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Remove or keep testicles

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  • Remove or keep testicles

    My son is 37 years old. In Jan he was diagnosed with extragonadal germ cell tumors in his abdomen and chest. There was no cancer in the testicles The Dr said he thinks it may have started there and died off since the ultrasound shows calcification in both testicles. He has undergone the 4 rounds of chemo that is protocol and the tumors have continued to shrink. The last MRI shows the abdomen tumor has shrunk by almost 75%. He has surgery scheduled in 2 weeks to remove that tumor. The lungs will be done in a second surgery. He is meeting with his surgeon later this week to discuss the surgery. They are recommending removal of both testicles. Of course we have concerns about that and since there is no cancer there I'm not sure it is necessary. They are saying that calcification is a precursor to cancer and it could return if they are not removed. As anyone who had no cancer showing in the testicles not had them removed?

  • #2
    What does your son think?

    Being without testicles is not the end of the world, especially if you don't plan to ever father more/any children. Hormone replacement can take care of any hormonal issues. Extragonadal tumors are already tricky to treat. I would perhaps contact some TC experts in this scenario, as it is not a common one.
    6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
    6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
    7/7/15: bHCG 56, AFP 42, LDH 322
    7/13/15 - 9/18/15: 4xEP
    10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
    10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
    4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
    4/20/16: RPLND @ IU - teratoma only!
    3/29/2018 all clears up to this date!

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    • #3
      Cancer attacked my healthy one many years ago. The remaining was non functional and shown to have minor calcification. I had to take testosterone and was shown to be sterile (Nice double whammy with the cancer diagnosis ). MANY MANY years later it (the non functional slightly calcified one) got more degenerated and developed cancer and was removed. So I guess I am an exampled of this prediction - but it took a long time to develop cancer. Has your son had sperm tests, and testosterone tests ? Is he producing any ? If they are "Dead" them removed. Get implants to restore appearance.
      "More human than human is our motto...."

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      • #4
        No there has been no testing for any levels. There was only an ultrasound done. He is meeting the surgeon tomorrow and would like to keep one but on the other hand he doesn't want to go through this again. It is difficult to know what to do when nothing is being explained that well. Thank you both for your input

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        • #5
          Email Dr E & get his thoughts, since your docs aren't very helpful. Even on this forum, we have only seen a few cases of extra-gonadal tumors so afraid this is pretty rare & you should get an expert's opinion before making decisions.

          Dave
          Jan, 1975: Right I/O, followed by RPLND
          Dec, 2009: Left I/O, followed by 3xBEP

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          • #6
            It may be worth asking for a repeat scrotal ultrasound and have the results reviewed by Dr. Einhorn as mentioned. There is the possibility of a burnt-out tumor in the testis but for there to be one in both testicles at the same time to me would be freakishly rare. Calcifications on their own do not necessarily lead to cancer in the future although it is possible. I would want to know the extent of the calcifications as they are not really considered a precursor to testis cancer but I have no idea how extensive they are, etc.

            Mike
            Oct. 2005 felt lump but waited over 7 months.
            06.15.06 "You have Cancer"
            06.26.06 Left I/O
            06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
            06.30.06 It's Official - Stage I Seminoma
            Surveillance...
            Founded the Testicular Cancer Society
            6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

            For some reason I do not get notices of private messages on here so please feel free to email me directly at mike@tc-cancer.com if you would like to chat privately so as to avoid any delays.

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