Staying Aware With Self-Checks After Surviving Testicular Cancer

Matt Froestad was a sophomore in college when he received his first testicular cancer diagnosis. Two years later, as a senior, it happened again.

He was always taught to perform self-exams and seek help if anything felt off, so that is what he did in 2009 when he found a lump on his right testicle. A urologist told him the only way to be certain it was cancer was to remove the testicle and do a biopsy, so he was scheduled the next morning for surgery. The stage 1a testicular cancer was caught early, and Froestad started a surveillance plan.

“After that first diagnosis it was definitely a shock that I — a relatively healthy, active 20-year-old in college — could get cancer,” he recalled in an interview with Heal®. He was fortunate enough to not receive chemotherapy or radiation and was able to lead a healthy lifestyle afterward.

“But always in the back of my mind was that I had cancer, and I kept an eye on the other testicle, probably a little closer than I did previously, just knowing that there was a chance that could happen again,” Froestad said. In his case, remaining vigilant was the right choice.

Understanding Cancer Recurrence

Dr. Shawn Dason, a urologic oncologist at The Ohio State University Comprehensive Cancer Center, Arthur G. James Cancer Hospital in Columbus, explained in an interview with Heal ® that recurrence in testicular cancer survivors is dependent on the staging of their first cancer and the risk factors. It’s important to talk with their oncologist to understand the risk. Depending on the individual, risk of recurrence could be low as 1% or as high as 50%.

“I think really the first thing is to have that conversation with their oncologist … to understand what their individualized risk is because it could basically range from very, very limited to very, very likely. And if it is very, very likely, that could be important (to know) in making (a survivor) want to get any kind of symptom properly addressed if (they) were to have it,” he said.

However, many survivors are still unaware they may be at risk for cancer recurrence, he added. Froestad said, “I didn’t know necessarily that it was possible, but it was.” He was a senior in college when he felt some pain and swelling over his left testicle during a self-exam and decided to call his urologist. The doctor gave Froestad a diagnosis of epididymitis (swelling around a tube at the back of the testicle), prescribed antibiotics and told him he would see him in a month.

After a month the swelling went down but the pain remained, Froestad said. He was scheduled for an ultrasound, during which growth in a mass was identified. His urologist was reluctant at the time to schedule another surgery, so he advised Froestad to get a second opinion near his home in Virginia.

The second doctor reached the same conclusion as earlier: The only way to be certain it was cancer was to remove the testicle. Froestad was scheduled for surgery two weeks later, and found out he again had testicular cancer. Prior to the surgery, he was able to “bank some sperm and get other things in order before going under the knife.”

Staying Educated and Aware

Dason recommends that testicular cancer survivors stay educated on recurrence, keeping up with regular followups, screenings and self-exams, as well as remaining vigilant about new symptoms. Unfortunately, he said, many survivors do not follow up.

“I definitely think there’s not enough awareness,” Dason said. “And you know the reason I say that is a lot of patients, I find, get lost to follow-up.”

He explained that because this patient population is younger, common life activities include moving, getting a new job, continuing education or starting a new relationship. Consequently, fewer patients return for follow-ups and necessary testing after surviving testicular cancer.

“I think it’s definitely something that, if we had more awareness that this is something that’s curable as long as we find it early enough and treat it appropriately, could make a big benefit in improving outcomes in these patients,” he added.

Most commonly, if a testicular cancer survivor receives another cancer diagnosis, it would involve the abdomen, which is harder for individuals to detect, Dason explained. Such discoveries really come from imaging, which is why follow-ups are important, he said. However, some symptoms to watch for include abdominal pain, back pain, gastrointestinal issues, difficulty eating, nausea, vomiting, constipation and indigestion. “It’s so critical that these people who have a previous diagnosis of testicular cancer know about recurrence because we approach cancer of the testicle as curable until it’s not,” he said.

Froestad, now 32, welcomed his first child this past December. He agrees with Dason and knows that because of his self-exams, he was able to notice something was off and catch the recurrence.

“I would probably just say continue to be proactive,” he said. “I will say, yes, having a cancer diagnosis is a blow … but it’s important to remain active … eating healthy — not to say I’m the healthiest eater either — but remain active to keep that balance and just continuing to have those regular appointments with your doctor and advocating for your health.”

Dason reassures patients that testicular cancer typically has a good outcome, and although recurrence can be hard emotionally and physically, there may be a brighter side.

“The outcome of most patients with testicular cancer is very good, even if you (received a diagnosis of ) a recurrence. It’s obviously very psychologically taxing and an emotional situation, but we usually have very good treatments that can get you over that,” he concluded. “The biggest thing is to have that perspective … there hopefully will be some light at the end of the tunnel, even (though) for some patients this is a second tunnel in the event of recurrence.”

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