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</TABLE>
 <A NAME=top></A><FONT FACE="Arial">Testicles
Newsbytes</FONT></CENTER></H1>

<P><B>T</B>esticular <B>C</B>ancer <B>A</B>wareness <B>W</B>eek
(tcaw.org) has compiled newsbytes on testicles and testicular
cancer.<BR>
</P>

<P><A HREF="#newsbytes"><B>Newsbytes</B></A></P>

<UL>
   <LI><A HREF="#marijuana"><B>Study Sees Link Between Marijuana Use,
   Testicular Cancer</B></A></LI>
   
   <LI><A HREF="#infertility"><B>Testicular Cancer and Infertility
   Linked?</B></A></LI>
   
   <LI><A HREF="#oneshot"><B>One-Shot Treatment Can Cure Testicular
   Cancer</B>: <B>Similar Cure Rate With Single Chemotherapy
   Treatment That Prevents Recurrence</B></A></LI>
   
   <LI><A HREF="#familia"><B>NCI Familia Testicular Cancer Study Now
   Recruiting</B></A></LI>
   
   <LI><A HREF="#keystats"><B>What Are the Key Statistics for
   Testicular Cancer?</B></A></LI>
   
   <LI><A HREF="#whatsnew"><B>What's New in Testicular Cancer
   Research and Treatment?</B></A></LI>
   
   <LI><A HREF="#vasectomy3"><B>Cancer, Vasectomy Connection
   Disproved</B></A></LI>
   
   <LI><A HREF="#ratesup"><B>Why is the rate of testicular cancer
   increasing?</B></A></LI>
   
   <LI><A HREF="#vasectomy2"><B>Vasectomy and Cancer
   Risk</B></A></LI>
   
   <LI><A HREF="#fewerdying"><B>Doctors Say Fewer Men Dying of
   Testicular Cancer</B></A></LI>
   
   <LI><A HREF="#youngman"><B>The Young Man's Cancer</B></A></LI>
   
   <LI><A HREF="#youngmen"><B>Young men think they are indestructible
   - a true story</B></A></LI>
   
   <LI><A HREF="#fertilityproblems"><B>Fertility problems linked to
   testicular cancer risk</B></A></LI>
   
   <LI><A HREF="#highdose"><B>High-dose chemo battles recurrent
   testicular cancer</B></A></LI>
   
   <LI><A HREF="#newdrugs"><B>New drugs may hold promise for
   testicular cancer undescended testicle</B></A></LI>
   
   <LI><A HREF="#cured"><B>Testicular Cancer Likely to Be Cured, Even
   When It Recurs</B></A></LI>
   
   <LI><A HREF="#survivalhigh"><B>Survival High with Early
   Treatment</B></A></LI>
   
   <LI><A HREF="#fertilityproblems"><B>Male Fertility Problems Linked
   to Testicular Cancer</B></A></LI>
   
   <LI><A HREF="#teenyears"><B>Experts Raise Eyebrow at Link Between
   Exercise in Teen Years and Testicular Cancer</B></A></LI>
   
   <LI><A HREF="#onehunglow"><B>One Hung Low</B></A></LI>
   
   <LI><A HREF="#rise"><B>Testicular Cancer on the Rise and Getting
   Younger</B></A></LI>
   
   <LI><A HREF="#infertilemen"><B>Infertile men at greater risk of
   testicular cancer</B></A></LI>
   
   <LI><A HREF="#spermbanking"><B>Sperm banking aids fatherhood after
   testicular cancer</B></A></LI>
   
   <LI><A HREF="#mountainbiking"><B>Mountain Biking can be Rough on
   the Testicles</B></A></LI>
   
   <LI><A HREF="#unmentionable"><B>Testicular Cancer No Longer
   Unmentionable</B></A></LI>
   
   <LI><A HREF="#unwilling"><B>Men "Unwilling" to Discuss
   Cancer</B></A></LI>
   
   <LI><A HREF="#tccure" style="text-decoration:none"><FONT COLOR="#0000FF"><B>Testicular
   Cancer Cure Rates Now So High Patients May Be More At Risk From
   Treatment</B></FONT></A></LI>
   
   <LI><A HREF="#ignoringlumps"><B>Ignoring Testicular Lumps Can
   Cause Unnecessary Deaths - Get Medical Help Early</B></A></LI>
   
   <LI><A HREF="#new"><B>New Testicular Cancer Warning</B></A></LI>
   
   <LI><A HREF="#fewerdying"><B>Doctors Say Fewer Men Dying of
   Testicular Cancer</B></A></LI>
   
   <LI><A HREF="/web/20150429165629/http://www.tcaw.org/menstuff/issues/byissue/lumpectomy.html"><B>"Lumpectomy"
   seems OK for some testicular cancers</B></A></LI>
   
   <LI><A HREF="#environment"><B>Risk Of Testicular Cancer Determined
   By Early Environmental Exposures</B></A></LI>
   
   <LI><A HREF="#outpacebreast"><B>Testicular Cancer Cases Outpace
   Breast Cancer in Califiornia</B></A></LI>
   
   <LI><A HREF="#tcearly"><B>Testicular cancer risk set early in
   life</B></A></LI>
   
   <LI><A HREF="#rise"><B>Testicular Cancer on the Rise and Getting
   Younger</B></A></LI>
   
   <LI><A HREF="#infertilemen"><B>Infertile men at greater risk of
   testicular cancer</B></A></LI>
</UL>

<P><A HREF="#secret"><B>No Longer a Secret</B></A></P>

<UL>
   <LI><A HREF="#men15-34"><B>Scott Hamilton and Testicular
   Cancer</B></A><B><BR>
   </B></LI>
</UL>

<P><FONT SIZE="-2"><A NAME=newsbytes></A></FONT><B>Newsbytes<BR>
</B>

<HR>

</P>

<P><A NAME=marijuana></A><B>Study Sees Link Between Marijuana Use,
Testicular Cancer<BR>
</B>

<HR>

Researchers say that young men who smoke marijuana weekly, or who
have smoked from their teen years on, face twice the risk of
developing nonseminona, an aggressive form of testicular cancer, the
Guardian reported Feb. 9.</P>

<P>Researchers said the elevated risk compared to nonusers may be due
to stimulation of immature testicular cells that can later become
tumors. The testicles are one of the few organs in the body that have
receptor sites for cannabinoids, the active ingredient in
marijuana.</P>

<P>Increases in the number of testicular-cancer rates since the 1950s
could be due to higher rates of marijuana use during the same time
period, experts said.</P>

<P>Current marijuana users had an overall 70-percent increased risk
of testicular cancer compared to nonusers.</P>

<P>"Our study is not the first to suggest that some aspect of a man's
lifestyle or environment is a risk factor for testicular cancer, but
it is the first that has looked at marijuana use," said researcher
Stephen Schwartz.</P>

<P>The study from researchers at the Fred Hutchinson Cancer Research
Center was published online in the journal Cancer.<BR>
<FONT SIZE="-1">Source: </FONT><A HREF="/web/20150429165629/http://www.jointogether.org/news/research/summaries/2009/link-between-marijuana.html"><FONT SIZE="-1">www.jointogether.org/news/research/summaries/2009/link-between-marijuana.html</FONT></A><FONT SIZE="-1">
</FONT><FONT SIZE="-1" COLOR="#0000FF"><IMG SRC="/web/20150429165629im_/http://www.tcaw.org/menstuff/books/coversmisc/arrow1.gif" WIDTH=22 HEIGHT=15 ALIGN=bottom></FONT><BR>
</P>

<P><A NAME=infertility></A><B>Testicular Cancer and Infertility
Linked?<BR>
</B>

<HR>

A study shows higher odds of testicular cancer in infertile men. Get
the details from this new research. "Infertile men with abnormal
semen analyses have a 20-fold greater incidence of testicular cancer
compared to the general population," researchers write in The Journal
of Urology.<BR>
<FONT SIZE="-1">Source: </FONT><A HREF="/web/20150429165629/http://www.webmd.com/content/article/115/111772.htm"><FONT SIZE="-1">www.webmd.com/content/article/115/111772.htm</FONT></A><FONT SIZE="-1">
<IMG SRC="/web/20150429165629im_/http://www.tcaw.org/menstuff/books/coversmisc/arrow1.gif" WIDTH=28 HEIGHT=15 ALIGN=bottom></FONT><BR>
</P>

<P><A NAME=oneshot></A><B>One-Shot Treatment Can Cure Testicular
Cancer</B>: <B>Similar Cure Rate With Single Chemotherapy Treatment
That Prevents Recurrence<BR>
</B>

