Ep. 88: The Ballgame That Can Save Your Life

Testicular cancer is a disease that can hit you at any age but the average age at diagnosis is only 33. One man is diagnosed with testicular cancer every hour. 470 men die from this in the US every year, and 10,000 men die from it worldwide.  These are sobering statistics. 

Who is most likely to get it? How is it diagnosed? How is it treated? What is the survival rate? How does it affect sexual function? There are many questions, and I have the answers for you on this episode, so tune in now.

Dr. Kanwal Bawa is America's favorite sex doctor, and the host of America's number one sex podcast, Dr. Sex Fairy. She is Cleveland Clinic trained, and a pioneer in the fields of sexual wellness, skin rejuvenation and hair restoration. She has a state-of-the-art practice in Boca Raton, Florida called Bawa Medical. She earned the moniker Dr. Sex Fairy due to her incredible advances in the field of intimate and sexual wellness.
 
Her patients fly to her from all over the world for vaginal rejuvenation, non-surgical labiaplasty, penis enlargement, Erectile Dysfunction treatments, better performance, increased libido, hormone replacement, and more. She also provides virtual consultations for those who are unable to travel to her for in-office treatments. Dr. Bawa also has her own line of Dr. Sex Fairy supplements which includes a testosterone booster, a nitric oxide booster and a libido enhancer.

To schedule a virtual or in-office consultation: https://www.bawamedical.com/contact/

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To schedule a virtual or in-office consultation with Dr. Bawa: https://www.bawamedical.com/contact/

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To watch Dr. Sex Fairy in video format: https://www.youtube.com/@drsexfairy

To learn more about sexual wellness: https://www.bawamedical.com/sexual-health/

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Transcript

Testicular Cancer

Welcome to the Dr. Sex Fairy Podcast. I am Dr. Kanwal Bawa, America’s favorite sex doctor and I am here to transform your life.  Our topic today is one that could save your life or that of someone near and dear to you. April is Testicular Cancer Awareness Month, and I want to get a head start on a conversation about this issue. Whether you are male or female, it will benefit you to listen to this episode fully because even if you don't have testicles, you may have a partner, child or sibling that does. My goal for this episode is to take the embarrassment out of the topic, and to blast critically important information out to the world. This is a conversation that needs to be had, and one that needs to be shared. Make sure you text a link to this episode to as many people as you can, both male and female.

Testicular cancer is a disease that can hit you at any age but the average age at diagnosis is only 33. One man is diagnosed with testicular cancer every hour. 470 men die from this in the US every year, and 10,000 men die from it worldwide.  These are sobering statistics. 

Who is most likely to get it? How is it diagnosed? How is it treated? What is the survival rate? How does it affect sexual function? There are many questions, and I have the answers for you on this episode, so don’t even think about leaving.

First I would like to thank you for loving the Dr. Sex Fairy Podcast, and making it a huge success. Thank you to those of you who have already left me a 5 star review, and especially for your lovely comments on Apple Podcasts. I am going to start reading one review a week on the podcast. Let’s start with a review from knokt209 titled “Sexual Enlightenment.” 

He says: “Dr. Sex Fairy is a beacon of light in the darkness of shame when it comes to sexual health. I came across her podcast while listening to the Swing Nation and thought she was so amazing, I listened to all of her episodes in less than two weeks! It’s no wonder she’s so highly popular and more importantly, esteemed. She is educating the world on sexual health with Podcasts and TikTok the way Gutenberg used the printing press to bring the information revolution. I’m currently 37 and while I can’t visit her now, I’m definitely going Bawa Big before 40!”

Isn’t that an incredible review? It made my day. It truly warms my heart to see that I am able to bring this much value to my listeners. For those of you who don’t know what BawaBig is, it is my world-famous technique for non-surgical penis enlargement. If you don't already follow this podcast, make sure you follow it now. I have released incredible episodes already, and there are many more to come!

Now let’s get back to our topic for today. Before I go into the details regarding how a man can check himself for testicular cancer, how it is treated, how it affects sexual function, and more, I want to discuss what it is, and bring attention to the prevalence of this disease first.

Testicular cancer is a male cancer that affects one or both testicles. Cancer cells form within the testicular glands which live inside the scrotum. People often think that the entire scrotum or balls as they are commonly referred to are testicles. In fact, testicles are tiny glands that live inside them. The testicles are where men form testosterone, and even sperm. Testicular cancer comes in two main types called seminomas and nonseminomas.

Together we can reduce that number if we learn the basics about testicular cancer. I am doing this episode to save lives, but I cannot save lives unless you listen to this episode fully. This topic is not a sexy one, but it is one that we all need to hear. It doesn't matter what your penis size is if you don't live to use it. It doesn't matter how long your erection lasts if you don't live to get one.

