Preserving Fertility During Testicular Cancer

While cancers in the reproductive system affect women, men too are not spared of developing one in their respective reproductive organs. Acknowledging this fact has well instilled the need to look into the possibilities of preserving fertility amid the diagnosis of testicular cancer by considering relevant options existing there. However, understanding what testicular cancer is, and what its causes and symptoms are need to be analyzed in the first place.   

Testicular Cancer – Causes And Symptoms

What is Testicular Cancer?

Testicular cancer refers to the abnormal cell growth starting in the testes. Being considered the second most common type of cancer occurring in young men, say between age 20 to 39, it is, from a general perspective, regarded as quite uncommon. The rarity of this kind of cancer is what makes it to be classified as Seminoma and Non-Seminoma testicular cancer. While the former develops more gradually, it is often diagnosed in men aged between 25 and 45.

On the other hand, the one that is more commonly found in young men comes under the non-seminoma cancer type. Surprisingly, those as young as in their adolescence have been found to develop non-seminoma testicular cancer. Even despite the disease being rare, testicular cancer occurrences were known to come to more than 1000 cases in early 2023 per estimates, the average age of diagnosis being 36 years. Nevertheless, it must be worth pointing out here that only about 1 in 250 people develop testicular cancer. Fortunately enough, the disease is curable, and only a few people die from it, precisely to mention, more than one in 5000.

Since any form of cancer is curable when it is diagnosed and treated early, so is it with testicular cancer, which should be as well.   

What Causes Cancer in the Testes?

Testicular cancer is caused by germ cells that form in one’s testicles. These clump together to turn into a mass/tumor. While it is these germ cells that otherwise eventually develop into sperm, the mass generated from the coagulation of these sperm also helps determine whether it is a seminoma or non-seminoma type of testicular cancer, where the former develops slowly and the latter instantly as was explained above.

Risk Factors of Testicular Cancer

Besides germ cells causing testicular cancer, the other factors leading to testicular cancer have mostly included those originating from environmental, genetic, and hormonal factors. Of note, causes coming under each of these factors have been presented in a table format as shown below:

Signs And Symptoms Of Testicular Cancer

A painless lump has been identified as the primary sign of testicular cancer. Whereas, symptoms include the following:

• Swelling characterized by sudden fluid build-up in the scrotum.
• Lump/swelling in either testicle.
• A feeling of heaviness in the scrotum.
• A dull ache in the groin or lower abdomen.

While the above-listed symptoms may present in the early stages, these doubtlessly necessitate a physician consultation, lest these will lead to more advanced forms, such as:

• Pain and discomfort either in the scrotum or testicle.
• Shrinking testicle/s or testicular atrophy.

Possibilities Of Fertility Post-Testicular Cancer Diagnosis

The chances of male fertility begin to decrease when testicular cancer is diagnosed. This is despite one of the testicles remaining intact or unaffected by the disease. Nevertheless, there is still hope for men who have one of their testes safe, provided that the one other testicle affected by cancer is removed as soon as possible to avoid the chances of spreading. This will mandate the removal of the affected testicle, lest it will be impossible to retain fertility if both the testicles have developed cancer and are subject to removal.

The question that may pop into one’s mind is, “whether treatment for testicular cancer affect fertility rate in men?” Answering the same depends on the overall health and the size and shape of the tumor. Since each of these accounts for individual factors, there also exist more general ones, including surgery, chemo/radiation therapy, or a combination of either two or three of these. Thus, chances for retaining fertility are undeniably reliant on these aspects, not to exclude the individual determinants.

It must be emphasized here that once a patient has had surgery to remove any of the testicles in the event of testicular cancer diagnosis, and where this may or may not be followed by chemo/radiation, chances are that male fertility will be impacted to a significant extent.

The only relieving thing to mention here is that unless chemo/radiation therapy is solely indicated, one may permanently become infertile. This fact in itself is enough to provide hope for those who need not have their testicles removed, but only undergo the stated therapy. Yet another statement that adds to the possibility of male fertility in this case is that men can only experience temporary infertility post testicular cancer treatment that only involves chemotherapy or radiation therapy.

The case with radiation therapy is that the unaffected testis will be shielded from harmful radiation due to the high-energy waves utilized there. Thus, as long as the unaffected testicle remains intact, fertility is retained/preserved.

Having had a thorough discussion on the possibility of regaining fertility after testicular cancer treatment, it could be stated that only those men can consider fertility preservation options who have required chemo/radiation therapy to treat their testicular cancer. Accordingly, the various options to preserve fertility in this category will be mentioned in the upcoming section.

Different Fertility Preservation Options In Testicular Cancer

As per expert recommendation, it is always safe to consider preserving one’s facility before proceeding with cancer treatment. This fact applies to both men and women. In light of this knowledge, two major options have been considered most appropriate. To date, these have included:

• Sperm Cryopreservation: Sperm freezing and storing in a fertility clinic or sperm bank is carried out in this option. This method facilitates storing live sperm for years and can be retrieved when required.
• Radiation Shielding: This procedure involves placing small lead shields over the unaffected testicles to protect them from high-energy radiation beams.  

Conclusion

Testicular cancer, though rare, presents as one of the most concerning factors affecting male fertility. As implied from the discussions carried out so far, a man may or may not regain fertility even after undergoing only chemo-cum-radiation therapy, not to mention surgery that will require one or both testicles to be removed depending on the cancer size and spread. The only way to retain one’s fertility would be to consider fertility preservation options before undergoing surgery or chemo/radiation therapy as deemed medically.