When a patient has suspected testicular cancer and presents for their initial evaluation, the physician is generally going to do an examination to examine the testicle. They will often draw some lab work, some blood work, where we evaluate for what are called the testicular tumor markers. We're looking for certain proteins that can be produced by testicular cancer, things such as LDH, AFP or alpha feta protein, or beta HCG. These are the tumor markers that we look for.
In some cases, we may do further evaluation with ultrasounds of the scrotum. And often we will do imaging tests, such as CT scans of the abdomen and pelvis. And sometimes of the chest or even the brain to see if there's any spread of the cancer.
But, throughout this process, it's very important to stay in touch with your physician and to know exactly why a physician is doing all of the things that they're doing. It's important to ask questions along the way. For example, you should be advised about the possibility of banking your sperm. Because, that is actually, your sperm can be affected throughout some of the treatments that we have for testicular cancer. So make sure you talk to your physician about sperm banking.
Other questions to ask would be, 'What is the type cancer that I have? What is the grade of the cancer that I have? What is the stage of the cancer?' These are all important determinants of what some of the treatment options are.
When you are presented with all of this information, then your physician should also talk to you about the options for therapy. Because, in many cases, it's not just one thing that has to be done. You may have choices. You're going to have a choice of monitoring. You may have a choice of having chemotherapy. Or, you may have a choice of having surgery. These are all very different treatments.
And when you make the selection for one treatment, there are potential consequences of that decision. So, you want to be informed about what the various are. What the pros and cons are, of each of the options. And then use that information to your advantage to make the decision that is best for you.
No matter what, it's also important to understand how to closely monitor your cancer. No matter what treatment you have all testicular cancer patients are monitored quite closely. You want to ask, 'What type of surveillance protocol am I going to need. How often do I need to get certain tests done over the next few years? How long do I need to follow my cancer before I know it's gone? What are my chances of recurrence? What are the odds that I'll have recurrence of disease? What are the odds that I will have or require additional therapies?' These are all important questions to have in mind when you go to see your physician.
Your physician may not be able to answer all those questions right up front. Because, some of these decision processes occur as you get more information. But, just be prepared to talk to the physician and make sure you try to understand the disease process and understand the rationale that the physician is taking in your treatment.