Let's start our discussion with risk factors. The top risk factors are as follows:

• Age: Testicular cancer is the most common cancer in males between the ages of 15 and 34. You heard me right. Between the ages of 15 and 34. Men in their 20s and 30s are most likely to develop testicular cancer with an average age at diagnosis being 33. This does not mean that those under 20 or over 40 are not at risk. It just means that it is most common in this age group.

• An undescended testicle: Testicles actually develop in the abdomen of a fetus not the scrotum. In 3% of male fetuses, the testicles don’t descend into the scrotum before birth. This is called cryptorchidism. In some cases one or both testicles don't descend at all, and in some cases they only descend partially. In the majority of these cases the testicle descends within the first year of life. 

If it does not, surgery called orchiopexy is required to move the testicle down where it belongs. While there does appear to be a correlation between undescended testicles and testicular cancer, there is no definitive cause and effect data. It does appear that there is a protective effect if the surgery is done sooner rather than later in life, ideally right after the first birthday and certainly before puberty.

• A personal history of testicular cancer: This group has the highest risk of developing testicular cancer again. Having had testicular cancer on one side makes you much higher risk for developing it on the other side. 2% of people with testicular cancer will develop it again. This may not seem like a very high risk but it is significantly higher than the average population.

• Family history of testicular cancer: A man with a father who had testicular cancer is two to four times more likely to develop it. If a man has a brother with testicular cancer, he has an 8 to 12 times higher risk of developing it. Research has shown that 49% of all the risk factors contributing to testicular cancer are, in fact, inherited.

• HIV infection: Men infected with HIV are more likely to develop testicular cancer. Other infections do not seem to pose the same risk.

• Race: White men are 4 to 5 times more likely to develop testicular cancer than other races. The next most common race to get it is American Indians. Then come Asians. And finally come blacks. In fact, black men rarely develop testicular cancer. However, black men should not take this as a license to forget about this issue because they are far more likely to die from it. 

• Body size: According to a 2008 British Journal of Cancer study, men who are 180-184 cm, or 5’9” to 6” tall are most likely to develop testicular cancer, and those over 185 cm or 6’ have a distinct increase in risk. Those taller than 195 cm or 6’4” have a markedly increased risk.

• Physical activity: You had better get your kids outdoors to play. A sedentary child will have a higher risk of developing testicular cancer since increased childhood physical activity has been found to be protective against it in adulthood.

• Environmental risk factors cannot be ignored. A University of Cincinnati study found that firefighters have double the risk of testicular cancer compared to the general population. They are exposed to several carcinogens during the course of work such as soot which is a group one carcinogen that is absorbed through the skin especially when firefighters sweat. Firefighting foam can increase the risk of testicular cancer as well. And these my friends, are just two examples of multiple exposures faced by firefighters in their effort to keep us safe. Other professions such as leatherworkers, metalworkers, carpenters, etc have a higher risk of testicular cancer as well. 

Now we should discuss testicular self-exams. You should do them at least once a month in the shower. After you soap yourself up, you should check one testicle at a time. You should examine it gently but make sure you roll the area between your thumb and fingers. Feel up and down the front and back of each side. Feel for any lumps or swelling. Also keep an eye on any changes in the size, shape or feel of your tissue. 

Testicular cancer can often show up as a painless lump, but don't ignore pain. Pain is never OK. It could be a cyst, an infection, cancer or something else. A doctor must examine you immediately if you find anything worrisome. I understand your hesitation in having somebody in your business but if you wait too long, you could end up being one of those men that die from testicular cancer every single day. 

Next let’s talk about how your doctor will likely investigate further to see whether you actually have testicular cancer. Unlike cancers like breast and colon cancer, there are no screening guidelines for testicular cancer. The most basic test is an ultrasound. It is painless and only takes a few minutes. You lie on an exam table and the ultrasonographer will put some gel on your scrotum and then rub the probe over the area to get a better idea about what lies beneath. 

Your doctor will also order blood tests to check for certain markers that are elevated when someone has testicular cancer cells in their body. For one, you will get a pregnancy test. Yes, a pregnancy test. You see, some forms of testicular cancer produce human chorionic gonadotropin, the same marker that is elevated in pregnancy. That said, a home pregnancy test is not a reliable way to diagnose testicular cancer because there are types of testicular cancer that don't elevate this protein. 

