Targeted Therapy And Immunotherapy
Targeted therapy and immunotherapy drugs attack cancer cells differently from standard chemo drugs. Little is known about their effects on fertility or problems during pregnancy.
Males taking thalidomide or lenalidomide have a high risk of causing birth defects in a fetus exposed to these drugs, which can stay in semen for a few months after treatment ends. Oncologists recommend that males and any sexual partner who is able to get pregnant use extremely effective forms of birth control, for example a condom for the man and a long-acting hormone contraceptive or IUD for the woman.
Causes And Risk Factors Of Testicular Cancer
The cause of testicular cancer is not known. But there are certain risk factors that may increase the chance of developing it. These include having an undescended testicle as a child. Or having a brother or father who had testicular cancer can slightly increase the risk.
Having a risk factor does not mean you will get cancer. And if you do not have any risk factors, you may still develop it.
Fertility After Testicular Cancer
Your fertility means being able to make someone pregnant.
After treatment for testicular cancer, you will usually still be able to make someone pregnant. But this depends on what treatment you need. Some treatments might affect your fertility.
Your doctor will talk to you about this before you start treatment. Even if there is a low risk that treatment will affect your fertility, your doctor will talk to you about sperm banking. This is when you collect and store your sperm for use in later fertility treatment.
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Other Causes Of Testicle Lumps And Bumps
As well as cysts, other causes of non-cancerous lumps and swellings on or around the testicles may include the following:
When part of the small intestine pushes through a small opening in your abdominal wall and down into your scrotum. Symptoms include swelling, bulging, aching and heaviness.
Similar to varicose veins, this is a collection of swollen veins in the scrotum.
Infection of the epididymis, just above the testicle, usually caused by an STI, such as chlamydia.
The twisting of a testicle in the scrotum, which can inhibit blood supply and nerve function. This can result in severe pain and swelling, and is considered a medical emergency.
Surrogacy And Gestational Carriers
Sometimes, a woman may not be able to give birth to a child. For some women, being pregnant could even be dangerous. In situations like this, having another woman carry the baby during pregnancy may be an option.
Surrogacy. Surrogacy involves a woman who will carry the baby through pregnancy. The woman carrying the baby is called a surrogate. The sperm of the man who will be the childs biological father is inserted into the cervix or uterus of the surrogate. This process is called artificial insemination. The child will carry the genes of the woman.
Gestational carrier. A gestational carrier is a woman who will carry an embryo from another womans egg and her partners sperm. The child will not carry the genes of the gestational carrier.
Surrogacy and gestational carrier laws are different in each state. It is important to consult an attorney if you choose this path for having a baby.
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Population And Study Design
In 1998 through 2002, the five national academic oncology units in Norway conducted a national multi-center follow-up survey to assess the long-term physical and psychological morbidity in testicular cancer survivors. All surviving unilateral germ-cell testicular cancer patients treated in Norway in 1980 through 1994 were identified through the Cancer Registry of Norway and the regional university hospitals. Former patients currently aged 1875 years were invited to participate in the survey, which consisted of a mailed questionnaire and an outpatient clinical examination that included laboratory tests, spirometry, audiometry, and an optional semen analysis at one of the five collaborating oncology units. Exclusion criteria included bilateral orchiectomy for any reason, extragonadal germ cell cancer, other malignancies except skin cancer, and mental retardation.
Following invitations to participate in the study and our receipt of written informed consent, the study population received the mailed questionnaire, which included 14 questions assessing pre- and post-treatment fertility . Men who indicated that they had not attempted to father a child but who reported paternity were categorized in the analyses as having an intention of fatherhood.
Why Are People Using Pregnancy Tests For Testicular Cancer
The use of a home pregnancy test to detect testicular cancer goes back to a social media post from several years ago. In it, the poster described his male friends positive pregnancy test.
Various comments urged the poster to tell his friend to see a doctor, as a positive pregnancy test in a male could be a sign of testicular cancer. After visiting a doctor, it did turn out that the test-taker had a small testicular tumor.
The rationale behind this is that testicular tumors can lead to an increase in a hormone called human chorionic gonadotrophin . This is the same hormone thats detected by home pregnancy tests.
Therefore, if a male uses a home pregnancy test and receives a positive result, it means extra hCG has been detected in the urine.
However, this is in no way a diagnosis. It should prompt a doctors visit for further testing.
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Can You Get An Erection Without Testicles And Are Your Balls Healthy
All your ball questions answered with our complete guide to testicle health.
When it comes to your nuts, do you know whats normal? If not, its time to get hands on, with our run-down of testicle health tips and advice.
