What causes TC and is my son likely to get it?

[bucky]

Now that I am in the midst of dealing with this ****ty cancer, does anyone have any info on what causes this type of cancer and what are the chances of my son developing it in the future? My wife and I were considering to have another child when all of this settles down but are scared in case our son has to go through this hell I am right now.

[Paul54]

Bucky,
That's a really good question I've asked myself many times. First, how did I get it with nil family cancer history limited to non-TC's in distant relatives in their 80's. Second, how likely is that my 3 younger brothers and 8 nephews on my mother's side will get it? My two sons are adopted so they fall into the general population of random events.

I have read everything I can find on this, and call upon college courses in anatomy, physiology, embryology, genetics, statistics and probability. All cancers have as a root cause a cellular mutation, so the question is what causes that? And with TC, there are so few cases relative to the population that it's difficult to build a statistically significant (meaningful) case for any one cause. TC is probably caused by several things.

In my own mind, I lump cancer causes into 5 main catagories:
-Genetic or chromosomal defect. This is much more evident in many female cancers, but there are enough cases of father-son, brother-brother, uncle-nephew, and cousins that this is somewhat likely for TC.
-Environment. Exposure to chemicals which either by themselves are carcinogenic or when combined get through the blood-testis barrier or pass from mother to fetus (called teratogenic).
-Radiation. Radioactive isotopes many of us or our parents have been exposed to including atomic bomb test fallout, water and air radon, and industrial waste. Could also be electromagnetic but many of these have been researched and ruled out (so far) including radar guns, microwave ovens, cell phones, high voltage transmission lines, and TV and monitor screens.
-Viral. Some types of cervical cancer, for example, but never heard this associated with TC.
-Completely random event not caught in time by your immune system.

I believe my TC was triggered at my somewhat high-than-average age by long-term exposure to a huge variety of chemicals starting with my chemistry set when I was 7 right through industrial plants I've been through, insecticides, pesticides, herbicides, electronics PCB's, paints, stains, cleaners, 10 years as a volunteer firefighter, and on and on. Lots of those chems have been banned. It could also be that my mother was exposed at some point and she passed down an egg with a mutation. (She was an electrical engineer and worked with our share of German scientists after World War 2 for several years until conceiving me. God knows what they worked with).

That leaves purely genetic. I have found a couple of very limited studies that show links to a gene on an X-chromosome (female side). If true, are these also caused by environmental factors or are they truly random events? Who knows. Very sketchy data. In any event, this would factor into brothers, nephews, and cousins, not father-son.

So how about facther-son? I have not come across any research that points to a genetic defect on a Y-chromosome. That would steer me to believe that father and son(s) where exposed to the same or similar chemicals or elements. From where? A partial list might include agricultural, household, industrial emissions, water or air radon, landfill, and public or private water supplies.

Bottom line is that the stats say that sons, brothers, and nephews are 4-8 times as likely to get TC as the general population. But that's still a very low probability and undoubtedly reduced if living in different areas or having eliminated the exposures.

I don't know if this helps or not. It is rambling, but this was a good excuse to get some thoughts onto paper, so to speak.

[Mom]

We have struggled with this issue in our family. In our case my husband and our son both were diagnosed with TC. My husband had risk factors, my son, none. Still he got it. Jay had EC, Seminoma and teratoma; Jeff had EC and teratoma. I will never forget driving my son home from one of his bleo shots. He was feeling particularly sorry for himself. Finally, I asked him if he had rather not been born than go through TC. He looked at me like I was crazy. "Of course I am glad I was born!!" Don't deny a future son life or your joy in having him because of this disease. Dianne

[petep]

I would speculate that it is most probably dictated by genetics...

- the avg. age for tc, is quite young...less time for environmental exposure

- I do not recall the stat, but those with an undescended testicle are at a higher risk...and that is a genetic issue

- I have read in many places that tc cancer cases are increasing at a rate of 2% a year...most experts write they do not know why...it would seem to me pretty obvious...30 years ago and longer tc cancer patients died...now they enjoy some of the highest cure rates...and go on to have kids...darwin is losing out, to our benefit.

Often cancers are genetic, linked to a trigger...could be environmental or other...

