Max's oncologist informed him that he would need to be treated with 2 cycles of chemotherapy. Each treatment cycle would last for three weeks.
- 37. How does standard chemotherapy work?
- 38. Why are cancer cells more susceptible to chemotherapy than normal cells?
- 39. Are normal cells affected by the use of chemotherapy?
Chemotherapy drugs are selected based on their effectiveness against the type of cancer. Max's testicular cancer will be treated with BEP (Bleomycin, Etoposide, Platinum also called cisplatin). Because chemotherapy drugs also damage normal cells, there are side effects to these drugs. Click on the following links to explore side effects of these 3 drugs (you may need to scroll down the page):
- 40. List common side effects from BEP.
Before starting chemotherapy, Max's doctor discussed sperm banking. Chemotherapy medications may lead to infertility. The oncologist explained that 80% are still able to father a child following testicular cancer chemotherapy. Twenty percent, however, are infertile. Max was referred to a fertility clinic that would freeze and store his semen samples. In the case of infertility, these samples could be used for artificial insemination in the future.
- 41. How long will a frozen semen sample be stored?
Max had a tough six weeks with the chemotherapy treatments. He was grateful it wasn't longer and was pretty sure if cancer didn't kill him, the chemo would. A week following his last treatment his serum tumor markers were again measured. Tumor markers are followed to see if the cancer is responding to treatment. Markers are usually not measured until at least two cycles of chemotherapy have been completed.
See: How Can We Tell if Chemotherapy is Working?
- 42. What is the difference between a complete response, a partial response, stable disease, or disease progression?
Max's received good news when his tumor marker results came back within normal range. Abdominal and pelvic lymph nodes on CT scan now appear normal in size. If the lymph nodes were still enlarged, the oncologist may have considered retroperitoneal lymph node dissection (RPLND).
Image of retroperitoneal lymph nodes (scroll about halfway down the page).
- 43. What side effects may occur with RPLND?
Max is now cancer free. He is advised to continue performing monthly self-testicular exams on his remaining testicle. Max will follow up with his doctor once a month for the first year following cancer. These appointments will then drop to every three months and then every six. His blood will be drawn to assess tumor markers, and X-ray and CT scans will be performed. Cancer cells are good at hiding. If any escaped the chemotherapy, cancer may come back. However, testicular cancer is one of the most curable cancers. If the cancer is contained within the testicle, the 5-year survival rate is 99%. With a stage II cancer like Max had, the 5-year survival rate is still 96%. Even if cancer had metastasized to the lungs or other organs, the 5-year survival rate is 74%. Max feels good about his odds. He's happy he caught cancer early and hopes to live a long and productive life.
Author Note: You may have wondered if Max's cycling had anything to do with his testicular cancer. The professional cyclist Lance Armstrong also had testicular cancer that had metastasized to the lungs and brain. For the male cyclists, you will be relieved to know that there have not been any studies that have shown a strong correlation between cycling and testicular cancer.