Most men’s testicles are a similar size, although it’s common for one to be slightly larger and one testicle often hangs lower than the other. But what should healthy testicles look and feel like, how can you tell if something is amiss, and what happens if you lose a gonad?
We spoke to male cancer information nurse Rob Cornes about the key testicle health questions to put your mind at ease:
Questions To Ask Your Health Care Team
Consider asking the following questions:
Will my cancer treatment plan affect my ability to have children?
Are there ways to preserve my fertility before I start treatment?
Will my treatment plan cause problems during pregnancy, labor, or delivery?
How long should I wait before trying to have a child?
How will trying to have a child affect my follow-up care plan?
Will trying to have a child increase my risk of recurrence?
Should I talk with an obstetrician who has experience with cancer survivors?
Where can I find emotional support for myself? For my spouse or partner?
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What If I Have A Low Sperm Count
Some men recover sperm production after cancer treatment but have a low sperm count and may not be able to conceive naturally. However, you may still be able to have a biologic child through in vitro fertilization . There are several steps involved in IVF, including:
- Ovarian stimulation: Your female partner takes hormone injections for about 10 days to stimulate a group of eggs in her ovaries to mature.
- Egg retrieval: While your partner is asleep under anesthesia , a very thin needle is passed through the wall of her vagina to remove the mature eggs from her ovaries. This procedure takes 10 to 20 minutes.
- Fertilization: The eggs are fertilized with your sperm in a laboratory. If your sperm count is low, they will inject a sperm into each egg . The fertilized eggs are kept in the laboratory for 3 to 5 days to make sure they start to divide and form healthy embryos.
- Embryo transfer: One or 2 embryos are placed in your partners uterus to attempt pregnancy. The others are frozen and stored for possible use in the future.
What Are My Other Options To Build A Family
Some men arent able to sperm bank before treatment or arent successful in having a child using their frozen sperm. Other ways to build a family are using donor sperm or adoption.
Using donor sperm involves using sperm from another man to impregnate your female partner. Young, healthy men provide their sperm to a sperm bank for donation. Most donors are anonymous, but some are willing to have the child contact them when they reach adulthood. You can select a donor based on various characteristics and traits that are shared on the sperm bank website.
You may also have a relative or friend who is willing to donate sperm for you. While this may be a good option for you, even with the best of intentions, you may have problems if expectations arent clearly defined. Sometimes, a relative or friend who wants to help will make an offer without understanding all thats involved. No matter how well you know the person, your donor should have psychological and medical screening. You should also both speak with lawyers who specialize in reproductive law.
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Treating Testicular Cancer That Comes Back
If testicular cancer comes back it can usually still be cured even if the cancer has spread to other parts of the body. Cancer that comes back is sometimes called a recurrence. You usually have further chemotherapy. Or you may have an high-dose chemotherapy with stem cell support.
Occasionally after chemotherapy, you may develop signs of cancer in areas such as the lungs, brain or liver. They may need surgery. Experienced surgeons do these operations in specialist units. If you need this type of operation, your doctor will talk to you about it.
Can My Testicular Cancer Treatment Make Me Infertile
Certain testicular cancer treatments may make it harder to get someone pregnant. If one of your testicles is removed, it doesnt affect the amount of sperm that your remaining testicle makes. But treatments like radiation and chemotherapy can lower your sperm count, either temporarily or permanently.
If youre going to be treated for testicular cancer, talk with your doctor about your fertility options. Some people choose to store some of their sperm before they get treated, which can be used later on to make a pregnancy.
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Beginning The Path To Pregnancy After Testicular Cancer
Years after completing cancer treatments, Morgan and Clay were ready to start a family. Although we knew there was an incredibly small chance wed be able to conceive without help, we tried for six months on our own, remembered Morgan. When their efforts didnt result in pregnancy, they turned to our Nashville fertility clinic for support.
The first step was assessing Clays fertility health, which revealed sterility. Thankful that he had stored sperm, the couple decided to try for pregnancy with intrauterine insemination in August 2017. When the IUI did not result in pregnancy, they turned to in vitro fertilization in October 2017.
Their IVF cycle only resulted in one healthy embryo. The embryo was transferred in January 2018 and they soon received the joyous news that Morgan was pregnant. As Morgan said, It was our only shot and it worked. Morgan and Clay welcomed their healthy son Colt into the world in September 2018. The couple was elated to achieve pregnancy after testicular cancer.
Treatments That Could Cause Male Infertility
Both cancer and cancer treatments can damage fertility. Here are some common treatments and their possible effects on fertility.
