Urologists advocate screening for testicular cancer, BPH

Urologists advocate screening for testicular cancer, BPH

Like many men’s health issues, testicular cancer long languished outside of the minds of men across the world. Then, in 1996, the condition was lifted into a more prominent place of awareness on the spectrum of cancers by famed bicylist, Tour de France winner and Texas-native Lance Armstrong.

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Armstrong’s testicular cancer spread to other parts of his body — his lungs, brain and abdomen — before he famously recovered and won seven consecutive titles in the prestigious Tour de France from 1999-2005. He later formed the LiveStrong Foundation, which works to raise awareness of cancers and how to recognize the disease and treat it.

More than 20 years later, national health organizations such as the Centers for Disease Prevention and Controlas well as local urologists in The Woodlands say men of all ages need to be hyper-vigilant for numerous health issues specific to men, including testicular cancer and BPH — known by its medical name of benign prostate hyperplasia.

The two conditions affect men of varying age ranges from teens to those in their 40s or 50s and older, and the conditions are often hard to catch because there are less outward symptoms or signs of a problem than other issues.

Two local urologists — Dr. Russell Libby, of Northwoods Urologyof Texas’ office in The Woodlands, and Dr. Christopher Hobaugh of the Kelsey-Seybold Clinicin The Woodlands — both said the keys to maintaining good health in relation to male-specific issues is understanding symptoms, being aware of age-appropriate testing recommendations and not hesitating to see a doctor if anything unusual or painful arises.

Libby said two decades following an awareness-boost from Armstrong, testicular cancer has become a condition that is treated differently and also viewed as highly “curable.”

“Testicular cancer is a condition in men that may have been traditionally been treated in a way that may differ from the past,” Libby said. “Today, we look at testicular cancer as a very curable issue.”

Hobaugh said BPH is “definitely very common,” and that as a practicing urologist who sees dozens of male patients a day, “we see a lot of it.” BPH is most common in men older than 50.

Libby and Hobaugh both said many males get testicular cancer as a teen or in their early 20s. According to statistics, the most common age range for acquiring the disease is 16 to 34 years of age.

Libby said testicular cancer is hard to detect because there is rarely any pain from the condition or tumor and otherwise there are few, if any, outward symptoms. The U.S. Preventive Task Force actually recommends not getting testicular exams for some age groups, something Libby said has frustrated practicing urologists.

“If someone feels something usual in their scrotum, they should see their doctor. Just because you have a mass on your testicle, it doesn’t mean cancer. We’ll perform a testicular ultrasound — of the testicles and scrotal contents — if we do find something we suspect is cancerous, we’ll do an ultrasound and tumor “markers,” Libby said. “If (the tests) are suggestive of testicular cancer, the testicle could be removed. We want to make sure the testicular cancer has not spread.”

Treating testicular cancer has many options, Libby noted. However due to the physiological aspects of the scrotum and testicles, many surgeries or treatments can have an adverse affect on a man’s fertility.

“Any time you operate on a testicle is a danger to fertility. If a man is in child years, it is importantly they make sure their fertility is added to the treatment plan. You may want to do sperm-banking” Libby added. “In terms of treatment, you get treated on the type of cancer you have. For most cancers, the testicle can be removed. in other instance, there is radiation, chemotherapy, removing lymph nodes or more serious operations. sometimes the more aggressive (cancer) you get the more invasive the surgery can be.”

Hobaugh and Libby said BPH — benign prostate hyperplasia — is becoming more prevalent in men each year. The condition is not related to prostate cancer, although it can be a precursor to the disease.

Hobaugh said BPH is basically, the prostate being enlarged.” Like testicular cancer, BPH is now treatable with a variety of methods including targeted medications as well as non-incision procedures done with trans-urethral instruments that are guided gently through the urethra to the prostate.

“(BPH) is the prostate causing problems with urination. Symptoms are urinary side effects — the stream is not as strong as it used to be. They are straining to empty their bladder,” Hobaugh said. “They may notice more frequency with urination at night or in the day. That is where we see the prostate’s size being a problem in urination. There are probably more men that have BPH than have prostate cancer. Some of the (testing) for prostate cancer is useful in (diagnosing) BPH. ”

Libby said BPH is the most prevalent problem he has seen in patients in recent years. Once symptoms such as a decrease in urinary stream, more frequent urination and notably urinating a lot at night, a man should seek an exam from their urologist, he added.

“We see a delay in men getting treatment for their prostate and then their bladder stops working efficiently,” Libby added. “I think most patients who come to see me have BPH and something else. Not ignoring (BPH) is super important. I do encourage my patients to get treatment for that before irreparable damage is done to their bladder. you want people to have a nice quality of life, without catheters.”

Once BPH is diagnosed, Libby said several treatment options are available including a newer treatment called UroLift as well as various procedures, Hobaugh said, that can be done with an in-office procedure under local anethesia and can be done in a one day appointment or with one night in the hospital.

“There is a basis spectrum of treatment for BPH. There are some medications we’ve been using a long time and there are some newer medications targeted at the prostate and there are a number of options for minimally invasive procedures,” Libby added. “UroLift is one of the minimally invasive techniques. Most of these procedures can be done with a camera inside the urethra and don’t require incisions.”