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Curing Cancer and Safeguarding Fertility

Mike Craycraft

Survivor/Founder, Testicular Cancer Society

While testicular cancer can occur at any age it typically strikes younger men, during the prime of their life. In fact, testicular cancer is the leading cause of cancer in males 15-35 years of age. Fortunately, it is also highly treatable. If caught and treated in an early stage testicular cancer is almost 100% curable and even at later stages, the survival rate is over 70%.

Thanks to treatment advances over the past 40 years, the overall 5-year survival rate for testicular cancer is now over 95%. While highly effective, these treatments also come with long-term burdens. Treatment interventions, such as surgical removal of the affected testicle(s) and any affected lymph nodes, as well as chemotherapy and radiation therapy can all lead to temporary or permanent infertility.

National guidelines recommend fertility preservation, such as sperm banking, be offered to all those diagnosed with testicular cancer, but only around 30% of those diagnosed go through the sperm banking process. While the cause of the low participation rates is multifactorial, many survivors report they were not aware of the need or offered the opportunity for sperm banking. 

More awareness and education about sperm banking would be beneficial. A 2018 review of the top 50 pediatric cancer centers revealed that only 30% of their websites contained information on male fertility preservation. Further complicating the situation, many treatment teams may be focused on the immediate needs of curing the patient’s cancer and inadvertently overlook long-term survivorship issues, such as fertility preservation. This is just one example of why being a self-advocate and taking an active role in one’s care is so important.

During the immediate shock of receiving a cancer diagnosis thinking about future fatherhood may not be on the top of the priority list. However, research in testicular cancer survivors indicates that the frequency and degree of infertility concerns are equal to their anxiety of disease recurrence. Put another way, after treatments end, those diagnosed are just as worried about being infertile as they are about their cancer coming back. Fertility preservation and security offered by having banked sperm could help reduce these long-term survivorship issues.There are still psychosocial barriers to overcome for sperm banking. Not all health insurance policies cover fertility preservation for males and laws in each state differ, but those laws are beginning to change. In 2020, for example, the “Colorado Building Families Act” passed, which requires all health benefit plans issued in Colorado to cover fertility preservation services starting January 1, 2022.  

Many survivors find having to go into a doctor’s office to produce a sperm sample a bit awkward. Luckily, technology is helping in that area as well. Now home collection kits, such as the Dadi Kit, are available to help facilitate the process and remove the awkwardness. The kits can be ordered to one’s home, where the sample can be produced, and over-night mailed back to the sperm freezing facility.

Most testicular cancer survivors will maintain their fertility, even after treatments, but there is no way to identify those at risk for infertility. Hopefully, with more awareness, less financial burdens, and newer technologies, all men facing a testicular cancer diagnosis and the treatments that could threaten their fertility, will be able to take advantage of the reproductive safeguards offered by sperm baking. 

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