Radiation therapy can slow down or stop sperm cell production if the testicle is in or near the target area for the radiation. A shield can help protect the testicles, but radiation can “scatter” within the body, so it’s difficult to shield the testicles completely. Total body irradiation used before some bone marrow transplants often causes permanent infertility. If the testicles get a mild dose of radiation, a manâs fertility may decrease but could recover over the next oneâfour years. If the radiation dose to the testicles is high, sperm production may be permanently damaged. Radiation damage to the part of the brain that controls hormone production can sometimes interfere with the hormone messages that control sperm production in the testicles.
The alkylating chemotherapy group does the most damage to fertility. It can cause germ cell loss or destruction and impact testosterone levels, which are crucial to male fertility.
Surgery to treat prostate or bladder cancer removes the prostate and seminal vesicles. These glands make the liquid part of a man’s semen. They also cut the pathway for sperm cells to be included in the semen. Men with testicular cancer or colon cancer sometimes have surgery that can cause ejaculatory dysfunction.
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What Are The Treatments For Testicular Cancer
Testicular cancer is very treatable, especially when its caught early. Your doctor will talk to you about testicular cancer treatment options. Depending on the stage and type of cancer, your treatment plan might include:
Surgery to remove the tumor
Your doctor may run tests to figure out which treatments are right for you. Talk with your doctor about your options, and be honest about your concerns.
Make a list of questions youd like to ask at each appointment. You also may find it helpful to seek a second opinion from another specialist when deciding the best treatment for you. In some cases, you might be offered a few options for treatment.
Late Effects Of Testicular Cancer Treatment
Sometimes side effects of treatment may take a long time to improve. Or some may not completely go away and may become permanent. These are called long-term effects. Other side effects may develop years after treatment finishes. These are called late effects.
They include hearing problems, changes in sensation in your hands and feet and heart or lung problems. There are different ways to manage these.
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Effects Of Cancer Treatment On Fertility
Cancer treatments may cause fertility problems affecting your ability to father a biologic child, including:
- Inability to produce sperm.
- Damage to nerves and blood vessels needed for erection and ejaculation.
- Inability to produce hormones that stimulate sperm production.
Not all cancer treatments cause fertility problems. It depends on:
- Your fertility before treatment.
- The type of surgery you had.
- The type and dose of chemotherapy you received.
- The area of your body treated with radiation and the dose of radiation you received.
Fertility problems from cancer treatment may be temporary or permanent. Some men regain the ability to produce sperm after treatment. This generally takes 1 to 3 years, but can sometimes take longer. Some men have only partial recovery, with low sperm counts, and some men never recover sperm production.
Because of the many factors that affect fertility, its hard to predict how any one person will be affected by treatment. We cant know for sure who will regain fertility after treatment is completed and who wont.
Will A Child Conceived After My Cancer Treatment Be Healthy
There is no evidence that children conceived after cancer treatment are at an increased risk for birth defects or other health problems. However, its important to use birth control during treatment to ensure you dont conceive with sperm that may have been damaged from exposure to chemotherapy or radiation. This damage might affect the health of the child. We also recommend that you use birth control for 1 year after completing chemotherapy and radiation therapy to ensure all damaged sperm have been cleared from your body.
Some cancers are hereditary, or passed down from parents to children. Ask your doctor or nurse if you have a hereditary cancer. If you do, you can meet with a genetics counselor to learn how this may affect the health of a child.
If you have a specific genetic mutation that can be passed on to a child, you may want to consider preimplantation genetic testing . PGT is a method of testing embryos that have been created by in vitro fertilization for the mutation you have. If you want, you can then choose only those embryos that dont have the genetic mutation when youre ready to attempt pregnancy.
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Emotional Considerations And Support For Fertility Issues
For some men, infertility can be one of the most difficult and upsetting long-term effects of cancer treatment. Although it might feel overwhelming to think about your fertility right now, most people benefit from having talked with their doctor about how treatment may affect their fertility and learning about options to preserve their fertility.
Although most people want to have children at some point in their life, families can come together in many ways. For extra support during this time, reach out to your health care team with questions or concerns, as well as to professionally led support groups.
If you are the parent of a young boy or teen with cancer, this video of fertility options for young male cancer patients from the Children’s Hospital of Philadelphia may help you talk with your son and his doctor.
Prognosis And Survival Rates For Testicular Cancer
When someone is diagnosed with testicular cancer, their doctor will give them a prognosis. A prognosis is the doctor’s opinion of how likely the cancer will spread and the chances of getting better. A prognosis depends on the type and stage of cancer, test results and a person’s age, fitness and medical history.
Testicular cancer has the highest survival rates of any cancer . Regular monitoring is a major factor in ensuring good outcomes, so it’s vital that you attend all your follow-up appointments.
If you have testicular cancer, your doctor will talk to you about your individual situation when working out your prognosis. Every person’s experience is different, and there is support available to you.
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