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    Battling Testicular Cancer

    Though curable, testicular cancer is often ignored by men who have it.

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    Nevertheless, he underwent an aggressive course of treatment: surgery to remove the affected testicle and to debulk tumors in his brain, and chemotherapy. A year later, Armstrong was pronounced cancer free.

    Uzzo and others hope celebrity cases will not only alert young men about testicular cancer but also convince them to begin performing self-examination so they are familiar with the size and feeling of their testicles and will be more likely to detect subtle, early changes. But if a study done at the University of Hiddersfield in England and appearing in the September 1999 issue of the European Journal of Cancer Care is any measure, most men still don't know much about the signs, symptoms, or risks of this cancer.

    In the study, researchers found that an overwhelming majority of the 203 male undergraduate and postgraduate students (20 to 45 years old) interviewed about testicular cancer either were uninformed or misinformed about the disease. More worrisome to researchers was the fact that only one man in the study group knew how to properly perform a testicular self-exam and actively practiced the procedure.

    Today, "I think there is an increased awareness because of the high profile cases," Uzzo says.

    With cure rates so high, attention is now being directed to improving treatments. Specifically, doctors would like to find ways of minimizing risks to a patient's fertility. A position paper by the National Cancer Institute indicates that many (though not all) of those undergoing chemotherapy can sufficiently recover sperm production to allow a patient to father a child. Similarly, radiation treatment for spread of certain types of testicular cancer can cause fertility problems because of radiation spillover to the remaining (normal) testicle, but again, this may resolve in some patients. Fortunately, in both circumstances, if fertility recovers, there appears to be no increased risk of birth defects as a result.

    Of course, there is no way to predict in advance who might be infertile. "Any cure can affect fertility," says Uzzo, noting that most patients bank their sperm before undergoing treatment. "While the No. 1 goal is to cure the patient of the disease, we are now concentrating our efforts on decreasing the morbidity of the types of treatment offered on fertility and minimizing any [problems] associated with chemotherapy."

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