Testicular Cancer Treatment in Los Angeles

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A Team Approach to Treating Testicular Cancer

Testicular cancer is the most common cancer in males between the ages of 15 and 35. It originates within the testicles, which are responsible for producing sperm for reproduction and producing male sex hormones like testosterone. With the right team, you can examine your options for treating testicular cancer and receive the care you need.

This cancer is relatively rare but is highly treatable. At Comprehensive Urology, a testicular cancer surgeon will guide you through all stages of the diagnosis and treatment of the disease.

Symptoms of Testicular Cancer

Men can have different signs and symptoms that can lead to the diagnosis of testicular cancer. Common testicular cancer symptoms include:

  • Pain in the testicle or groin
  • Enlargement of the scrotum
  • Mass felt in the testicle
  • Loss of energy

Risk Factors for Testicular Cancer

There are certain risk factors associated with testicular cancer. Beverly Hills doctors at Comprehensive Urology can help identify these risk factors, which can include the following:

  • Race: Caucasians have a higher risk than African Americans
  • Age: Younger men (ages 15-35) have a higher risk of developing this disease than older men
  • Undescended Testicle: Adults with testicles that have not descended into the scrotum have a higher risk. Even if the testicles were repaired during childhood.
  • History of Testicular Cancer: A man who has been diagnosed with testicular cancer in one testicle has a slightly increased risk of developing cancer in the remaining testicle. Still, the overall risk is low.
  • Family History: Men who know family members with this disease may be at increased risk.

Infertility & Family Planning After Testicular Cancer

Most men diagnosed with testicular cancer are concerned about the possibility of becoming infertile after treatment. There are many different treatments for testicular cancer. As such, the short-term and long-term effects may vary. Below we included an overview of what to expect with each treatment in regards to fertility.

Surgery

Typically, removing a testicle does not have a serious effect on a man’s sexual performance or his ability to procreate. The remaining, healthy testicle will produce more testosterone and sperm to make up for what was lost. Most men will still be able to have an erection. However, the orgasm may feel different because it will be a dry climax. Surgical removal of a testicle has no negative impact on a man’s fertility. Still, some patients consider storing sperm regardless.

Chemotherapy

Chemotherapy does not affect a man’s ability to have sex. Still, most men complain of little to no sex drive for some time after treatment. Unfortunately, chemotherapy has been shown to cause infertility. So your doctor may strongly advise you to store sperm before treatment. The higher the dose of chemotherapy, the higher the risk of causing infertility.

Radiotherapy

Radiotherapy may be given as an alternative or in addition to chemotherapy treatment. It is especially common if the cancer has spread elsewhere in the body. Radiotherapy to the nodes in the abdomen does not affect a man’s ability to have sexual intercourse and does not usually cause infertility. However, just like with surgical procedures, it might be a good idea to store sperm anyway.

Contraception During Treatment

Men with testicular cancer are strongly advised not to pursue conception during chemotherapy or radiotherapy treatment. These types of treatment can damage your sperm and possibly harm a baby conceived at this time. Medical professionals usually advise men to avoid conceiving a child for about a year after treatment has ended. This allows the sperm to recover from any damage that chemotherapy or radiotherapy may have caused. Fortunately, many men who have been treated for testicular cancer can have families after they are fully recovered.

Testosterone Replacement Therapy

In some cases, the remaining testicle does not produce enough testosterone. In even rarer cases, a man may need to have both testicles removed from an advanced case of testicular cancer.

A lack of testosterone may affect a man’s ability to get an erection and may reduce his sex drive. Other symptoms may include tiredness, low energy, and osteoporosis, a condition characterized by the thinning of bones. If you are experiencing any of these symptoms, your doctor may measure your testosterone levels to see if you are a good candidate for testosterone replacement therapy. This can be given as:

  • A gel
  • An injection into a muscle
  • An implant
  • Or as a patch that is attached to the skin

Men who go through testosterone replacement therapy can usually increase their sex drive and regain their energy.

Preserving Fertility After Testicular Cancer Treatment

Most men can still father children after testicular cancer treatment. Still, the fertility of some men after treatment is hampered. This is due to the type and amount of treatment needed to treat the cancer. Going through cancer is difficult enough without the possibility of being unable to conceive a child. Fortunately, there are possible methods to preserve a man’s fertility.

Storing Sperm (Sperm Banking)

Sperm banking is a common and safe technique that has been used for many years. It involves the freezing of your sperm. This is strongly recommended for men who will need to receive chemotherapy, which is damaging to the sperm. However, even if your risk of becoming infertile are low, your doctor may still advise you to store two to three samples of sperm.