<HR>

Cancer researchers report a single dose of chemotherapy might work
just as well as radiation treatment in curing testicular cancer.</P>

<P>Currently, most men with early-stage disease undergo surgery to
remove the affected testicle, then have follow-up radiation therapy
to make sure the cancer is "cured." Using a combination of surgery,
radation, and chemotherapy, this cancer has one of the highest cure
rates of all cancers.</P>

<P>But radiation therapy, which requires several weeks of treatment,
can cause cancer to occur in other organs two decades or more after
the original cancer is treated, says R. Timothy Oliver, MD, professor
of oncology at Barts and the London Queen Mary's School of
Medicine.</P>

<P>Moreover, radiation therapy can damage the remaining testicle,
thus destroying fertility.</P>

<P>Testicular cancer accounts for only about 1% of all cancers in men
-- usually young men, according to the National Cancer Institute.</P>

<P>Oliver presented his findings at the annual meeting of the
American Society of Clinical Oncology.</P>

<P>A better option, he says, is a single shot of Paraplatin, a potent
chemotherapy drug. Oliver tells WebMD this single-shot treatment is
as effective as radiation for preventing recurrence of seminoma,
which is a common type of testicular cancer.</P>

<P>Oliver tested this approach in 1,447 men who received either
radiation treatment or the one-shot chemotherapy treatment. During
the study from June 1996 to March 2001, 543 men had the one shot
therapy while 904 men had radiation therapy.</P>

<P>"After three years, there was no significant difference in
relapse-free survival," he says. The disease-free survival in the
Paraplatin group was just over 95% and it was 97% in men treated with
radiation.</P>

<P>And in terms of actual recurrences of cancer, new cancers were
later detected in 10 men treated with radiation, while only two men
in the chemotherapy group had recurrent cancers.</P>

<P>Oliver says the one-shot treatment is also less toxic then
radiation. And most men reported less fatigue and nausea, which meant
they were able to return to work sooner than men treated with
radiation.</P>

<P>Robert J. Mayer, MD, director of gastrointestinal oncology at the
Dana-Farber Cancer Institute, tells WebMD the study results are
important because even though testicular cancer has a high cure rate
with radiation therapy, "it's important that we select treatments
that are the least toxic to our patients." He notes, however, that
long-term data are needed to confirm Oliver's finding that one-shot
treatment is as good or better than radiation.</P>

<P>If the positive results of this study stand the test of time -- if
results at 10 or 20 years are as promising as these early results --
Oliver says it may be possible to treat testicular cancer by removing
just the cancerous tissue, rather than the entire testicle. That
would mean that "for the first time, men may have the option of
testicular-conserving therapy just as women undergo lumpectomy to
save their breasts."<BR>
Source: <FONT SIZE="-1">By Peggy Peck American Society of Clinical
Oncology 2004m Abstract 4517: "A randomised comparison of single
agent carboplatin with radiotherapy in the adjuvant treatment of
stage I seminoma of the testis, following orchidectomy." R. Timothy
Oliver, MD. Robert Mayer MD.</FONT><BR>
</P>

<P><A NAME=keystats></A><B>What Are the Key Statistics for Testicular
Cancer?<BR>
</B>

<HR>

The American Cancer Society estimates that in the year 2004 about
8,980 new cases of testicular cancer will be diagnosed in the United
States. An estimated 360 men will die of testicular cancer in the
year 2004.</P>

<P>Testicular cancer is one of the most curable forms of cancer.
Studies show that the cure rate exceeds 90% in all stages combined.
The 5-year survival rate for stage I testicular cancer is 99%. The
5-year survival rate for stage II disease, in which cancer has spread
to local lymph nodes, is 95%. If the cancer has spread beyond the
lymph nodes (stage III), the 5-year survival rate is around 75%.</P>

<P>The 5-year survival rate refers to the percentage of patients who
live at least 5 years after their cancer is diagnosed. Five-year
rates are used to produce a standard way of discussing prognosis. Of
course, many people live much longer than 5 years. Five-year relative
survival rates exclude patients dying of other diseases. This means
that anyone who died of another cause, such as heart disease, is not
counted.</P>

<P>Keep in mind that 5-year survival rates are based on patients
diagnosed and initially treated more than 5 years ago. Improvements
in treatment often result in a more favorable outlook for recently
diagnosed patients.<BR>
<FONT SIZE="-1">Source: </FONT><A HREF="/web/20150429165629/http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_are_the_key_statistics_for_testicular_cancer_41.asp?sitearea="><FONT SIZE="-1">www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_are_the_key_statistics_for_testicular_cancer_41.asp?sitearea=</FONT></A><FONT SIZE="-1">
<IMG SRC="/web/20150429165629im_/http://www.tcaw.org/menstuff/books/coversmisc/arrow1.gif" WIDTH=28 HEIGHT=15 ALIGN=bottom><BR>
</FONT></P>

<P><A NAME=whatsnew></A><B>What's New in Testicular Cancer Research
and Treatment?</B>

<HR>

Important research into testicular cancer is underway in many
university hospitals, medical centers, and other institutions around
the country. Each year, scientists find out more about what causes
the disease, how to prevent it, and how to improve treatment.</P>

<P>Scientists are studying the changes in DNA of testicular cancer
cells to learn more about the causes of this disease. Their hope is
that improved understanding will lead to even more effective
treatment.</P>

<P>Clinical trials have refined doctors&#146; approaches to treating
these cancers and are expected to answer additional questions. For
example, studies have identified factors to help predict which
patients have a particularly good prognosis and may not need lymph
node surgery or radiation therapy. On the other hand, studies have
found unfavorable prognostic factors that suggest certain patients
may benefit from more intensive treatment.</P>

<P>New drugs and new drug combinations are being tested for patients
with recurrent cancer. Stem cell transplantation is being studied as
a strategy for helping men who have tumors with a poor prognosis
tolerate more intensive chemotherapy. And chemotherapy combinations
are being refined to see if eliminating certain drugs, replacing them
with others, or lowering doses can reduce side effects for some men
without reducing the effectiveness of treatment.</P>

<P>Recent studies have found that men who are HIV-positive have an
increased risk of developing testicular cancer and that most of these
men can be cured using standard treatment (orchiectomy, chemotherapy,
and/or radiation therapy) and can experience an improved quality of
life despite their HIV status.<BR>
<FONT SIZE="-1">Source: </FONT><A HREF="/web/20150429165629/http://www.cancer.org/docroot/CRI/content/CRI_2_4_6X_Whats_New_in_Testicular_Cancer_Research_and_Treatment_41.asp?sitearea="><FONT SIZE="-1">www.cancer.org/docroot/CRI/content/CRI_2_4_6X_Whats_New_in_Testicular_Cancer_Research_and_Treatment_41.asp?sitearea=</FONT></A><FONT SIZE="-1">
<IMG SRC="/web/20150429165629im_/http://www.tcaw.org/menstuff/books/coversmisc/arrow1.gif" WIDTH=28 HEIGHT=15 ALIGN=bottom><BR>
</FONT></P>

<P><A NAME=familia></A><B>NCI Familia Testicular Cancer Study Now
Recruiting<BR>
</B>

<HR>

Testicular cancer is the most common malignancy among young men ages
15 to 35, with approximately 8,980 cases diagnosed annually in the
U.S. A few clear risk factors exist, including cryptorchidism
(undescended testicle), a prior history of cancer in one testicle
(the opposite testicle is at increased risk), and other rare
conditions where the testes develop abnormally. Among those men
diagnosed with testicular cancer, about 1-3 percent report a family
history of the disease. Brothers of affected individual are 8 to 10
times more likely to develop testicular cancer, and men whose fathers
had testicular cancer are four times more likely to develop
testicular cancer, when compared with the relatives of men who have
never had testicular cancer. While some genetic clues are starting to
emerge, the gene(s) that cause testicular cancer have yet to be
discovered.</P>

<P>Clinical researchers from 14 different countries have banded
together in an effort to find the gene(s) involved in causing
familial testicular cancer. They have formed an organization called
the International Testicular Cancer Linkage Consortium (ITCLC), and
pooled the information collected from the families they each
identified, to do a systematic search for these genes. In 2000, these
investigators published evidence that a familial testicular cancer
gene might be located on the X-chromosome, and they proposed that
this might explain the higher risks in some families, especially
those families in which at least one of the affected men had
bilateral testicular cancer (EA Rapley et al: Nature Genetics 2000;
24:197-200). This candidate gene has been named the Testicular Germ
Cell Tumor-1 (TGCT1) gene, and efforts to further refine the
chromosomal location and determine the DNA structure of the gene are
now underway. The gene itself has not yet been identified.</P>

