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April 27, 2018 by Nova IVI

What is testicular cancer ? What are the fertility preservation options for cancer patients ?

Fertility in Men

The month of April is recognised as “Testicular Cancer Awareness Month” worldwide to spread awareness amongst patients, survivors, and loved ones and raise caution. In the spirit of spreading awareness on Testicular Cancer in India, we will be talking about fertility preservation options for patients who have been diagnosed with testicular cancer.

Different types of cancer affecting men is on the rise all over the world. Thankfully, testicular cancer has one of the highest curable rates with 99% for Stage 1 treatment where the cancer is contained to testicles and 96% for Stage 2 when it has spread to the lymph nodes in the abdomen. Testicular cancer can affect men between 15 and 45 years.

Types of testicular cancer in men

There are two types of testicular cancer. Seminoma can occur in all ages and aren’t aggressive. These can be treated with radiation therapy.
Nonseminoma occurs in the earlier stage of life and known to spread rapidly. There are different types of Nonseminoma cancer depending on the origin of cancer. An effective way to stop this type of cancer is with chemotherapy, as they are not very sensitive to radiation.

What is the cause of testicular cancer

Cancer that occurs in the testes, abdomen, or scrotal region can be due to:

  1. Genetic factor
  2. Cryptorchidism also known as undescended testicles. During birth or shortly thereafter, if the testicles are not descended from the abdomen, there is a high-risk factor for cancer.
  3. Hypospadias is a condition in which men are born with penis and urethra abnormality. There is a higher risk of testicular cancer in men who have Hypospadias.
  4. CIS or Carcinoma in Situ is a pre-cancerous stage with the presence of a large number of abnormal cells in the testicles. If this is left untreated, it could progress to testicular cancer.

There is no definite way of detecting testicular cancer. Usually an irregular lump in the scrotal region or severe abdomen and back pain might be indication of testicular cancer. Keep in mind, there are various reasons why lumps form in the scrotal region and it may not always be a cancer.

To be sure, we suggest a routine check-up with your doctor.

How does testicular cancer affect fertility in men

The testis is extremely susceptible to radiation waves and chemotherapy. Either of the treatment could target and kill dividing cells in the region and affect spermatogenesis resulting in damage of primordial sperm cells. This leads to oligospermia or azoospermia in the patients.

If you are a young male with future plans to conceive biologically, we suggest you think of alternative options like fertility preservation before undergoing cancer treatment.

Here are some fertility preservation options for men during and after cancer treatment.

Sperm freezing

Sperm cryobanks will give you options of freezing your sperms before going through radiation or chemotherapy treatments. The sperms can be kept frozen indefinitely and used when you opt to conceive through IVF.

If you are unable to ejaculate with sexual stimulation, you can try stimulation methods such as electroejaculation.

TESE

Testicular tissue cryopreservation is a treatment method suggested for boys who have reached puberty and men with azoospermia. It can also be tried in cases where you did not opt for sperm cryobanking before the treatment.

The process involves extracting tissue from the testicle and extracting sperms with the help of a biopsy. If there are sperms detected, they will be frozen until use.

Radiation shielding

During radiation treatment, special shields are placed over both the testicles to reduce the damage to the cells in the area. This might help to a certain extent and protect the cells against radiation and chemotherapy.

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