Intra-Cytoplasmic Sperm Injection (ICSI)

ICSI is an option for men who are not producing much sperm or for those who will need to begin cancer treatment quickly. This fertility treatment only requires a single sperm to fertilize an egg.

Extraction of Testicular Tissue or Fluid

A newer fertility technique in sperm by extracting a piece of testicular tissue or fluid. Small amounts of fluid or tissue are removed by inserting a needle into the testicle or by making a small cut in the scrotum. The fluid or tissue is examined, followed by removal and storage of the sperm for future use.

STAGING OF TESTICULAR CANCER

Once Testicular Cancer has been diagnosed, your doctor will order a number of tests to help determine the stage of the disease. That is, we look to see if the cancer has spread to other areas. Tests can include:

  • CT Scan
  • Repeat Tumor Markers

Do you suspect you have testicular cancer? Or have you been recently diagnosed? It is important to understand that this disease is one of the most treatable types of cancer! As with most cancers, the treatment options will depend on the type and stage of the disease.

Diagnosing Nonseminoma

To receive an accurate diagnosis and personalized treatment plan for nonseminoma, you need the right team. Please do not hesitate to get in touch with the experienced and dedicated team at Comprehensive Urology in Los Angeles. Our urologists are highly trained and have access to the most advanced treatment options and technologies at Cedars-Sinai Medical Hospital. Call (310) 499-2756 or contact us online today!

The most common signs and symptoms associated with testicular cancer include:

  • Pain in the testicle
  • A sensation of heaviness in the scrotum
  • Swelling of a testicle
  • A lump or mass in on or both testicles
  • Back or lower abdomen pain
  • And even pain or lumps in other parts of the body

The urologists at Comprehensive Urology will conduct the following tests to identify testicular cancer:

  • Physical examination
  • Abdominal and pelvic CT scan
  • Chest x-ray
  • Blood tests
  • Ultrasound of the scrotum
  • Removal of one or both testicles

Treatment Options for Nonseminoma

Nonseminoma occurs as four different types. Depending on the type and stage, the following treatments may be necessary:

  • Surgery (Orchiectomy): Removal of part or all of one or both testicles.
  • Active Surveillance: The earliest stages of testicular cancer may not require immediate treatment beyond surgery. Instead, a urologist will schedule regular appointments to monitor recurrence of the disease to avoid unnecessary or excessive treatment.
  • Radiation: Any remaining cancer cells left after surgery are destroyed with high-energy radiation beams. Radiation typically targets the lymph nodes throughout the body in which cancer cells may have spread.
  • Chemotherapy: Intravenous drugs kill the remaining cancer cells left behind after surgery.

Finding the Right Team

Have you or someone you love been diagnosed with testicular cancer? Then it is crucial to work with a team of testicular cancer doctors who have:

  • Extensive experience
  • A strong track record for achieving the best possible outcome for their patients

The team at Comprehensive Urology has both.

Retroperitoneal Lymph Node Dissection (RPLND)

One of the most common tactics is to remove the lymph nodes in the retroperitoneum. This helps in two ways:

  • For diagnosing whether the testicular cancer has metastasized
  • And preventing the disease from spreading to other parts of the body

The lymph nodes are located throughout the entire body, and cancer can spread through them. RPLND then can serve as a diagnostic or preventative measure. It is very often used as a precursor or alternative to chemotherapy.

Not every patient who has been diagnosed with testicular cancer will need to have lymph nodes removed. So it is very important to discuss your treatment options with our board-certified urologists to determine the best treatment plan.

What to Expect During RPLND

RPLND is performed under general anesthesia and can take up to six hours. However, this can vary, depending on the stage and type of cancer. At Comprehensive Urology, our surgeons strongly believe in performing RPLND with an emphasis on nerve-sparing techniques. This way, we can preserve as much normal nerve function as possible. In some cases, patients may suffer nerve damage that interferes with the nerves that control ejaculation. Our team places great importance on protecting each client’s quality of life while also providing the most advanced medical care possible to treat testicular cancer.

What Is the Recovery Like?

The recovery period following RPLND will depend largely on three factors:

  • Type of procedure an
  • Extent of the dissection
  • And the patient’s overall health

This procedure is considered a major operation regardless of the technique used. So patients should expect to spend at least a few days in an intensive care unit. This is followed by 7-10 days at Cedars Sinai Medical Center before returning home. Immediately following RPLND, patients may experience one or more of the following:

  • Pain around the incision site
  • Nausea
  • Fatigue
  • Poor appetite
  • Use of urinary catheter
  • Constipation
  • Gas cramps

Patients will be encouraged to move and walk 4-6 times a day to help prevent complications, such as blood clots or chest infections. The expert nursing staff will assist with breathing and leg exercises. Additionally, they help with pain management until the patient is ready to return home.