<P>Studying high-risk families is the major way of identifying genes
that cause diseases, and this strategy provides unique opportunities
to examine other risk factors as well. Under the leadership of Mark
H. Greene, M.D., the Clinical Genetics Branch (CGB) at the National
Cancer Institute in Bethesda, MD has recently begun to actively
recruit new families. Criteria for enrollment into the study include
at least one of the following: 1) two or more men in the family have
testicular cancer, 2) one family member has bilateral testicular
cancer (that is, separate cancers involving both testicles), or 3)
one family member with testicular cancer is a member of a set of
genetically identical brothers, such as twins or triplets. Since
multiple-case testicular cancer families are relatively rare, Dr.
Greene and his colleagues have been contacting both physicians and
testicular cancer support/advocacy organizations, in an effort to
identify additional families.</P>

<P>As part of its research strategy, the NCI study team has joined
the International Testicular Cancer Linkage Consortium. The Clinical
Genetics Branch is contributing genetic material (DNA) collected from
the new families it has identified to this international research
effort. The goal is to assemble a large enough group of high-risk
families to permit locating the proposed gene on the X chromosome,
and perhaps finding other genes as well. Eventually, it is hoped that
this research will lead to the development of laboratory tests to
identify individuals who are at increased genetic risk of testicular
cancer.</P>

<P>The CGB team also hopes to make significant contributions to
understanding the full spectrum of the hereditary testicular cancer
syndrome. In addition to helping identify the gene or genes that
cause familial testicular cancer, they hope to better describe its
clinical features, explore whether these families are at a higher
risk of other cancers, perform the first systematic review of the
pathology of familial testicular cancers, examine the emotional and
psychosocial issues affecting family members, develop better health
care choices for at risk individuals, and create a repository of
biological specimens to be used in various laboratory studies
intended to help us learn more about how testicular cancer
develops.</P>

<P>Families may participate either by providing questionnaire
information and blood samples from their home communities, or they
may travel to the NIH Clinical Center for an in-person evaluation.
Expenses related to coming to the NIH, and the costs involved in
participating in the study, are covered by the study's budget. More
information on the study can be found online at: <A HREF="/web/20150429165629/http://familial-testicular-cancer.cancer.gov/">http://familial-testicular-cancer.cancer.gov</A><BR>
<FONT SIZE="-1">Source: </FONT><A HREF="/web/20150429165629/http://www.tc-cancer.com/familial.html"><FONT SIZE="-1">www.tc-cancer.com/familial.html</FONT></A><FONT SIZE="-1">
<IMG SRC="/web/20150429165629im_/http://www.tcaw.org/menstuff/books/coversmisc/arrow1.gif" WIDTH=28 HEIGHT=15 ALIGN=bottom></FONT><BR>
</P>

<P><A NAME=tcearly></A><B>Testicular cancer risk set early in
life</B><BR>

<HR>

The risk of testicular cancer is established in large part by
environmental exposures early in life, results of a new study
suggest, although the researchers admit that at this point they
aren't exactly sure what type of exposures increase the risk.</P>

<P>For at least 50 years, there has been an "unexplained" epidemic of
testicular cancer in several populations, although there is a marked
difference in the occurrence of the disease among countries, Dr.
Anders Ekbom, of the Karolinska Hospital in Stockholm, Sweden, and
associates explain in the Journal of the National Cancer
Institute.</P>

<P>For example, the incidence of testicular cancer is roughly twice
as high in Sweden as it is in Finland and Denmark. "These differences
cannot be explained solely by genetic differences, but environmental
exposures, particularly early exposures, have been implicated in the
&#91;development&#93; of testicular cancer," according to the
team.</P>

<P>To investigate further, Ekbom's group identified 93,172 Finnish
men who immigrated to Sweden between 1969 and 1996. These immigrants
were less likely to develop testicular cancer than the Swedish
general population.</P>

<P>There was no link between age at immigration or duration of stay
in Sweden and the reduced risk of testicular cancer.</P>

<P>"The findings are compatible with the hypothesis that lifetime
risk of testicular cancer is determined early in life, possibly
before birth," Ekbom and colleagues write.</P>

<P>"Although we are still without a good hypothesis regarding what
exposures are associated with an increased incidence of testicular
cancer, our results strongly implicate early exposures as major
determinants," they say.</P>

<P><FONT SIZE="-1">Source: &nbsp;</FONT><A HREF="/web/20150429165629/http://quiz.ivillage.com/health/tests/menshealth.htm"><FONT SIZE="-1">quiz.ivillage.com/health/tests/menshealth.htm</FONT></A><FONT SIZE="-1">
<IMG SRC="/web/20150429165629im_/http://www.tcaw.org/logos/arrow1.gif" WIDTH=28 HEIGHT=15 ALIGN=bottom>
</FONT>&nbsp;<BR>
</P>

<P><A NAME=tccure></A><B>Testicular Cancer Cure Rates Now So High
Patients May Be More At Risk From Treatment<BR>
</B>

<HR>

The treatment of testicular cancer has become so successful and
relapse rates are now so low that doctors face a problem unheard of
20 years ago - patients are living long enough to suffer long term
side effects that are potentially life-threatening and decrease the
survivors' quality of life.<BR>
<FONT SIZE="-1">Source: European Society for Medical Oncology,
</FONT><A HREF="/web/20150429165629/http://www.intelihealth.com/IH/ihtIH/WSIHW000/333/8012/346356.html"><FONT SIZE="-1">www.intelihealth.com/IH/ihtIH/WSIHW000/333/8012/346356.html</FONT></A>
<FONT SIZE="-1"><IMG SRC="/web/20150429165629im_/http://www.tcaw.org/logos/arrow1.gif" WIDTH=28 HEIGHT=15 ALIGN=bottom></FONT><BR>
</P>

<P><A NAME=ignoringlumps></A><B>Ignoring Testicular Lumps Can Cause
Unnecessary Deaths - Get Medical Help Early</B>

<HR>

Some young men put their lives at risk by hiding large testicular
lumps, said researchers in The Lancet (Vol. 359:1632, 1666).</P>

<P>Testicular cancer that has spread to other parts of the body has a
high rate of cure (more than 80%). And even those who have a type of
high-risk disease can be easily cured if caught early. In a case
reported by H. D. de Boer, MD, and colleagues at the University
Medical Centre in St. Radboud, the Netherlands, a 17-year-old man
died in a car accident, and it was later discovered that he had
testicular cancer.</P>

<P>His medical history showed no abnormalities, and except for
complaints of abdominal pain after the accident, he had been without
any symptoms, de Boer said.</P>

<P><B>Overlooked Tumor Found</B></P>

<P>In trying to learn of the cause of the young man's death, doctors
found a large tumor of the right testicle. His cancer had spread to
the liver, bone, and other areas of the body, De Boer said. They
found that a blood clot that reached his lungs caused his death. The
authors believed the delay in diagnosis may have been due to the
patient's lack of knowledge, embarrassment, ignorance, or fear of
cancer. "This tragic case reminds us&#133;early recognition of
testicular carcinoma is essential," said the authors.</P>

<P>It has been shown that treatment delay of more than three months,
de Boer said, is linked to shorter survival rates. The lump had
probably been noticeable for months, according to Jeremy P.C. Steele
and R. Timothy Oliver, medical oncologists at St. Bartholomew's
Hospital in London, who commented on the case in the same
journal.</P>

<P><B>Self-Exam and Proper Medical Exam Vital</B></P>

<P>Such cases are not exceptional, they said. In their experience
they treat about 50 new patients with testicular cancer each year,
and four of these have huge testicular masses that have been hidden
for months. They said that no single reason is given, but some
patients admit to being afraid of seeing doctors, and in some, the
family doctor said nothing was wrong. Steele and Oliver said doctors
should teach men to check for testicular lumps, and when spotted,
know that they are a medical emergency.</P>

<P>The Dutch authors agreed: "It is important to encourage testicular
self-examination and to emphasize the need for prompt medical advice
in the event of change in a previously normal testicle."<BR>
<FONT SIZE="-1">Source: American Cancer Society, </FONT><A HREF="/web/20150429165629/http://www.cancer.org/eprise/main/docroot/NWS/content/NWS_3_1x_Ignoring_Testicular_Lumps_Can_Cause_Unnecessary_Deaths"><FONT SIZE="-1">www.cancer.org/eprise/main/docroot/NWS/content/NWS_3_1x_Ignoring_Testicular_Lumps_Can_Cause_Unnecessary_Deaths</FONT></A><FONT SIZE="-1">
<IMG SRC="/web/20150429165629im_/http://www.tcaw.org/logos/arrow1.gif" WIDTH=28 HEIGHT=15 ALIGN=bottom></FONT><BR>
</P>

