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Olympian's Cancer: Treat or Compete?
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Eric Shanteau Delaying Testicular Cancer Treatment Until After Beijing Olympics
Reviewed By Louise Chang, MD
July 14, 2008 — Olympic swimmer Eric Shanteau, 24, says he has testicular cancer and is delaying his testicular cancer surgery until after he's done competing in Beijing.
According to media reports, Shanteau noticed a testicular abnormality but didn't see a doctor until his girlfriend urged him to do so. Shanteau got the testicular cancer diagnosis a week before the Olympic trials. Shanteau's doctors recommended surgery as soon as possible but saw no signs that the cancer had spread.
After weighing his options and risks — and his life's work to get to the Olympics — Shanteau decided to delay treatment until after the Olympics. He'll be closely monitored during the games and will drop out if there is any sign his cancer is spreading.
Taking a Risk?
Shanteau's testicular cancer is in its early stages and can be closely monitored by blood tests and CT scans, and that makes his case unique, says Stephen Williams, MD, professor of medicine at Indiana University School of Medicine and director of the Indiana University Melvin and Bren Simon Cancer Center, where cyclist Lance Armstrong was treated for testicular cancer. Williams isn't treating Shanteau.
"He could be treated before things get out of hand," Williams tells WebMD. "In his particular case, I actually think that the decision that he made — given the circumstances — is acceptable. I would not ever want to be quoted as saying there's no hurry in getting testicular cancer treated, because nothing could be farther from the truth."
Not all doctors are comfortable with Shanteau's decision to delay his testicular cancer surgery.
"If he hasn't had his testicle removed ... it would be just stupid. Just have it removed ... because there's a chance of it spreading over the next month," urologist Ronald Hrebinko, MD, of the University of Pittsburgh Medical Center, tells WebMD.
The surgery is "not a big operation; it doesn't involve muscle cutting or anything like that," explains Hrebinko, who isn't one of Shanteau's doctors. Shanteau would likely only need a few days off from the surgery, Hrebinko says.
Of the 8,000 new cases per year in the U.S., 80% to 90% occur in men younger than 35, according to Otis Brawley, MD, chief medical officer of the American Cancer Society.
Reluctant to See a Doctor
Shanteau's initial reluctance to see a doctor is "very, very common," Brawley tells WebMD.
"Many women at least see a gynecologist every year or every couple of years in their 20s and 30s. But most young men don't see physicians so they don't have a relationship with a physician. 'Who do you call? How do you even go about seeing a doctor?' is something that you'll hear a 21- or 22-year-old say," Brawley says.
Hrebinko says that "most people at that age are healthy, and you tend to think you're invincible in your teens or 20s, so you'll ignore things." For instance, Hrebinko says the biggest testicular tumor he's seen was "the size of a rugby ball" in a college student who ignored it in the hopes that it would go away.
But Williams says public awareness about testicular cancer is growing, and that ignorance about it is "much less of a problem than it used to be."
People with testicular cancer don't necessarily feel ill, and being in Olympic shape is not a guarantee that cancer won't strike. Shanteau — and Lance Armstrong — prove that healthy people can get cancer.
"Most of these [cases] are just out of the blue. It's a random gene mutation. It could happen to anybody," Hrebinko says.
Hrebinko and Brawley urge men to seek medical attention if they notice any testicular abnormalities while showering, for instance. Those abnormalities are "usually painless swelling or firmness in the testicle," which may start as a pea-sized or lentil-sized lump, Hrebinko says.
How aggressive Shanteau's testicular cancer isn't clear. "It depends on the pathology," Brawley says. "There are a host of different kinds of testes cancer, some that need to be treated in 72 hours and some that are very slow growing."
Testicular cancer treatment may include surgery, chemotherapy, and/or radiation.
"There are patients that we have who get surgery, chemotherapy, and radiation, and there are patients who just get one or two of those," Brawley says. "It's going to depend on what the actual pathology is and what the actual stage or degree of spread is."
Will Shanteau still be able to compete in the Olympics?
"I think it would be something that would weigh on your mind a little bit but apparently it sounds like he's doing OK," Williams says. "From a physical point of view, the status of his disease is such that I don't think any symptoms of his disease would interfere with his competing."
SOURCES: Associated Press. NBC Olympics. Stephen Williams, MD, professor of medicine, Indiana University School of Medicine; director, Indiana University Melvin and Bren Simon Cancer Center. Otis Brawley, MD, chief medical officer, American Cancer Society. Ronald Hrebinko, MD, urologist, University of Pittsburgh Medical Center.
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