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Ummm...really?? Don't screen for TC? What a joke.

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  • Ummm...really?? Don't screen for TC? What a joke.

    Couldn't believe I ran across this. Nonsense.
    03/10/16 - Something is seriously wrong
    03/11/16 - Ultrasound shows 7cm mass
    03/15/16 - CT scan: enlarged 1.5cm retroperitoneal node
    03/15/16 - Markers: HCG 2, LDH 220, AFP 2.8
    03/21/16 - Right I/O, Path: classic seminoma tumor 7.1cm (Stage IIA)
    05/03/16 - Radiation treatment started: 18 days/30 Gy

  • #2
    Yeh, I know, sounds ridiculous, doesn't it? However, I've heard this before, and the point is that there is more"harm" caused by false positive screening results than there are benefits from regular screenings, since TC is so exceeding rare. They also state that most TCs are found accidentally in the shower, or by partners, rather than by regular checks.I can understand how they reached their recommendation.With only 5.4 cases/100,000 men, statistically, it really does not make any sense to screen regularly. Unless, of course you are one of the ones who find a problem early enough to get it cured.

    In any event, in case anyone wants to look into this further, here is a link to the page where the photo posted came from:


    Here is a link to more in depth discussion of why they make that recommendation:


    This is also noteworthy:

    Recommendations of Others

    The American Academy of Family Physicians recommends against routine screening for testicular cancer in asymptomatic adolescent and adult males6. The American Academy of Pediatrics does not include screening for testicular cancer in its recommendations for preventive health care7. Finally, the American Cancer Society does not recommend testicular self-examination8
    So this is not an isolated recommendation.

    Last edited by Davepet; 06-25-16, 06:29 AM.
    Jan, 1975: Right I/O, followed by RPLND
    Dec, 2009: Left I/O, followed by 3xBEP


    • #3
      I can understand the screening question - but the final point from Dave on not undertaking TSE boggles the mind. If I hadn't been doing monthly self-examinations, I certainly wouldn't have picked up my cancer until it had progressed significantly further. That really doesn't sound like good advice.

      - T
      30 Jul 14: Discovered lump
      31 Jul 14: GP referral to specialist
      4 Aug 14: Clinical diagnosis of tumour, blood samples taken, CT scans, USS (confirming ~2cm tumour)
      8 Aug 14: Left radical orchidectomy (plus test results back: CT normal, no mets; blood markers slightly elevated: AFP 14.16, HCG 4.9, LDH 149)
      29 Aug 14: Pathology results: Stage 1A Mixed Non-Seminomatous Germ Cell Tumour (composition: Yolk-sac Tumour and Mature Teratoma)

      24 Sep 14: Started precautionary adjuvant 1xBEP
      23 Oct 14: All clear; on surveillance


      • #4
        I think part of the reasoning for no screening is if people go to docs at the first sign of symptoms, they still have a very high chance of cure, unlike some other cancers.

        I think doctors and educators should make those who have a history of undecended or missing testicle more aware of their elevated risk of TC. If I was made aware I would have been doing self examinations and probably could have caught it at stage 1 instead of 3a. I had no idea TC was even a thing until I started looking up why my ball was enlarged and my back hurt.
        6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
        6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
        7/7/15: bHCG 56, AFP 42, LDH 322
        7/13/15: begin 4xEP, end 9/18/15
        10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
        10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
        4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
        4/20/16: RPLND @ IU - teratoma only!
        10/22/19: all clears up to this date!


        • #5
          Contrasting, but Canadian Cancer Society recommends regular screening.

          Here's the link with a nice video :

          December 15, 2015 : Right I/O. Markers normal.
          December 24, 2015 : Merry Christmas ! 100 % pure EC, no LVI.
          January 7, 2016 : CT scan : 2 RPLN of 8 and 9 mm
          February 2016 : Markers normal.
          March 2016 : Markers normal.
          April 2016 : Abnormal B-HCG (43). 14 mm (from 8) and 10 mm (from 9) lymph nodes.
          April 25, 2016 : Happy birthday ! Relapsed confirmed.
          May 2, 2016 : BEP x 3 begins.
          July 3, 2016 : BEP x 3 ends.
          July 2016 : Serum tumor markers normal. 10 mm (from 14) and 6 mm (from 10) lymph nodes. Back on surveillance !
          December 23, 2016 : Merry Christmas ! Serum tumor markers normal. 6.8 mm (from 10) and no more visible (from 6) lymph nodes. Surveillance continues.
          June 2017 : Serum tumor markers normal. 4 mm (from 7 mm) lymph node. Surveillance continues.


          • #6
            Australia Cancer Council position is that they will not even run promotion of Awareness or Self Checks siting the low mortality rate - really bugs be when a could of "fashionable" cancers get all the focus and sponsorship. Canada does seem to have good awareness campaigns as does the UK.

            Really to me - self checks would be an easy education item.
            TC1: May 2001 / Right orchiectomy / seminoma stage 1 / Radiation
            TC2: July 2008 / Left orchiectomy / seminoma stage 1 / X2 Prostheses / Reandron (long term Testosterone injections)


            • #7
              Not surprisingly such decisions to perform screening or not come down to what is the "value of a life" and as we evolve to the single payer system here in the US we will see our gov't making more of these decisions. It could be reasonably accurate to quantify: Direct Cost of Screening (awareness,education,etc.) + Indirect cost (medical follow-ups of non-clinical significance) and compare this to Cost Savings of Treatment Attributed to Screening (lower medical cost for early Identification). If screening is not being recommend it means someone has calculated that Cost Savings do not Outweigh expense. A logical person would also agree that with no screening vs. screening their will be a lower survival rate associated with non-screening. What our government will now routinely decide for us is Cost Savings from no Screening = X and this is acceptable considering we expect Mortality to only increase by Y. Many other countries have already been operating in this paradigm and we have seen affect on treatment recommendations such as frequency of RPLND between US vs. EU.

              Unfortunately, just dollars and cents.