Testicular cancer

For young men, talking is key to early detection of testicular cancer, UM expert says

 

Special to the Miami Herald

Self-examination of the testicles might be easy enough for most men. Going to a doctor to report that they found something—that’s a whole different issue.

Testicular cancer affects about one out of every 270 men, and is most common in men ages 20 to 35, according to the American Cancer Society.

Spending a couple of minutes in the shower feeling for any hard lumps, once a month, can help with early detection, says Dr. Bruce Kava, associate professor at the University of Miami Miller School of Medicine.

If detected early, patients often need just a single surgery called Retroperitoneal Lymph Node Dissection (RPLND) to remove the affected testicle and lymph nodes, Kava said.

Ninety-nine percent of men who are diagnosed early and undergo this treatment are completely cured. Doctors are now able to preserve sexual function during this procedure, although it can still impact fertility.

Two Miami natives, David Gandell and Frank Andrews, were not so lucky. They were diagnosed late, after struggling for months to talk about their health issues. Their obstacles were different, but they shared a common problem: It was difficult for them to open up about their sexual health.

“When you find something wrong with it, you feel your manhood is gone,” said Gandell, who watched his testicle rapidly grow over eight months before seeing a doctor in 2004.

A frequent blood donor, Gandell thought screenings for donors were good substitutes for doctor visits and hadn’t seen one in years. As a 29-year-old model and fitness trainer, he took the praise he received for maintaining his external physique as a sign of good health, he said.

“I knew there was something wrong. Everything in my mind told me what it was. But I started telling myself, ‘It’s a hernia, it’s a bump, okay maybe I rode the bike the wrong way,’ ” he said.

As much as he tried to keep it a secret, anxiety about his problem began taking a toll on his health and relationships. His boss noticed his constant unease, and told him to take some time off to get checked out. He did, and what followed was a long journey through 98 treatments of chemotherapy and a number of major surgeries.

In remission for seven years, he now works as a motivational speaker and life coach, sharing his story across the country in the hopes of giving people a way to start difficult conversations.

“It becomes an open conversation when it’s about someone else, and not about you,” he said.

Just as women have had success in campaigning for breast cancer awareness, Gandell believes the same can be achieved for men’s sexual health issues. He cites professional cyclist Lance Armstrong, who also survived testicular cancer, and his LiveSTRONG campaign as a source of inspiration even after he admitted to doping in 2012.

Frank Andrews, a former resident of Key Biscayne and an active surfer, still finds it difficult to talk about sexual health with most of his male friends.

“It has to do with the stigma,” Andrews said. “It’s our machismo that over time has been engrained in the way of our social norms. We have to be that strong.”

Andrews was 29 when he first felt something unusual on his testicle and decided to be proactive. After getting hit by a board in a surfing accident, he went to a doctor to get checked out.

Over the next two years Andrews was misdiagnosed by three different doctors. His main symptom was a worsening abdominal pain that eventually left him bedridden with the overbearing sense that death was not more than a year away.

His doctors sent him away with antibiotics and painkillers. It was only when his sister set up an appointment for him with a specialist that he received a proper diagnosis and treatment.

By then the cancer had wrapped around several major organs. In addition to months of exhausting chemotherapy and three major surgeries (including one lasting 17 hours), Andrews sacrificed his dream of finishing a master’s degree in film production at the Savannah College of Art and Design.

“One thing I really learned from all this that I tell everyone trust your body, and when you feel something is wrong don’t take no for an answer,” he said. “If I had gone the extra mile about six months before, it would have made a world of a difference.”

Unlike Andrews, most men who feel a lump will not seek medical advice, said Kava, who performed the procedure on both men.

Testicular cancer is very curable. Advances in technology are allowing patients who detect early enough to avoid the harmful effects of more intense treatments such as chemotherapy and radiation, Kava said.

“Over the last 30 years, even though there’s still denial, studies show men are coming to us earlier than they used to,” Kava said. “But it’s still not good enough.”

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