<P><A NAME=new></A><B>New Testicular Cancer Warning<BR>
</B>

<HR>

The latest issue of the <I>Lancet</I> features the case of a
17-year-old who died four days after a road accident in which he had
sustained only minor injuries. He was killed by a blood clot in the
lung, which a post-mortem found was not linked to the accident, but
to a testicular tumour which had probably been present for months.
Another example of the importance of men reporting any worrying lumps
to their GP.<BR>
<FONT SIZE="-1">Source: BBC News Online</FONT><BR>
</P>

<P><A NAME=fewerdying></A><B>Doctors Say Fewer Men Dying of
Testicular Cancer</B>

<HR>

Early diagnosis and more effective treatments mean that deaths from
testicular cancer are decreasing worldwide, despite a rise in the
number of new cases of the illness, researchers reported on
Friday.</P>

<P>Their study, published in The Lancet medical journal, showed that
chemotherapy treatment could help to reduce death rates for the most
common cancer among men aged 25 to 29.</P>

<P>"Testicular cancer is a classic example of cancer that is
generally curable when the right treatment is given," said Professor
Peter Boyle of Britain's Imperial Cancer Research Fund, a co-author
of the report.</P>

<P>"In spite of the number of cases increasing, deaths from
testicular cancer have been declining in North America and Western
Europe since the late 70s," he added.</P>

<P>Death rates from the disease in men younger than 45 fell by about
a third in the late 1980s compared to the 1970s.</P>

<P>Cases of testicular cancer, which affects one in 600 men, had been
increasing since the 1930s. Denmark, Switzerland and Norway have the
highest rates in the world.</P>

<P>After peaking in the United States in the 1960s, deaths from the
illness have dropped by over 70%. In most of Europe deaths have
declined by 67% since the 1970s. But in Eastern European nations the
decline is only 22%--behind the United States, Japan and most of the
rest of Europe.</P>

<P>"We must find out why testicular cancer death rates are so
different in central and Eastern Europe," Boyle said, "otherwise
there will continue to be several hundred preventable deaths
occurring every year."</P>

<P>The researchers said their results indicate widespread
inconsistencies in adequate treatments in central and Eastern Europe.
If money is the problem, they suggested that urgent measures are
needed to ensure that the best treatment is available to
everyone.</P>

<P>Testicular cancer is curable in 90% of cases if it is caught and
treated early. Symptoms include a lump or sore on the testicle, pain
or soreness, a persistent cough, blood in the urine and stomach and
bowel problems.</P>

<P>Scientists suspect exposure to high levels of the female hormone
oestrogen in the womb could be part of the reason for the increase in
the disease.</P>

<P>Familial testicular cancers account for an estimated 20% of
cases.</P>

<P>There are also more cases among first-born sons and non-identical
twins.</P>

<P><FONT SIZE="-1">Source: </FONT><A HREF="/web/20150429165629/http://news.excite.com/printstory/news/r/010608/17/health-cancer"><FONT SIZE="-1">news.excite.com/printstory/news/r/010608/17/health-cancer</FONT></A><FONT SIZE="-1">
<IMG SRC="/web/20150429165629im_/http://www.tcaw.org/logos/arrow1.gif" WIDTH=28 HEIGHT=15 ALIGN=bottom></FONT></P>

<P>&nbsp;</P>

<P><A NAME=environment></A><B>Risk Of Testicular Cancer Determined By
Early Environmental Exposures<BR>
</B>

<HR>

A new study has found that Finnish men who immigrated to Sweden have
a risk of testicular cancer that is comparible with that of men in
Finland, suggesting that risk of testicular cancer is determined by
environmental exposures early in life.<BR>
<FONT SIZE="-1">Source: Journal of the National Cancer Institute,
</FONT><A HREF="/web/20150429165629/http://www.intelihealth.com/IH/ihtPrint/EMIHC268/333/22002/368399.html?d=dmtICNNews&amp;hide=t&amp;k=basePrint"><FONT SIZE="-1">www.intelihealth.com/IH/ihtPrint/EMIHC268/333/22002/368399.html?d=dmtICNNews&amp;hide=t&amp;k=basePrint</FONT></A><FONT SIZE="-1">
<IMG SRC="/web/20150429165629im_/http://www.tcaw.org/logos/arrow1.gif" WIDTH=28 HEIGHT=15 ALIGN=bottom><BR>
</FONT></P>

<P><FONT SIZE="-1"><A NAME=ratesup></A></FONT><B>Why is the rate of
testicular cancer increasing?<BR>
</B>

<HR>

Trends are valuated in the incidence of testicular germ cell cancer
in Ontario over the last 30 years.1 They report that the rate has
increased about 60% overall, consistent with a 2% annual increase,
and that the increase has been greatest in the youngest group (age 15
to 29).</P>

<P>Their finding is not surprising. Over the last couple of years the
media have publicized an increase in the incidence of testicular
cancer and a decline in the average sperm count. An increased
incidence of testicular cancer has been reported worldwide; in
northern Europe the incidence has increased by 3 to 4 times. This
epidemiologic evidence has been accompanied by provocative reports of
a reduction in testicular size and spermatogenesis rate in several
countries.</P>

<P>It is a reasonable hypothesis that toxins acting during the early
fetal development of the gonads are involved in the reduction in
testicular size and spermatogenesis rate and the increase in the
incidence of testicular germ cell cancer.</P>

<P>It is possible that some tumours are removed before they are
rejected immunologically or undergo involution and disappear.
Currently, however, almost all patients diagnosed with localized
testis cancer present with a palpable testicular mass. These masses,
if left untreated, progress rapidly. Thus, the impact of
overdiagnosis is at best minor and insufficient to explain the
sustained worldwide increase in incidence.</P>

<P>Also, several reports have suggested a relation between testicular
germ cell cancer and a sedentary lifestyle (i.e., increased
testicular temperatures), focusing on the role of heat as a toxic
insult. More research is needed to answer these question.</P>

<P><FONT SIZE="-1">Source: For the complete report by Laurence H.
Klotz, MD , Associate Professor in the Department of Surgery,
University of Toronto, and the Toronto &#173; Sunnybrook Regional
Cancer Centre, Toronto, Ont.</FONT> go to<FONT SIZE="-1">
</FONT><A HREF="/web/20150429165629/http://www.cma.ca/cmaj/vol-160/issue-2/0213.htm"><FONT SIZE="-1">http://www.cma.ca/cmaj/vol-160/issue-2/0213.htm</FONT></A><FONT SIZE="-1">
<IMG SRC="/web/20150429165629im_/http://www.tcaw.org/logos/arrow1.gif" WIDTH=28 HEIGHT=15 ALIGN=bottom>&nbsp;<BR>
</FONT></P>

<P><A NAME=outpacebreast></A><B>Testicular Cancer Cases Outpace
Breast Cancer in Califiornia<BR>
</B>

<HR>

According to the California Cancer Registry, and the American Cancer
Societies <I>Cancer Facts and Figures 2000</I>, there were 411 new
cases of breast cancer in women 0-34 and 461 new cases of testis in
men. Testicular cancer is usually more serious because it is at a
more advanced stage when young men finally get it checked. Yet a
recorded message while waiting to speak to someone at the American
Cancer Society suggest women 20 and over have a mammogram every three
years. No comment about young men and their greater risk of dying of
testicular cancer. Also, the ACS provides a free self-exam card to
hang on your shower nosel regarding a breast cancer self-exam (which
older, over-weight men should consider getting), and they used to
have one for young men on a testies self-exam, but no longer provide
it. We have produced and provide <A HREF="/web/20150429165629/http://www.tcaw.org/merchandise/merchindex.html">such
a card</A> for young men and would be interested, if we could get
funding, to produce one and make it available to college dorms,
housing units and social organizations. Let us know if you know of
someone who would be interested in helping us with this project.<BR>
</P>

<P><A NAME=rise></A><B>Testicular Cancer on the Rise and Getting
Younger<BR>
</B>

<HR>

According to the <I>American Cancer Society</I>, around 8,980 young
men will be diagnosed with testicular cancer and around 360 young men
will die in the US&nbsp;alone this year. The risk of the cancer is 5
to 10 times higher in men with a history of undescended testes
(cryptorchidism), a condition where the testes remain in the abdomen
at birth. Whites are also four times as likely as African Americans
to develop the cancer. It also appears as if men's age at diagnosis
of the cancer is getting younger. Most cases are between 12-50.</P>