It may take several months before patients feel fully recovered from the operation. Patients will have a scheduled follow-up visit within 4-6 weeks after the surgery to discuss the results and whether additional treatment is necessary. Regular check-ups will be necessary to monitor for recurrence of the disease.

Potential Risks and Complications

As with any surgical operation, there are potential risks and complications associated with RPLND. It is safe for patients to have these lymph nodes removed. However, the surgical procedure itself has a minimal risk of the following:

  • Wound infection
  • Bowel obstruction
  • Necessary retreatment
  • Nerve damage
  • Retrograde ejaculation

The urologists at Comprehensive Urology strive to help patients achieve the best possible outcome. We always work to ensure that each patient receives the comprehensive and personalized care they need to overcome testicular cancer.

Chemotherapy

If you have been diagnosed with testicular cancer, you likely will need chemotherapy to ensure that the disease is fully eradicated. In many cases, chemotherapy is combined with other treatments for testicular cancer, for maximum effect. Keep in mind, every patient is unique. As such, our board-certified urologists strongly believe in working closely with each patient to develop a personalized treatment plan suited to his needs and goals.

Chemotherapy is essentially the use of prescription drugs to treat a disease, such as cancer, by treating the entire body. Surgery and radiation are effective at targeting the main source of cancer. However, chemotherapy can help kill cancer cells that may have spread to other body parts.

Chemotherapy is commonly administered via oral medication or intravenously at regular intervals. This allows the patient to rest and healthy cells to regenerate after dosages. The number of dosages and cycles of chemo will depend on:

  • The specific drugs being used
  • Type of cancer
  • Stage of the disease
  • And the patient’s age and overall health

The treatments can be adjusted based on how the patient reacts and how effectively the drugs kill the cancer cells. However, it is ideal for patients to go through the full cycles and dosages as prescribed to ensure the best possible outcome.

What Are the Side Effects of Chemotherapy?

While highly effective in most cases, the anti-cancer drugs used in chemotherapy are strong. As such, they can cause a variety of side effects, as even healthy cells are damaged. The side effects will depend on the specific medications that are used, as well as the patient’s unique reaction. The most common side effects that testicular cancer patients experience with chemotherapy include:

  • Hair loss
  • Loss of appetite
  • Nausea
  • Vomiting
  • Fatigue
  • Reduced resistance to infections
  • Mouth sores
  • Easy bruising
  • Changes in taste
  • Skin discoloration, sores, or dryness
  • Partial hearing loss
  • Lung, kidney, or liver damage

Fortunately, most side effects are typically only temporary. Throughout treatment, our patients have access to a wide range of professionals, including:

  • Nurses
  • Nutritionists
  • Oncologists
  • And our expert urology team

Together, we can minimize the effects of chemotherapy as much as possible. It is important to keep track of the side effects and discuss any additional treatment options to help relieve the symptoms.

Follow Up and Recovering from Chemo

Fortunately, most patients do not encounter long-term side effects or consequences of chemotherapy. Therefore, the recovery process is fairly quick. The time it takes to return to everyday life will depend on the patient’s overall health and the

type of chemotherapy taken. Most patients begin to feel better in a matter of days once treatment has ended.

Radiation Therapy

In some cases, the tumors are removed with the entire testicle in a procedure called an orchiectomy. Once removed, radiation therapy may be recommended to eliminate any possible remaining cancer cells. The goal is to completely clear the body and prevent recurrence. Radiation is a highly effective method for killing cancer cells. It especially helps if these cells have spread to other body parts, such as the lymph nodes.

What to Expect During Radiation Therapy

Radiation therapy can be administered externally or internally. External radiation therapy uses high-energy beams, often X-rays. These are directed at certain parts of the body to kill cancer cells. The patient lies on a table while the machine aims the energy beams at the testicles and other areas that may have cancer cells. Internal radiation therapy involves a radioactive substance placed directly in or near the cancer. It typically is housed in a “seed,” needle, wire, or catheter in order to kill the cancer cells.

Following radiation therapy, you may experience the following:

  • Fatigue
  • Nausea
  • Diarrhea
  • Redness
  • Irritation of the skin around the groin and other treated areas

The possible side effects typically improve over time after treatment.

Infertility Issues

Radiation often causes infertility when treating testicular cancer. So it is important to discuss options for preserving your sperm before treatment. Comprehensive Urology encourages our patients to undergo sperm banking before surgery or radiation to preserve their reproduction options. In some cases, radiation may only cause temporary infertility for one to two years. Still, we encourage our patients to keep their options open.

Schedule Your Consultation Today

The sooner you receive expert care and treatment, the better. Contact Comprehensive Urology today to set up a consultation and learn more about testicular cancer treatment options in Los Angeles.