ask your healthcare provider to explain other possible problems, including benign cysts, torsion or twisted testicles, and inflamed testicles.
What type of testicular cancer do I have?
According to the American Cancer Society, “More than 90% of cancers of the testicle develop in special cells known as germ cells. These are the cells that make sperm.” The two primary types of germ cell tumors in men are:
- Seminomas tend to grow and spread much slower than non-seminomas. The two main subtypes of these tumors are classical seminoma and spermatocytic seminoma. Doctors can tell the two apart by observing them under a microscope.
- Non-Seminomas usually occur in men between their late teenage years and early 30s. The four primary types of non-seminoma tumors are yolk sac carcinoma, embryonal carcinoma, choriocarcinoma, and teratoma.
What stage is it?
The three stages of testicular cancer affect your type of treatment, but at all stages, conventional cancer treatments require removal of the testicle through orchidectomy.
- Stage I. This initial stage describes a primary testicular tumor, which after removal, will require examination to determine the type of cancer you have. For most men with non-seminomas, orchidectomy is followed by extensive observation with blood work and scans. A seminoma, on the other hand, may need chemotherapy and perhaps radiotherapy.
- Stage II. At this stage, cancer has spread to the abdominal lymph nodes, which can be removed through retroperitoneal lymph node dissection (RPLND). Your doctor may also recommend chemotherapy and perhaps radiotherapy.
- Stage III. At this stage, cancer has spread to other parts of the body. Thus, most doctors will recommend chemotherapy as a necessary treatment.
What type of treatment should I get?
Knowing about the positives and negatives of your treatment options is crucial. As mentioned earlier, conventional cancer treatments usually include orchidectomy, RPLND, chemotherapy, and radiotherapy. You need to learn about their long-term effects and what could happen if you refuse treatment. Therefore, it is essential to ask your doctor as many questions about them as possible.
Will I be able to have sex again?
Having one of your testicles removed should not negatively impact your sex life, especially since refinements in surgery and other treatments significantly reduce these problems. However, any treatment can cause changes in sexual functioning, including:
- Testosterone Drop: If you experience a decline in your testosterone level due to extensive therapies, replacement therapy may be an appropriate procedure to correct the problem.
- Retrograde Ejaculation: If you undergo nerve-sparing surgery, the only change in physical functioning may be retrograde ejaculation, which is when a man’s sperm during ejaculation goes into the bladder and is released through urination.
- Chemo Drugs in Sperm: Another thing to consider about chemotherapy is how the drugs can mix with your sperm during ejaculation. Thus, it is of utmost importance to use a condom to avoid exposing your partner to the substance.
Additionally, psychological factors can play a significant role in sexual functioning. This a completely normal reaction that may be corrected with sexual counseling.
Will my reproductive organ change in appearance after treatment?
For most men, the scrotal sac is usually preserved and will not appear much different. However, an implant is an option during or after an orchidectomy.
Are there risks for infertility?
According to Stephen Boorjian, MD, assistant professor in urologic oncology and a surgeon at Fox Chase Cancer Center in Philadelphia, “Any treatment has the potential to impact a man’s fertility.” But for the majority of men, surgery to remove one testicle does not do so.
Regarding other medical procedures, around 50 percent of men who have had chemotherapy or radiotherapy will become permanently infertile, depending on the type of therapy and duration of exposure. However, for the rest, fertility is possible even during therapy. It may also resume six months after chemotherapy, and two years after radiotherapy. This is because sperm may be damaged until this point.
In conclusion to infertility and testicular cancer, it is best to consider sperm banks, especially since there is no accurate predictor of whether you will become infertile after treatment.
Do I need to see other doctors?
You may require seeing different specialists throughout the course of your treatment. Though there are several urologists experienced in orchidectomy, there are specialists trained in nerve-sparing techniques needed for RPLND. Also, because the disease is quite rare, make sure that your oncologist has experience in treating testicular cancer. Ask your doctor for referrals or have your oncologist consult with a specialist.
What is my survival rate?
According to the American Cancer Society, the five-year survival rate for men with localized testicular cancer is at 99 percent. For those with lymph node involvement, the survival rate is at 96 percent. And even if cancer has spread, roughly 72 percent of testicular cancer patients will survive.
Talking to your doctor is vital to make informed decisions about your health and recovery. These nine suggested questions are a good starting point to help you learn more about your cancer and treatment. However, you are still encouraged to ask additional questions that are important to you and will help you better understand your disease, treatment plan, and overall care.
Are you looking for alternative testicular cancer treatments?
Cancer in the testicles is a life-threatening disease that requires immediate medical care. If you are on the lookout for a cross between conventional and alternative cancer treatments, New Hope is the cancer care team you seek. Call us today at 480-757-6573 to start your testicular cancer treatment plan.