<P>(Editor:&nbsp;&nbsp;We want to
<FONT COLOR="#FF0000"><B>STOP</B></FONT> right now and say if you are
a male, or have a brother, or a son who is between 12-50, learn the
SIMPLE self examine you can do in private in the shower. 360 men will
die this year primarily because they ignored the symptoms or didn't
cfind it in time. Click here to read each side <A HREF="/web/20150429165629/http://www.tcaw.org/logos/testicularexam1.jpg">Side
1</A> and <A HREF="/web/20150429165629/http://www.tcaw.org/logos/testicularexam2.jpg">Side 2</A>
RIGHT&nbsp;NOW and learn what to do! If you want to purchase this
waterproof guide to hang on your shower nozzle to remind you to check
once-a-month, <A HREF="testiclesreminder.html">Click here</A> and we
will remind you, free of charge.)</P>

<P>Studies have suggested that prenatal exposure to hormones may
increase cancer risk. Twin pregnancies, obesity and other conditions
that increase estrogen levels in pregnancy are associated with a
higher risk of testicular cancer. The increased use of
fertility-promoting hormones may be linked in some way to the
increase, also. Some studies have found a weak relationship between
testicular cancer and inguinal hernia, low birth weight, early birth
order, and a sedentary lifestyle. However, <A HREF="#hamilton">Scott
Hamilton</A> (the ice skater) was a victim of testicular cancer.</P>

<P>More study is needed to uncover the causes of testicular cancer,
but less than $100,000 was budgeted for such research in the year
2000. So, let's each do are part to protect ourselves and those we
love from being a statistic.<BR>
</P>

<P><A NAME=infertilemen></A><B>Infertile men at greater risk of
testicular cancer<BR>
</B>

<HR>

Men in couples with fertility problems are more likely to develop
testicular cancer than other men. A study of over 32,000 Danish men
has found that these men are 1.6 times more likely to develop this
cancer, suggesting that both conditions have a common cause. One
popular theory is that key testicular cells are damaged while males
are still in their mother&#146;s womb by environmental pollutants
that increase their exposure to oestrogen. On the positive side,
testicular cancer is still a relatively rare condition &#150; on
average, a man has just a one in 450 chance of developing it &#150;
and can almost always be effectively treated if caught early.
Nevertheless, men with fertility problems should make sure they
examine their testicles regularly for lumps and swellings.<BR>
</P>

<P><A NAME=secret></A><B>No Longer a Secret<BR>
</B>

<HR>

Many young pro sports idols have contracted TC, some with terminal
diagnosis, and survived. This speaks to a generation that can get
through the "taboo" of talking about it, and start reversing the
trend. <A HREF="#hamilton">Scott Hamilton</A> (pro ice skater)
received the most publicity, Brian Piccolo (pro-football), Marlin's
Mike Lowell (baseball), Trevor Dodds (Golf), Clarence Rose
(PGA&nbsp;golfer's 18 month old son), Jim Howley (Tri-athlete), and
MTV&nbsp;funnyman Tom Green.<BR>
</P>

<P><B><A NAME="men15-34"></A><A NAME=hamilton></A>Scott Hamilton and
Testicular Cancer<BR>
</B>

<HR>

Scott Hamilton, 39 year old world famous ice skater, talked about his
bout with testicular cancer on Dateline NBC. He has overcome the
cancer, but it has been tough. And what we know from all cancer's is
that you have a better chance to beat it the sooner you learn about
it. So, how come we don't tell young men most impacted by it, those
15 to 40, of how to detect it? I don't know of any program in any
high school that teaches boys how to test for it (set an anchor for
the two sided shower hanger). Chico State University student health
department were misdiagnosing it up to three years ago. Lewis &amp;
Clark College in Portland, had a hanger in ever shower informing
everyone how to test for breast cancer. Not one shower that we could
find the same thing for men on testicular cancer. And, the American
Cancer Society provides these water proof cards free of charge.</P>

<P>While it only kills around 360 young men a year, these brothers,
sons, boyfriends, and friends probably would not have died if anyone
had the guts to teach them how to test for it. It should be in every
gym program. Its diagnosis should be taught in all school health
programs. And, young men who were born with an undescended testicle
should be informed, from the start, that they are at greater
risk.</P>

<P>It is among the easiest to cure when detected early. However, in
early stages testicular cancer may be symptomless. When symptoms do
occur they include: Lump about the size of a pea on one of the
testicles, epididymis or vas, enlargement of a testicle, heavy
sensation in groin area or testicles, dull ache in abdomen area. If
you find a lump or have any of the above symptoms, see your doctor
immediately for an accurate diagnosis.</P>

<P>A once-a-month simple self-examination can help catch this cancer
at its early stage. The most convenient time to examine yourself is
while taking a shower or bath. The warm water causes the skin to
relax, making the examination of the underlying tissue easier. First:
Examine your testicles. Slowly roll each testicle between the thumb
and fingers. Try to find any hard, non sensitive lumps. Second:
Examine the epididymis for lumps. This crescent-shaped cord is behind
each testicle. This area is tender so do not be alarmed. Third:
Examine the VAS (the sperm-carrying tube which extends from the
epididymis) of each testicle.</P>

<P>As a parent, provide this information to a son in this age group.
Also, talk to your high-school and college about providing this
information in gym class or anywhere else where all male students
will get the information in a positive, serious manner. Tell them
about this website and let them know that they can get water proof
informational cards from us for use in your shower or <A HREF="/web/20150429165629/http://www.tcaw.org/merchandise/merchindex.html#testies">download</A>
it directly from this website. No boy should die from this cancer.
The only ones who die from this cancer are the ones who didn't know
they should do a monthly check, or knew and didn't do it. It's a
shame to loose anyone to this disease. But who will tell them how to
protect themselves?<BR>
</P>

<P><A NAME=vasectomy3></A><B>Cancer, Vasectomy Connection
Disproved<BR>
</B>

<HR>

Undergoing a vasectomy does not increase a man's risk of contracting
prostate cancer, a study forom New Zealand finds. Though some
previous studies have produced mixed findings about a link between
vasectomy and prostate cancer victims, researchers at the University
of Otago-Dunedin say their two-year study of 923 prostate cancer
victims and 1,224 "control" subjects showed no connection. "Our
results are consistent with several recent studies that have not
found a significant association between vasectomy and prostate
cancer," says the study in the Journal of the American Medical
Association.<B> </B><BR>
</P>

<P><A NAME=vasectomy2></A><B>Vasectomy and Cancer Risk<BR>
</B>

<HR>

Some studies have raised questions about a possible relationship
between vasectomy (an operation to cut or tie off the two tubes that
carry sperm out of the testicles) and the risk of developing cancer,
particularly prostate and testicular cancer. Such a relationship, if
proven, would be of importance because about 1 in 6 men over age 35
in the United States has had a vasectomy.</P>

<P><B>Testicular Cancer</B></P>

<P>Testicular cancer is much less common than prostate cancer,
accounting for only 1 percent of cancers in American men. This type
of cancer is most often found in men ages 15 to 35. A few studies
have suggested a link between vasectomy and an increased risk of
testicular cancer, but it is possible that the increase in cases of
testicular cancer seen in these studies may be due to factors other
than vasectomy. It is also possible that the vasectomy procedure
increases the rate at which an existing, but undetected, testicular
cancer will progress. At this time, it is believed that there is
either no association or a weak association between vasectomy and
testicular cancer, but more research is needed before definitive
conclusions can be made.</P>

<P>Men concerned about testicular cancer should talk to their doctor
about the symptoms to watch for and an appropriate schedule for
checkups.</P>

<P><B>References</B></P>

<UL>
   <LI>Brawley OW, Knopf K, Thompson I. The epidemiology of prostate
   cancer part II: the risk factors. Seminars in Urologic Oncology
   1998; 16(4):193-201.</LI>
   
   <LI>Lesko SM, Louik C, Vezina R, Rosenberg L, Shapiro S. Vasectomy
   and prostate cancer. Journal of Urology 1999;
   161(6):1848-1852.</LI>
   
   <LI>Lightfoot N, Kreigr N, Sass-Kortsak A, Purdham J, Buchan G.
   Prostate cancer risk. Medical history, sexual, and hormonal
   factors. Annals of Epidemiology 2000; 10(7):470.</LI>
   
   <LI>Schwingl PJ, Guess HA. Safety and effectiveness of vasectomy.
   Fertility and Sterility 2000; 73(5):923-936.</LI>
   