Your doctor will also test for alpha fetoprotein or AFP. Interestingly, the AFP test is used to check for genetic abnormalities in a fetus during pregnancy. The third important blood test is lactate dehydrogenase or LDH. These are important tests overall but cannot be used to diagnose testicular cancer independently because not every type of testicular cancer will be positive for these. Diagnosis has to be a more comprehensive approach that includes imaging and a clinical exam by a doctor. While biopsies are often done in other cancers to make a definitive diagnosis, they are rarely done to diagnose testicular cancer to avoid the risk of spreading it. 

To check to see if the cancer has spread to other parts of the body, your doctor may also order other imaging studies such as a chest x-ray, CT scan, MRI, PET scan or bone scan. If you catch it early enough while it is still localized, you have a 99% 5-year survival rate. Even if it spreads to the general region, you have a 96% 5-year survival rate. If it spreads further away, you have a 73% 5-year survival rate. Look at celebrities like Lance Armstrong and Scott Hamilton who have survived it. They have gone on to live rich, fulfilling lives.

Treatment options include an orchiectomy which is the removal of a testicle. There is also radiation that can be used after an orchiectomy to target lymph nodes. It can also be used independently for a seminoma which is sensitive to radiation. Lymph nodes may also be removed depending on the type of testicular cancer. And then there is chemotherapy, a treatment that uses drugs to kill cancer cells, which is often used if the cancer has spread to other areas.  

So you got treated. Now what? The sexual side effects from testicular cancer treatment can be crippling, and we will discuss them in detail right after discussing these side effects:

·      The primary side effect of surgery is swelling and pain in the scrotum, which can last for several weeks. Some men may also experience temporary numbness in the groin area or loss of sexual function.

·      Common side effects of chemotherapy include nausea, vomiting, fatigue, hair loss, and a higher risk of infection. Some chemotherapy drugs can also cause peripheral neuropathy, which is a tingling or numbness in the hands and feet. This may or may not be permanent. It can even cause hearing problems, hypertension, heart disease, metabolic syndrome, lung scarring and even other cancers.

·      Side effects of radiation therapy for testicular cancer may include fatigue, skin irritation in the treated area, and extensive damage to nearby tissues and organs especially the heart and lungs. It can even cause acid reflux and Peptic Ulcer Disease.

·      Men who undergo orchiectomy may experience a drop in testosterone levels, which can cause symptoms such as fatigue, decreased muscle mass, and decreased sex drive. Testosterone replacement therapy can help manage these symptoms, but it can also cause acne, mood swings, and an increased risk of blood clots.

The sexual side-effects of treatment can have a significant impact on a man’s life. They include:

1.      Erectile Dysfunction (ED): It is the inability to achieve or maintain an erection firm enough for sexual activity. Surgery, chemotherapy, and radiation therapy can all cause ED by damaging nerves, blood vessels, or muscles in the penis.

2.      Loss of libido: Testosterone is a hormone that plays a key role in sexual desire. Surgery, chemotherapy, and radiation therapy can all lower testosterone levels, which can lead to a decreased sex drive.

3.      Infertility: Testicular cancer and its treatment can cause infertility by damaging the testicles or interfering with sperm production. You should know that men with testicular cancer tend to have lower quality sperm so fertility preservation must be discussed with your doctor immediately, and the sperm preserved before treatment is started.

4.      Orgasmic dysfunction: Surgery, chemotherapy, and radiation therapy can affect the nerves and muscles involved in orgasm, making it more difficult to achieve orgasm, or by decreasing the intensity of orgasm.

Since the treatment regimen differs based on the kind of testicular cancer someone has, the side effects can vary accordingly. There is hope for the men suffering from all these problems and more. If you have survived testicular cancer but are living a sub-par life, there is no need to suffer in silence. You should contact your doctor about the general and sexual side effects of treatment should you develop them. You can also contact me for a virtual consultation or an in-person visit to my practice Bawa Medical in Boca Raton, Florida. 

I treat men with sexual dysfunction all the time, and as a cancer survivor myself, I am better able to help you navigate through life after cancer. Be it BawaWave to increase blood flow and improve your pelvic floor strength, be it the BawaShot to improve the penile tissue quality and function, be it BawaBig to restore your penis size non-surgically, be it the Dr. Sex Fairy sexual wellness supplements to improve function and libido, or any of the other tools in my special Dr. Sex Fairy toolbox, there is something I can do to help. 

The late actor Christopher Reeve once said, "Once you choose hope, anything's possible." His words are a powerful reminder that having hope and a positive attitude can make all the difference in overcoming obstacles, including cancer. Surviving cancer is a difficult journey, but with hope, determination, and support, it is possible to overcome even the toughest of challenges.

As I said at the beginning, this episode will save lives if enough people hear it. Do share a link to it with as many people as you can.

Until next time.