Testicular cancer can be cured

By Bruce Emond

JAKARTA (JP): Unlike breast and skin cancers, testicular cancer rarely makes news.

An exception was when cyclist Greg LeMond returned from his own battle with the disease to win the Tour de France. The highlight of the American's recovery was when his wife gave birth to a child after LeMond's cancerous testicle was removed.

Although it is little known, testicular cancer is the most common cancer among young men; however, it is often successfully treated if detected early.

"Testicular cancer has a lower incidence in Indonesia and other Asian countries than in the West, but it is still the most common cancer among men aged 15 to 35," said urologist Dr. Rainy Umbas of the Dharmais Cancer Hospital and Cipto Mangunkusumo Hospital.

He believed the difference in incidence could be connected to more frequent use of estrogen by pregnant women in the West, although the exact causes of the cancer were not known.

"At the moment, from the data we have compiled from Dharmais and Cipto, we see about 10 patients a year with the cancer," Rainy said.

However, he did not discount the possibility of misdiagnosis or the incidence of the cancer increasing as Indonesians adopt more western-oriented lifestyles.

A urologist from Medistra Hospital in Bekasi said the incidence of the cancer appeared to be much lower than other cancers of the male reproductive and urinary organs which tended to strike men in later life.

"I've seen cases of cancer of the prostate and the urinary tract, but in my five years here I have yet to see one of testicular cancer," he said.

Rainy said the significant aspect of the cancer was its treatability if caught early enough.

"Perhaps it's the one cancer that can be almost completely cured if caught at an early stage. Treatment often involves removal of the cancerous testicle," he added.

Even in former cancer patients with only one functioning testicle, Rainy said "up to 70 percent" would still be able to father children. "Of course there will be a reduction in sperm quantity when you remove one of the testicles but there is still the likelihood of having children."

Key to treating the disease, he added, was recognizing tell- tale symptoms.

"We need to inform the public about this disease so men know how they can recognize the signs. Testicular cancer, like breast cancer, can be caught through self-examination."

Rainy advised men to conduct regular self-examination of their testicles to be able to recognize changes in size and shape. It should be done at a particular time, such as when taking a shower.

He said symptoms included: * a persistent swelling in one testicle; * a feeling of discomfort in the testicles; * one or both of the above symptoms accompanied by a dry cough and/or swollen lymph nodes, which could be indications that the cancer has spread.

Other diseases, including bacterial infections and sexually transmitted diseases (STDs), can cause similar symptoms so it is important for doctors to rule them out.

"Examination and blood tests can determine if it's testicular cancer. What doctors need to keep in mind is that testicular cancer is a possibility with such symptoms," Rainy said.

A nurse at an English hospice said treatment of the cancer, even if successful, could kill sperm production. "I would advise men with the cancer to freeze their sperm before any treatment, especially if it involves radiation."

She warned patients who have gone into remission after cancer treatment not to assume they were clear of the disease. She told of having patients with terminal cancer who had conquered testicular cancer when young.

"The amazing thing about cancer is how it often crops up in other parts of the body later on. We had one man come in with lymphoma, he was about 36 and had had testicular cancer when he was in his 20s. He was a keep fit fanatic but the cancer returned in another part of the body, which is the interesting thing about this disease.

"Of course, it's not interesting if you are the one with it."