   <LI>Stanford JL, Wicklund KG, McKnight B, Daling JR, Brawer MK.
   Vasectomy and risk of prostate cancer. Cancer Epidemiology,
   Biomarkers &amp; Prevention 1999; 8(10):881-886.</LI>
</UL>

<P>This fact sheet was reviewed on 2/04/02<BR>
</P>

<P><A NAME=fewerdying></A><B>Doctors Say Fewer Men Dying of
Testicular Cancer</B>

<HR>

Early diagnosis and more effective treatments mean that deaths from
testicular cancer are decreasing worldwide, despite a rise in the
number of new cases of the illness, researchers reported on
Friday.</P>

<P>Their study, published in The Lancet medical journal, showed that
chemotherapy treatment could help to reduce death rates for the most
common cancer among men aged 25 to 29.</P>

<P>"Testicular cancer is a classic example of cancer that is
generally curable when the right treatment is given," said Professor
Peter Boyle of Britain's Imperial Cancer Research Fund, a co-author
of the report.</P>

<P>"In spite of the number of cases increasing, deaths from
testicular cancer have been declining in North America and Western
Europe since the late 70s," he added.</P>

<P>Death rates from the disease in men younger than 45 fell by about
a third in the late 1980s compared to the 1970s.</P>

<P>Cases of testicular cancer, which affects one in 500 men, had been
increasing since the 1930s. Denmark, Switzerland and Norway have the
highest rates in the world.</P>

<P>After peaking in the United States in the 1960s, deaths from the
illness have dropped by over 70%. In most of Europe deaths have
declined by 67% since the 1970s. But in Eastern European nations the
decline is only 22%--behind the United States, Japan and most of the
rest of Europe.</P>

<P>"We must find out why testicular cancer death rates are so
different in central and Eastern Europe," Boyle said, "otherwise
there will continue to be several hundred preventable deaths
occurring every year."</P>

<P>The researchers said their results indicate widespread
inconsistencies in adequate treatments in central and Eastern Europe.
If money is the problem, they suggested that urgent measures are
needed to ensure that the best treatment is available to
everyone.</P>

<P>Testicular cancer is curable in 90% of cases if it is caught and
treated early. Symptoms include a lump or sore on the testicle, pain
or soreness, a persistent cough, blood in the urine and stomach and
bowel problems.</P>

<P>Scientists suspect exposure to high levels of the female hormone
oestrogen in the womb could be part of the reason for the increase in
the disease.</P>

<P>Familial testicular cancers account for an estimated 20% of
cases.</P>

<P>There are also more cases among first-born sons and non-identical
twins.</P>

<P><FONT SIZE="-1">Source: </FONT><A HREF="/web/20150429165629/http://news.excite.com/printstory/news/r/010608/17/health-cancer"><FONT SIZE="-1">news.excite.com/printstory/news/r/010608/17/health-cancer</FONT></A><FONT SIZE="-1">
<IMG SRC="/web/20150429165629im_/http://www.tcaw.org/logos/arrow1.gif" WIDTH=28 HEIGHT=15 ALIGN=bottom></FONT><BR>
</P>

<P><A NAME=youngman></A><B>The Young Man's Cancer<BR>
</B>

<HR>

If you think you don't have to worry about cancer until after your
fiftieth birthday, consider this fact: The risk of getting testicular
cancer is highest between the ages of 15 and 35.</P>

<P>Testicular cancer is a relatively uncommon disease, with an
estimated 7,600 cases every year. Yet, it is the most common form of
cancer among men between the ages of 15 and 40 and its incidence has
increased sharply over the past three decades. Fortunately,
testicular cancer is one of the most treatable cancers when it's
caught early -- and that's simple to do because the testes are easily
accessible for external examination. But don't wait until you see
your doctor. You can prevent this cancer from spreading to other
organs and becoming deadly by performing regular
self-examinations.</P>

<P><B>What is Testicular Cancer?</B></P>

<P>The testicles are two egg-shaped glands suspended below the penis
in the scrotum. After puberty, the testes produce the male hormone
testosterone, which is responsible for many male characteristics,
such as body hair and deepening of the voice. The testes also produce
the sperm that fertilizes a woman's egg during reproduction.</P>

<P>Testicular cancer is the growth of a malignant (cancerous) tumor
that originates in the testes. About 95 percent of masses in the
testes are malignant, and if untreated, will grow and spread to other
organs. Early detection is key to curing this disease.</P>

<P><B>Who's at Risk?</B></P>

<P>While any man can develop testicular cancer, especially between
the ages of 15 and 40, certain factors make men more vulnerable.
These include:</P>

<P>An undescended testicle (cryptochordism). If you have or have had
an undescended testicle your risk of developing testicular cancer
increases by three to 14 percent. This is particularly true if the
testicle descended after age six or never descended at all.</P>

<P>A testicle that has atrophied (wasted away or shrunk) as a result
of the mumps or a viral infection.</P>

<P>Family history. If you have a brother, or other family member who
has had testicular cancer, you may have an increased risk for the
disease.</P>

<P>Exposure to diethylstilbestrol (DES) may be a risk factor for
testicular cancer. From 1946 through the 1970's, DES was used to
treat pregnant women who had a high risk for miscarriage. Studies
have already established a link between DES and vaginal cancer in the
daughters of women who took DES during pregnancy. Studies are under
way to see if such a link exists in sons as well (for more
information, call the DES Cancer Network at 800-337-6384).</P>

<P><B>Early Detection</B></P>

<P>Your physician should include an examination of your testes during
every routine medical examination. But since that probably occurs
only once a year, you can improve your chance of detecting a problem
as early as possible by performing a testicular self-examination
(TSE) every month.</P>

<P>Testicular Self-Exam (TSE). Performing this simple, 3-minute
self-examination once a month, will help you detect testicular
cancer. The best time to check yourself is in the shower because
fingers glide over soapy skin, and it's easier to concentrate on the
texture underneath. After a warm bath is also good because the heat
causes the skin to relax, making the exam easier.</P>

<P>As you perform these monthly self-exams, you will learn what is
normal for you. That way you will be better able to detect any of the
following symptoms:</P>

<UL>
   <LI>A small, hard, usually painless lump, pea-size or greater, on
   the front or side of the testicle.</LI>
   
   <LI>Enlargement of a testicle or a change in a testicle's
   consistency.</LI>
   
   <LI>A heavy feeling in the testes.</LI>
   
   <LI>Pain or discomfort, which may develop in one testicle or
   around the groin. But don't wait for pain to develop. Report any
   signs or symptoms, such as swelling, lumps, or heaviness, to your
   doctor immediately.</LI>
   
   <LI>Enlargement of the lymph nodes in your groin or neck. The
   lymph nodes are glands that produce white blood cells and fight
   infection. When swollen, they feel round (about the size of a
   small marble or larger) and are often tender or painful.</LI>
</UL>

<P>If you find anything out of the ordinary, contact your doctor
promptly because about 95 percent of masses in the testes are
malignant. Early detection and prompt treatment is the best way to
guarantee a cure.</P>

<P>1. Start by examining one of your testicles. Slowly roll it
between your thumb and fingers, applying slight pressure and looking
for hard, painless lumps.</P>

<P>2. Then examine your epididymis (the comma shaped cord behind each
testicle). It may be tender to the touch, but it's the location of
most non-cancerous problems.</P>

<P>3. Continue by examining the vas (the sperm-carrying tube that
runs up from your epididymis), which normally feels like a firm,
movable, smooth tube.</P>

<P>4. Repeat the same procedure on your other testicle.</P>

<P><B>Diagnosis</B></P>

<P>If the scrotum doesn't feel normal, your doctor will probably
order an ultrasound exam, which uses sound waves to make a picture of
the inside of your testes. A number of other examinations and tests
may be needed to rule out or confirm cancer or to stage the disease
(find out how far it has progressed). The following tests may be used
for that purpose:</P>

<P>Blood and urine samples to measure the function of other organs.
Also, a blood test for tumor markers (chemicals produced by
testicular tumors and released into the blood stream) can help detect
the disease and monitor tumor activity before, during, and after
treatment.</P>

<P>Chest x-rays or computed tomography (CT) scans of the abdomen and
chest (a CT scan is a painless procedure in which a beam moves around
the body and forms a detailed picture on a computer screen that can
show any developing abnormalities).</P>

<P>Once testicular cancer has been confirmed, the physician has to
determine what kind of cancer it is in order to decide what treatment
is best. The tumors that form testicular cancer are divided into two
major groups:</P>

