Testicular Cancer:
Survival High with Early Treatment
Introduction
Glenn Knies wasn't thinking the worst when he felt the abnormality in his
groin area 11 years ago. It was probably a hernia, he guessed.
He had just finished working out. In the shower, he noticed his right
testicle seemed enlarged.
"I thought I had strained something," says Knies, an insurance adjuster in
Schwenksville, Pa. He was 23 and barely out of college at the time.
"I wasn't having any discomfort or symptoms to speak of," he says. "I was
strong as ever, and there was nothing else to indicate a problem."
He mentioned the condition to his mother, a nurse, who urged him to see a
urologist quickly. She suspected something more serious than a hernia was
bothering her son.
His doctor determined the enlargement was cancer, and he removed Knies' right
testicle, the standard first-line treatment for testicular tumors. Later, after
tests showed that cancer may have spread to the lymph nodes deep within the
abdomen where the testicles drain, doctors also removed the nodes.
But the lymph nodes were "clean," free of cancer, Knies says. It was the
first sign that he probably was going to be OK, that his doctor likely had
gotten all the cancer after removing the testicle. To make sure, a regimen of
regular examinations followed--monthly at first, tapering off to annually after
five years. Eleven years later, he still has a yearly exam but considers himself
a cancer survivor.
Most Common Cancer in Young Men
Cancer of
the testicles --egg-shaped sex glands in the scrotum that secrete
male hormones and produce sperm--accounts for only about 1 percent of all
cancers in men, according to the National Cancer Institute. About 7,000
Americans were expected to get the disease in 1995, with an estimated 325
deaths. Compared with prostate cancer, estimated to kill 40,400 of its 244,000
victims in 1995, testicular cancer is relatively rare. However, in men aged 15
to 34, it ranks as the most common cancer. For unknown reasons, the disease is
about four times more common in white men than in black men.
Only 15 years ago, a diagnosis of testicular cancer was grim news. Ten times
as many patients died then as now. But dramatic advances in therapeutic drugs in
the last two decades, along with improved diagnostics and better tests to gauge
the extent of the disease, have boosted survival rates remarkably. Now,
testicular cancer often is completely curable, especially if found and treated
early.
The Food and Drug Administration has approved several drugs to treat
testicular cancer, including Ifex (ifosamide), Vepesid (etoposide), Velban
(vinblastine sulfate), Blenoxane (bleomycin sulfate), and Platinol (cisplatin).
Many medical professionals regard Platinol as the "magic bullet" for treating
certain forms of testicular cancer. FDA approved the platinum-based drug for use
after surgery or radiation. Platinol almost always is used in combination with
other chemotherapy drugs.
"[Platinum-based treatment] is truly the great success story for solid-tumor
chemotherapy," says S. Bruce Malkowicz, M.D., co-director of urologic oncology
at the University of Pennsylvania Medical Center. These drugs have helped cut
testicular cancer's death rate and bolster its cure rate, he says, adding that
many patients "respond very nicely" to platinum-based drug treatments, which are
effective even when cancer has spread beyond the testicle.
"That is not a death sentence," Malkowicz says. About 70 percent of men with
advanced testicular cancer can be cured, according to the National Cancer
Institute.
Detection and Diagnosis
![[male anatomy]](http://images.medicinenet.com/images/ccf/52887_diagram.gif)
Most testicular tumors are discovered by patients themselves--either by
accident, as Knies did, or while performing a self-examination
on each testicle. "The usual presentation is of an enlarged, painless lump,"
says Malkowicz. "Occasionally there can be pain." The lump typically is
pea-sized, but sometimes it might be as big as a marble or even an egg.
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