Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Cancer Care

Fremont and San Leandro Medical Centers

Overview

Testicular cancer is a type of cancer that develops in 1 or both testicles. It is the most common cancer in young men ages 15 to 35, although it can occur in older men as well. It is also one of the most curable cancers.

Testicular tumors can be either noncancerous (benign) or cancerous (malignant). Most tumors found in the testicles are cancerous and are highly treatable, even in cases where the cancer has spread (metastasized) beyond the testicle.

Testicular cancer is often curable, It is important that treatment be started soon after the diagnosis. Treatments for testicular cancer include surgery, radiation therapy, and chemotherapy.

Before treatment begins, you may consider storing your sperm if you plan to have children in the future. Even before diagnosis, up to half of men with testicular cancer have a low number of sperm. Sperm collection before treatment allows as much healthy sperm as possible to be frozen and stored.

Additional References:

Surgery

The type of surgery you receive will depend on the specific type and stage of your cancer. All stages of the 2 types of testicular cancer (known as seminoma and nonseminoma) are usually treated with radical inguinal orchiectomy to remove the testicle that contains cancer. Very rarely, cancer is found in both testicles. In these rare cases, we remove both testicles during a bilateral orchiectomy.

After having a testicle removed, you may decide to have an artificial testicle implanted in your scrotum. The prosthesis is filled with saline to make it feel like a normal testicle, and the size would match your remaining testicle.

For small stage I cancers, orchiectomy may be followed by careful monitoring to watch for signs of cancer coming back. This strategy is called surveillance, which involves regular follow-up visits for at least 10 years after your diagnosis. For some early stage seminomas, surgery may be the main treatment option.

The lymph nodes in the back of the abdomen, called the retroperitoneal lymph nodes, are a common location for testicular cancer to spread. If your cancer has spread or is at risk for spreading to these lymph nodes, we may remove them during an operation called retroperitoneal lymph node dissection.

Surgery Side Effects

Having a testicle removed does not typically affect your ability to have children because the remaining testicle still produces sperm. Sometimes, sperm counts actually improve after the cancerous testicle is removed.

Your testosterone levels are also unlikely to be affected by an orchiectomy as long as your other testicle is normal. This means you are still able to achieve an erection and orgasm.

If both testicles are removed, you no longer produce sperm. You may consider sperm collection before surgery if you plan to have children. Your body will no longer make enough testosterone, which can cause these symptoms:

  • Decreased sex drive (libido)
  • Inability to achieve a normal erection and orgasm
  • Hot flashes
  • Fatigue
  • Mood changes
  • Loss of muscle mass
  • Bone mineral density loss 

Testosterone supplements are needed to prevent and control these problems.

If you had lymph nodes removed from the back of the abdomen, the nerves that control the ejaculation of sperm may be damaged. This can result in infertility. However, advances in surgical methods that spare the nerves have reduced the risk of this side effect.

Retroperitoneal lymph node dissection may also cause temporary side effects, including infection or bowel obstruction (blockage).

We will talk with you about the possible side effects of your surgery and how we plan to manage them.

Radiation Therapy

Radiation therapy uses high-energy X-rays to kill cancer cells. The most common type is external-beam radiation therapy, which delivers radiation from a machine outside the body.

Radiation may be used after the testicle is removed, but the radiation beam is not aimed at the scrotum. Instead, it is aimed at the retroperitoneal lymph nodes to kill cancer cells that may have spread there.

We mainly use radiation therapy to treat seminomas, which are much more sensitive to the effects of radiation than nonseminomas. Radiation treatments are usually given 5 days a week for 3 to 4 weeks.

Radiation Therapy Side Effects

Although radiation is directed at cancer cells, nearby healthy tissue may also be affected. In order to limit damage to normal tissues, we use the exact dose needed for your cancer and take special care to target it. Possible side effects of radiation therapy to treat testicular cancer include:

  • Skin changes, such as redness or mild tanning
  • Fatigue
  • Nausea
  • Diarrhea
  • Problems with sperm production
  • Another type of cancer

If you wish to preserve fertility, we also recommend sperm analysis and sperm banking before radiation therapy. We can also place a special shielding device over the remaining testicle to reduce radiation dose. We also have ways to provide relief from nausea and other side effects of radiation therapy, so talk with us about any symptoms you experience.

Additional References:

Chemotherapy

Chemotherapy drugs attack and kill cancer cells.

Known as systemic chemotherapy, these drugs enter the bloodstream and attack testicular cancer cells that have spread to the lymph nodes or other parts of the body. You may receive chemotherapy after surgery to remove the testicle. Chemotherapy may also be given before or after removal of lymph nodes.

Often, advanced cases of testicular cancer can be cured with chemotherapy. The type and stage of your testicular cancer will determine which chemotherapy drugs you receive.

If testicular cancer comes back after chemotherapy, you may receive high doses of chemotherapy.

Chemotherapy Side Effects

Chemotherapy works by killing rapidly dividing cancer cells. However, chemotherapy can also harm healthy cells that grow quickly. This can cause a variety of side effects, and the severity depends on the type and dose of the drugs, as well as the length of time they are given. You may experience 1 or more of these common side effects of chemotherapy:

  • Hair loss
  • Nausea and vomiting
  • Loss of appetite
  • Mouth sores
  • Fatigue
  • Low blood cell counts

We have effective methods for preventing and managing these chemotherapy side effects. For example, medications can prevent or treat nausea caused by chemotherapy. Most side effects typically go away when treatment ends.

Some side effects, however, are not temporary. Possible long-term side effects include:

  • Fertility problems. Chemotherapy can lower sperm counts and increase the risk of infertility. If you want to have children in the future, we will discuss your options for fertility preservation before treatment begins.
  • Damage to nerves and organs. Nerve damage can result in hearing loss and pain or numbness in the hands and feet. Blood vessels in the heart may be damaged, increasing the risk of heart problems many years after treatment. Other drugs may affect the functioning of the kidneys or lungs.
  • Second cancer. In less than 1 percent of cases, chemotherapy causes a new cancer (usually leukemia) to develop years after treatment for testicular cancer.

We will discuss the possible short-term and long-term side effects of chemotherapy and how we plan to prevent and manage them.

Additional References:

Follow-Up Care

Follow-up appointments are an important part of your cancer care. During these regular visits, we do physical exams, blood testing for tumor markers, and imaging tests to make sure there is no cancer in your body. These tests will be done more frequently during the first few years after treatment. We also watch for the development of long-term side effects of treatment.

Clinical trials

We are always looking for new and better ways to treat testicular cancer. Clinical trials are research studies that test new treatments or procedures that may prove better than current treatments. We will talk with you about whether a clinical trial may be right for you.

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