<P>1. Seminomas, or cancer that originates in the sperm cells,
account for 40 percent of all testicular cancers. This type of tumor
is generally very responsive to radiation.</P>

<P>2. Non-seminomatous tumors make up the remaining 60 percent of
testicular cancers and include several varieties of tumors.
Approximately 30 to 40 percent of testicular cancers involve more
than one type of tumor. A metastatic tumor (one that has spread to
other parts of the body) may be made up of cells different from the
cells of the primary, or first, tumor.</P>

<P>The next step is to determine the stage of the cancer, or how far
it has spread. There are three main stages of testicular cancer:</P>

<P>Stage I. Regardless of the size of the tumor, the cancer is
limited to the testes and has not spread to the lymph nodes or other
organs.</P>

<P>Stage II. The cancer has begun to affect the area of the abdomen
that lies behind the stomach (peritoneum). It also includes cancers
that have spread to the lymph nodes, but not to a distant organ.</P>

<P>Stage III. Cancer that has spread to one or more distant
organs.</P>

<P><B>Treatment</B></P>

<P>The good news is that testicular cancer is among the most curable
of cancers, especially when detected early. Since the majority of all
testicular tumors are cancerous, the first treatment is usually
radical orchiectomy, which involves the surgical removal of the
affected testicle and all of the adjoining tubes.</P>

<P>If only one testicle is involved, radical orchiectomy will
probably not affect sexual function. However, it is important to find
a surgeon experienced in this particular type of surgery because if
lymph glands at the back of the abdomen have to be removed, the
surgeon must take special care to protect the nerves associated with
ejaculation. Nerves damaged during surgery can cause infertility.</P>

<P>After surgery, adjuvant (or additional) therapy is often needed
depending on the type of tumor and the stage of the cancer.</P>

<P>In general, the treatments most commonly used are:</P>

<P>Radiation therapy, which is usually highly effective against
seminomas, may be used to eradicate the cancer or to shrink the size
of tumors too large to operate.</P>

<P>Chemotherapy (the use of powerful anti-cancer drugs) is usually
used when the tumor cannot be completely removed surgically (such as
with microscopic disease), the disease has spread to other organs, or
the cancer recurs. Since chemotherapy may damage testicular function
and cause infertility, a man may want to consider the option of
storing sperm in a sperm bank prior to treatment.</P>

<P>In cases where the cancer has spread to the abdomen, additional
surgery may be needed to remove affected lymph nodes in the area.</P>

<P><B>Follow-up Care</B></P>

<P>If treatment is successful, the disease goes into complete
remission (it is no longer present). But there is still a chance that
the cancer will return, particularly during the first two years after
therapy. About 10 percent of men treated for testicular cancer
experience a relapse. Still, almost all of these cases can also be
cured -- usually with chemotherapy -- when caught early enough.
Physicians monitor patients for recurrences with regular physical
exams, CT scans of the abdomen, chest x-rays, and blood tests to
measure tumor marker levels.</P>

<P>Men who are dissatisfied with their appearance after surgery can
have an artificial testicle implanted. These implants are filled with
silicone gel and have the weight and feel of a normal testicle.
However, though recent concerns about a connection between the
leakage of silicone gel and the occurrence of rheumatic symptoms
(joint aches and pains, fatigue, inflammation) have primarily been
raised by women with ruptured or leaking breast implants, there have
also been a few complaints from men with testicular implants.</P>

<P><B>Undescended Testicles</B></P>

<P>During fetal development, a male child's testicles develop in the
abdomen. Before birth they normally descend into the scrotum (a pouch
of skin underneath the penis that houses the testes). In a small
number of boys, especially those who are born prematurely, one or
both testicles fail to descend by the time of birth. In most of them,
the testicles descend during the first nine months of life.</P>

<P>The cause of undescended testicles cannot be explained in most
cases. But according the American Academy of Pediatrics, these
factors may play a role:</P>

<P>There may not have been enough of certain hormones from the mother
or the developing testicles to stimulate normal maturation.</P>

<P>The testes themselves may be abnormal in their response to the
hormones.</P>

<P>There may be a physical blockage.</P>

<P>In some cases, there may be a link with hormonal medications taken
by the mother (one reason pregnant women are advised to avoid
them).</P>

<P>If a child has undescended testicles, his scrotum will be small
and appear underdeveloped. If only one testicle has descended, the
scrotum may look full on one side and empty on the other. If the
testicles are sometimes in the scrotum and at other times absent
(such as when he is cold or excited), they are said to be
"retractile." This condition usually corrects itself with time.</P>

<P>A physician should carefully examine male infants during routine
medical examinations to ensure that their testes have descended. If
one or both testes are undescended by one to two years of age,
treatment should be started.</P>

<P>Undescended testicles may be treated with hormone injections
and/or surgery. The lower the testes, the more likely that the
hormone injections will be successful. Usually, but not always,
treatment with hormones is tried first. If that is unsuccessful, a
surgery called orchiopexy can be performed. During this operation,
the testes are brought down into the scrotum and attached to the
walls so that they will not retract.</P>

<P>If testicles remain undescended for over two years, a boy will
have a higher than average risk of being infertile (though perhaps
not impotent) when he matures. He will also have an increased risk of
developing testicular cancer, particularly if the testicle is left in
its abnormal position. Fortunately, with early and proper treatment,
all of these complications can usually be avoided.</P>

<P>For More Information: AHCPR offers a free copy of their Managing
Cancer Pain. Agency for Health Care Policy and Research,
800.358.9295. Health Pages. Publication: The Young Man's Cancer.
1998. (Online) <A HREF="/web/20150429165629/http://www.thehealthpages.com/ar-testi.html">www.thehealthpages.com/ar-testi.html</A>
<FONT SIZE="-1"><IMG SRC="/web/20150429165629im_/http://www.tcaw.org/logos/arrow1.gif" WIDTH=28 HEIGHT=15 ALIGN=bottom></FONT><BR>
</P>

<P><A NAME=youngmen></A><B>Young men think they are indestructible -
a true story<BR>
</B>

<HR>

I was 23 years old and invincible. Or so I thought. Then one day,
playing softball in a suburb of Chicago, where I live, I got kicked
in the groin by the nice guy playing shortstop. When I checked myself
out in the shower later, I found what felt like a ball bearing inside
my right testicle, as if one end were hardened.</P>

<P>So I did what most guys would do: I put it out of my mind. Or
tried to. I couldn't believe it was anything serious. My wife and I
had just married. We were closing on our first house. I was in the
third month of a new job. Everything was going great.</P>

<P>Then I noticed the testicle was getting larger. Finally I made an
appointment with my primary care physician -- and started what turned
into a five-month battle.</P>

<P>The visit with my doctor took exactly 20 minutes. He set up an
appointment with a urologist the next day who examined me, looked me
in the eye and said, "You're a smart kid. I'm glad you came to see
me."</P>

<P>When results from a blood test and an ultrasound came back, the
urologist sat down with my wife and me and gave us the news: There
was a 95% chance I had cancer. Getting kicked in the groin during the
softball game hadn't caused the disease, of course; it had just
prompted me to check things out in time to catch the tumor, which was
already there. The testicle had to be removed right away, the
urologist said. I couldn't believe my ears.</P>

<P>Just like that, I had become part of a trend: I had likely been
stricken with a form of cancer that has, over the past three decades,
increased in frequency an astonishing 60% (according to the U.S.
Centers for Disease Control and Prevention), striking mostly young
men like me. The doctor probably told me that it was a very curable
cancer, but I was in such a state of shock, I could barely understand
what he was saying.</P>

<P>That next Monday -- just after moving into our new house -- I went
in for surgery. I was home that afternoon, with a huge bandage on my
crotch and a gigantic ice pack in my pants. The procedure, called an
orchiectomy, involves removing the testicle through an incision in
the groin. A week later the biopsy report came back: "Nonseminomatous
mixed germ-cell tumor primarily consisting of embryonal
carcinoma."</P>

<P>In other words: Cancer.</P>

<P>Luckily, the report said the cancer hadn't spread to my lymph
nodes or bloodstream. Even so, I was faced with a tough decision. I
could watch and wait to see if the cancer was truly cured. Or I could
undergo what's called a retroperitoneal lymph node dissection, or
RPLND. In short, a surgeon opens you up from below the navel to the
middle of your chest, lifts your internal organs out of the way, and
removes all the lymph nodes that could be cancerous if the tumor has
spread.</P>

