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A Young Man Faces Testicular Cancer

Why it's so serious.
By Erik Strand
WebMD Feature
Reviewed by Craig H. Kliger, MD

Aug. 7, 2000 -- I was 23 years old and invincible. Or so I thought. Then one day, playing softball in a suburb of Chicago, where I live, I got kicked in the groin by the nice guy playing shortstop. When I checked myself out in the shower later, I found what felt like a ball bearing inside my right testicle, as if one end were hardened.

So I did what most guys would do: I put it out of my mind. Or tried to. I couldn't believe it was anything serious. My wife and I had just married. We were closing on our first house. I was in the third month of a new job. Everything was going great.

Then I noticed the testicle was getting larger. Finally I made an appointment with my primary care physician -- and started what turned into a five-month battle.

The visit with my doctor took exactly 20 minutes. He set up an appointment with a urologist the next day who examined me, looked me in the eye and said, "You're a smart kid. I'm glad you came to see me."

When results from a blood test and an ultrasound came back, the urologist sat down with my wife and me and gave us the news: There was a 95% chance I had cancer. Getting kicked in the groin during the softball game hadn't caused the disease, of course; it had just prompted me to check things out in time to catch the tumor, which was already there. The testicle had to be removed right away, the urologist said. I couldn't believe my ears.

Just like that, I had become part of a trend: I had likely been stricken with a form of cancer that has, over the past three decades, increased in frequency an astonishing 60% (according to the U.S. Centers for Disease Control and Prevention), striking mostly young men like me. The doctor probably told me that it was a very curable cancer, but I was in such a state of shock, I could barely understand what he was saying.

That next Monday -- just after moving into our new house -- I went in for surgery. I was home that afternoon, with a huge bandage on my crotch and a gigantic ice pack in my pants. The procedure, called an orchiectomy, involves removing the testicle through an incision in the groin. A week later the biopsy report came back: "Nonseminomatous mixed germ-cell tumor primarily consisting of embryonal carcinoma."

In other words: Cancer.

Luckily, the report said the cancer hadn't spread to my lymph nodes or bloodstream. Even so, I was faced with a tough decision. I could watch and wait to see if the cancer was truly cured. Or I could undergo what's called a retroperitoneal lymph node dissection, or RPLND. In short, a surgeon opens you up from below the navel to the middle of your chest, lifts your internal organs out of the way, and removes all the lymph nodes that could be cancerous if the tumor has spread.

The prospect terrified me. But so did the idea of doing nothing.

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