All that said, I do know that after being diagnosed, I jumped in my car to drive home, and threw my cell phone in its usual spot, on my lap, in my crotch...and quickly took it away wondering???....

(RF energy - law of inverse squares...double the distance and "energy" goes down 4x....but if the transmitter is very, very close, you are getting most of the energy...its why cell phone mfgs always have a dislaimer to keep the phone at least 1/2" away from your body at most times....)

[S L]

Even if it turns out all TC cases are eventually found to have a genetic link, and the chances of a son developing TC are at the high end of estimates around 8X, the chances of contracting any of dozens of other cancers during a lifetime are enormously greater. And most of those have much greater physical impact and much lower survival rates. And with two teenagers, don't get me started about chances of motor vehicle accidents and fatalities. And more people perish from household carbon monoxide poisoning and fires than TC. Then cardiac, pulmonary, circulatory disease......... Not to be morbid, but life is a roll of the dice. Roll away.

Thank you for stating it so succinctly.

Steven

[Smartie]

Now that I am in the midst of dealing with this ****ty cancer, does anyone have any info on what causes this type of cancer and what are the chances of my son developing it in the future? My wife and I were considering to have another child when all of this settles down but are scared in case our son has to go through this hell I am right now.

Hiya Bucks.

If you are blessed with another son in the future, he will have a tiny risk of getting TC. Although sons of TC patients have an increased risk of getting testicular cancer, the risk is still absolutely minuscule. Try for a baby and celebrate life.

[Fed]

This thread brings me back to a discussion that has come up multiple times here. The bigger question is "what causes cancer to manifest itself?" A recent issue of Newsweek (from about three weeks ago; it has Winston Churchill on the cover) has an outstanding article by Robert Weinberg, an MIT professor who is arguably the most influential and highly respected cancer basic scientist, and Anthony Komaroff, a faculty member at Harvard Medical School. The article explores recent research on the factors that lead to cancer.

(Disclaimer: I'm now putting the "geek hat" on)

The manifestation of cancer is always due to a genetic defect. Like the authors say in the article, "cancer is a disease of malfunctioning genes." We have to be careful, though, how we use the word "genetic". Because the defects are genetic in nature, it does not necessarily mean that the defects are inheritable. This distinction is crucial, and it can lead to a lot of confusion, hence my emphasis. About 10% of all cancers occur in people that have inherited genes that put them at a greater risk for developing the disease, but having the necessary gene (or the mutation, for that matter) will not necessarily cause cancer to manifest itself. So far there is no scientific evidence that proves testicular cancer is inheritable. The fact that close relatives have it suggests that it could be, but it's not solid evidence.

The most common source of the mutations that lead cells to become cancerous are oxygen radicals produced during normal cellular processes like aerobic respiration. Cells have the machinery to fix these problems; if they didn't, everyone would be getting cancer at a very, very young age. Of course, there are other lifestyle habits such as smoking and unhealthy eating habits that could increase the odds of developing cancer (the Newsweek article also notes that only about 2% of cancers are due to environmental factors).

As far as TC is concerned, I believe it is widely accepted that the mutational changes that lead to the formation of TC occur in utero during embryogenesis and the early stages of fetal development, and I point as evidence the existence of extragonadal germ cell tumors. Nobody knows what makes these precancerous cells "wake up" when they do, and long ago I gave up on pondering why mine decided to go haywire sometime in the middle of 2006 (or possibly before): this is a task for the epidemiologists. On this note, if anyone here is offered the opportunity to participate in a study that delves into these issues, I highly encourage partaking in it. It won't provide the answer, but more data points can help develop hypotheses as to possible causes.

At this point in the game, I no longer delve into the "why?". The bigger concerns are 1) elucidating and eliminating the factors that can lead to cancer, and 2) how to find better treatments for the cancers we are not good fighting.

Going back to Bucky's original post: don't let your diagnosis of cancer preclude you from wanting and having another child. That next kid of yours will be proud to have a Dad who has fought this and, most importantly, not let the idea of cancer take over his life.

[petep]

and to paul54's point....despite the possible genetic link, with tc, the odds are so low of "passing" to a son....

time for me to ht the hay....i'm taking my son out fishing tomorrow....6am wake up call....3.5 hours of sleep...ouch...

pete