I like to think of myself as somewhat of a testicular cancer research liaison. In this self-appointed role, I seek out and read new research about the disease, while attempting to actually understand it. In some cases, I reach out to the researcher for further explanation, which often leads to even deeper insights. From there, I like to summarize the findings and bring it to the masses in an easily palatable manner.
Recently, I stumbled upon a new research study entitled “Neurotoxicity Among Survivors of Testicular Cancer: A Population-based Study”. In the far off land of Canada, researchers wanted to determine if cisplatin-based chemotherapy had an effect on neurotoxicity in cancer survivors.
In the 1970s, Dr. Lawrence Einhorn added a new chemotherapy drug called cisplatin to testicular cancer treatment. This addition transformed testicular cancer from a death sentence to nearly a fully curable cancer. However, about forty years later, later-term effects are now popping up as survivors age.
I personally was dosed with three rounds cisplatin (a total of 15 doses) and am always curious about what to expect on the road ahead. Since I continue to struggle with short term memory issues, my ability to focus, and some word retrieval, I thought this study may answer some of my questions. Afterall, neurotoxicity sounds like it has to do with diminished brain function.
Turns out neurotoxicity actually has more to do with pain, numbness, or tingling in the extremities, which is actually a side effect I do not have… yet.
In simplest terms, the researchers tracked 2,650 cases of testicular cancer between 2000-2010. While all of these patients underwent the removal of half of their family jewels, roughly 920 also received chemotherapy.
These two cohorts (surgery only versus surgery and chemo) had their doctor’s visits for neurotoxicity-related reasons (including visits for leg cramps/leg pain/joint pain/etc) tracked both before and after their respective treatments.
The non-chemo group essentially had no difference between doctors visits with two testicles versus one. Two years prior to diagnosis, about 18% of the patients met with a doctor for related symptoms, and this percentage held steady two years after their surgery.
However, in the chemotherapy group, there were substantial differences.
Depending on the amount of chemo the patient retrieved, visits increased anywhere from 10% to 20%. Essentially, the higher the amount of chemo, the greater the increase.
Specifically, survivors who underwent four rounds of chemotherapy went from 17% prior to diagnosis to 37% after. Three round survivors increased from 17% to 28%. As a guy who danced three rounds with the chemo devil, I’m happy to find that it’s only a one in four shot in experiencing it. I’m even happier that I managed to be one of the lucky three.
So what does this mean for testicular cancer patients and survivors?
The most important takeaway is that men facing cisplatin chemotherapy for testicular cancer must be made aware of this potential risk. My own oncologist made sure I understood this possible side effect before I began my regimen, but not all men are given the same level of care.
This is especially critical if a man is to undergo four rounds. In the study’s own words, “there seems to be a clinically significant increase in neurotoxicity between three and four cycles of chemotherapy.”
Unfortunately, there does not appear to be a way to effectively prevent or treat nephrotoxicity from cisplatin. Furthermore, the closest replacement drug for cisplatin, carboplatin, is not nearly as effective in preventing relapse or death from testicular cancer.
Nonetheless, the researchers are working to “identify effective strategies for the prevention and management of this common late effect of chemotherapy.”
For the average man, there’s one thing to be made clear here.
While testicular cancer is highly curable, it’s often unpreventable. However, you can lessen the likelihood of needing chemotherapy by performing bit.ly/absotselfexams If you catch it early enough, a simple surgery may be all you need, entirely forgoing this neurotoxicity issue.
Best done during or after a shower when the scrotum is relaxed, a self-exam is a quick and effective way to catch testicular cancer early on. Just place your index and middle fingers under the testicle with your thumb on top. Firmly but gently, roll the testicle between your fingers. Any weird lumps or bumps should be checked out by a doctor ASAP. When you get out of the shower, be sure to look for signs of changes in shape, color, or swelling.
To sum it all up, to avoid chemotherapy-induced tingling in your arms and legs, make sure you give your balls a good tickle once a month.
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