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    Testicular Cancer Cure Poses Problems

    Too Much of a Good Thing continued...

    Fossa says she believes that most men with early testicular cancers are overtreated, especially if they have tumors known as seminomas, considered to be less aggressive cancers. Seminomas account for about 40% of all testicular cancers.

    "I think we overtreat 80% of stage I seminoma patients," she says. "They don't need radiotherapy, but they are getting it. These patients can be watched very carefully and they will do fine. But that is not a very popular notion in the United States."

    It is the approach, however, that appealed to testicular cancer survivor Doug Bank when he was diagnosed a decade ago. Even though he had the type of tumor considered to be more aggressive, Bank said his own research convinced him that surgical removal of the affected testicle and close observation was all he needed.

    "My doctor didn't know what he was talking about," he said. "He suggested a treatment protocol that hadn't been used in a decade. If I hadn't done my own research, I might have gone through with it."

    Bank, who is now 36, says he decided against the lymph node surgery due to concerns about infertility. He made this decision after reading 80 articles on the subject and getting six other opinions. He now runs a web site devoted to informing testicular cancer patients about their options, and he is the father of three.

    Testicular cancer specialist David J. Vaughn, MD, agrees that the long-term health effects of testicular cancer treatment need study. But he says there is a danger that less aggressive treatments would result in more patient deaths. Vaughn is an associate professor of medicine at the University of Pennsylvania and runs a program on living well after cancer, sponsored by the Lance Armstrong Foundation.

    "I have great concerns about the potential late effects of treatment, but I would also have great concerns about compromising therapies," he tells WebMD. "Testicular cancer is one of the big victories in oncology, and, in my view, it is dangerous to think about doing anything that would potentially compromise cure rates."

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