If you’re a male and you have testicular cancer, the odds are in your favor because it’s among the most curable forms of cancer.
According to the U.S. Health Department’s National Cancer Institute, testicular cancer patients have a 99-percent five-year relative survival rate when the cancer is confined to the testicle. When the cancer has only spread as far as abdominal lymph nodes, federal data show that 95.8 percent of patients live. When testicular cancer spreads to other areas of the body, like the lungs, records show that 72.5 percent of patients survive.
So, what makes testicular cancer so curable?
Physicians aren’t 100-percent sure, but Paul Unger, a medical oncologist at the Vermont Center for Cancer Medicine, offered several reasons.
“There’s been a tremendous amount of research and work on this type of cancer. But, in part, it’s curable because men tend to feel a lump in their testicle and say, ‘What the heck is this?’ And they get it checked early,” Unger said. “A lot of testicular cancers are caught in the early stages and they’re operated on to take out the testicle.”
While some medical specialists believe testicular cancer is particularly treatable because of its fast-growing nature, Unger isn’t buying it.
“There are other fast-spreading cancers, like Leukemia for example, that we have an awful lot of trouble curing,” he said.
HOW THE CANCER WORKS
Testicular cancers are often classified under two main categories: seminoma and non-seminoma.
Although there are many subtypes of cancer cells under the non-seminoma label, there is only one subtype of seminomas: pure seminoma. The main reason oncologists classify testicular cancer tumors under these two headings, explained Unger, is that they’re treated differently. While seminomas respond well to radiation, non-seminomas are more sensitive to chemotherapy.
By simply evaluating a tumor by CT-scans, it’s nearly impossible to determine what type of cancer that particular tumor might be, said Unger. Only after a pathology analysis of the cell types do oncologists know what they’re dealing with.
These cancers spread, just like many other cancers, due to rapid cell multiplication in the absence of regulation. Unger used a workplace analogy to put this phenomenon into perspective.
 “It’s sort of a little bit like a foreman in a brick shop,” he said. “You’re making bricks, and you make a big pile of bricks, and the foreman looks over and says, ‘Whoa! That’s a lot of bricks, we don’t need anymore today.’ So you stop, and you say, ‘OK.’ But, in a cancer cell, the foreman leaves and the cells are no longer regulated, so they grow and they grow … and they keep growing and then that’s sort of what a tumor is.”
Males who are born with an undescended testicle and undergo an early operation are at an increased risk of testicular cancer, Unger noted. Familial ties have also been correlated to some cases of testicular cancer. As for cell phones and computers as causes of cancer, Unger said that there’s no data to even suggest a person could get testicular cancer from such personal electronic devices.
According to the American Cancer Society, about half of all cases of testicular cancer appear in men ages 20-34. And according to the National Cancer Institute, in 2012 there were 8,600 new cases of testicular cancer in the U.S.
TREATING THE CANCER
In the past, when doctors found that a man had testicular cancer, they not only performed an orchiectomy to remove the testicle but they also performed an invasive surgery to remove abdominal lymph nodes, known as retroperitoneal lymph node dissection. The dissection was used as a preventative treatment to ensure that the cancer wouldn’t spread.
Testicular cancer treatments then began to really evolve in the 1980s.
“In the mid ’80s, as new drugs were developed and tried on different patients, (oncologists) realized that some drugs were exquisitely effective on testicular cancer,” Unger said. “So you could take a patient with testicular cancer that had spread to other parts of the body like the lungs and even the brain and treat them with chemotherapy and it would all go away. That’s sort of the Lance Armstrong story.
“But that doesn’t happen in almost any other cancer,” the doctor warned. “So what is it about the cells that spread and the fact that it started in the testicle that makes this cancer so sensitive to these drugs? Honestly, no one knows.”
Over the past 10 years, another form of treatment has proven to be effective for testicular cancer: surveillance.
If after an orchiectomy, a patient’s blood markers return to normal, and no other masses are observable, data show that about 80 percent of men are already cured, said Unger. While chemotherapy would reduce a person’s chance of the cancer recurring, chemotherapy isn’t healthy for people. So if one can avoid it, physicians generally recommend that he or she should.
Furthermore, in the case of testicular cancer, if the cell growth is spotted early enough, data show that chemotherapy and lymph node dissection surgery are still effective treatments for recurring testicular cancer. For that reason, surveillance requires frequent and regular examinations.
When a testicular cancer patient takes the route of surveillance, he will submit himself to regular blood work, X-rays and CT-scans for five years, but he might be able to avoid chemotherapy or lymph node dissection surgery.