<P>The prospect terrified me. But so did the idea of doing
nothing.</P>

<P><B>Surfing for Survival</B></P>

<P>I got on the Internet, looking for help and information. I found
plenty of it, along with moral support. I also found out about
Indiana University, known for its expertise in treating testicular
cancer. I made an appointment, and a week later my wife and I hit the
road.</P>

<P>I've since learned that testicular cancer is often misdiagnosed.
The problem -- as I was about to learn firsthand -- is that because
it's so rare, most doctors don't see it all that often. The ones back
home had told me the cancer hadn't spread. But when the same slides
were reviewed at Indiana University, the report indicated that, in
fact, it had. I had learned one important lesson: Always get a second
opinion. Always.</P>

<P>With this latest round of bad news, I decided to have the dreaded
RPLND. I wanted to kill this beast while I had the upper hand.</P>

<P>At the age of 23, I never thought I'd have to make my peace with
God. But on the morning of the surgery, I did. Saying goodbye to my
wife before entering the operating room was hard enough. But one of
the most difficult moments was when I saw my dad for the first time
after surgery. He looked shaken, and as he took my hand, he asked in
a low voice how I was doing. I gripped his hand as hard as I could
and told him not to worry.</P>

<P><B>Feeling Like Burnt Toast</B></P>

<P>The six days I spent in the hospital were pretty tough. At first I
needed help getting out of bed. By the third day, I was just
beginning to feel better when my primary care doctor came to see how
I was doing. He happened to mention in passing that my urologist had
found one node that was positive for cancer. And then he left.</P>

<P>There I was, in the middle of a visit with my wife, when this guy
walks in, drops a bomb, and then walks out. I was devastated.</P>

<P>My urologist laid out the situation the next day. There was a 70%
to 80% chance that I was cured already. Two rounds of chemotherapy
would raise those odds to 95%. I wanted the best odds I could get,
but I'll admit it: I was really afraid of chemotherapy. Fear of the
unknown, I guess.</P>

<P>The first couple of days on chemo were pretty easy. But by the end
of the first week I felt horrible -- like burnt toast. The drugs had
affected my hearing and made me feel like I was in a tunnel. The
knuckles on my hands turned dark. My skin felt thickened. And I felt
as if I had just smoked 100 cigars in a row -- my lungs hurt that
badly. Then my hair started falling out.</P>

<P>In all, I did two rounds of chemotherapy, three weeks each. On
Oct. 21, 1997, the treatments ended. I couldn't have been happier.
Now it was time to get back to my life.</P>

<P><B>The Aftermath</B></P>

<P>In an odd way, I feel lucky. Testicular cancer is among the most
treatable ones around. But even though 95% of patients with the
condition beat it and survive at least five years, according to the
American Cancer Society, that still leaves 5% who don't. Men do die
of this disease. And most of them are young and in the prime of their
lives.</P>

<P>If I had waited much longer, my story might have ended
differently. One key to beating this disease is detecting it early.
That's why I tell everyone: If you think something is wrong, don't
wait. Go to your doctor. Another key is following up to make sure it
doesn't come back.</P>

<P>Since the surgery I've struggled a bit to get my life back in
order. Sometimes I feel a little bitter that I had to go through
this. But mostly I know that this experience made me realize what a
gift my life is. I have a loving wife, a wonderful family, great
friends, and all kinds of opportunities. And my wife and I just got
the best gift possible. Our first child, a girl, is due to be born
this November. (Just so you know: We conceived her the old-fashioned
way.) Believe me, I'm planning to be around a long, long time to
enjoy being a dad.</P>

<P><FONT SIZE="-1">Source: Like most young men, the writer thought he
was indestructible. Then he was diagnosed with cancer and found
himself in the battle of his life. By Erik Strand. Medically reviewed
by Dr. Craig H. Kliger. Erik Strand is a mechanical engineer in
Plainfield, Ill., where he still enjoys playing softball.</FONT><BR>
</P>

<P><A NAME=fertilityproblems></A><B>Fertility problems linked to
testicular cancer risk<BR>
</B>

<HR>

Men with fertility problems may be at increased risk for testicular
cancer, according to results of a large study of Danish men.</P>

<P>While previous studies in Denmark have suggested there is a link
between infertility and testicular cancer, those studies measured a
man's fertility by the number of children he had. The new study
looked at sperm quality and showed that men with abnormalities were
two to three times more likely than other men to develop testicular
cancer, researchers report in the September 30th issue of the British
Medical Journal.</P>

<P>The incidence of testicular cancer has risen in Europe and the US
in recent decades, and some evidence suggests semen quality has
declined over the same time period.</P>

<P>Dr. Rune Jacobsen of the Danish National Research Foundation in
Copenhagen and colleagues looked at sperm count, as well as the shape
and movement of sperm, among more than 32,400 men who had semen
samples taken between 1963 and 1995. Each man was part of a couple
with fertility problems.</P>

<P>Overall, the men had a higher-than-average risk for testicular
cancer. Among men with sperm abnormalities, the cancer risk was two
to three times higher than average.</P>

<P>Poor sperm quality and testicular cancer may share an underlying
cause, the authors suggest. Because testicular cancer strikes young
men, experts have speculated that the risk of the disease begins
early in life or even in the womb. For example, exposure to maternal
hormones during pregnancy may trigger cell malformations that later
show up in men as fertility problems and testicular cancer.</P>

<P>Despite this possible new risk factor for testicular cancer, it is
important for men to keep the risk in perspective, according to
Jacobsen's team. Only 89 of the more than 32,000 men developed
testicular cancer, making a man's risk for the disease "very small,"
the researchers note.</P>

<P><FONT SIZE="-1">Source: British Medical Journal 2000;321:789-792.
</FONT><A HREF="/web/20150429165629/http://www.healthanswers.com/Centers/Disease/NewsStory.asp?newsid=9247&amp;id=testicular+cancer&amp;parent=cancer"><FONT SIZE="-1">www.healthanswers.com/Centers/Disease/NewsStory.asp?newsid=9247&amp;id=testicular+cancer&amp;parent=cancer</FONT></A><FONT SIZE="-1">
<IMG SRC="/web/20150429165629im_/http://www.tcaw.org/logos/arrow1.gif" WIDTH=28 HEIGHT=15 ALIGN=bottom></FONT><BR>
</P>

<P><A NAME=highdose></A><B>High-dose chemo battles recurrent
testicular cancer<BR>
</B>

<HR>

High-dose chemotherapy combined with a stem-cell transplant can boost
survival in men who have had a relapse after being treated for
testicular cancer, researchers report.</P>

<P>Most men with testicular cancer can be cured with the combination
of surgery and chemotherapy. However, as many as 30% may require
additional treatment, according to Dr. Lawrence H. Einhorn and
associates from Indiana University Medical Center in
Indianapolis.</P>

<P>In a 3-year study of 65 men suffering a cancer relapse, the men
received high-dose chemotherapy followed by either a bone-marrow
transplant or stem-cell transplant to replenish the immune system
damaged by the chemotherapy, which can be extremely toxic.</P>

<P>More than 40% of patients had a complete response to the high-dose
chemotherapy, the authors report, and another 20% had no evidence of
tumor after additional surgery. Fifteen additional patients had a
partial response.</P>

<P>Overall, nearly 60% of patients were continuously free of cancer
after high-dose chemotherapy either alone or combined with other
treatments, according to the report in the October issue of the
Journal of Clinical Oncology.</P>

<P>Some of the side effects of the chemotherapy were fever, diarrhea,
nausea, mouth sores or kidney toxicity, though none of the patients
died from the treatment.</P>

<P>"This is a message of hope," Einhorn said in a statement issued by
the journal. "For patients who are not cured with the initial
chemotherapy, we can now tell them with confidence that there is more
than a 50% chance they can still be cured with second-line
therapy."</P>

<P><FONT SIZE="-1">Source:: Journal of Clinical Oncology
2000;18:3346-3351. </FONT><A HREF="/web/20150429165629/http://www.healthanswers.com/Centers/Disease/NewsStory.asp?newsid=9242&amp;id=testicular+cancer&amp;parent=cancer"><FONT SIZE="-1">www.healthanswers.com/Centers/Disease/NewsStory.asp?newsid=9242&amp;id=testicular+cancer&amp;parent=cancer</FONT></A><FONT SIZE="-1"><B>
</B><IMG SRC="/web/20150429165629im_/http://www.tcaw.org/logos/arrow1.gif" WIDTH=28 HEIGHT=15 ALIGN=bottom></FONT><BR>
</P>

<P><A NAME=newdrugs></A><B>New drugs may hold promise for testicular
cancer undescended testicle<BR>
</B>

<HR>

A type of drug known to immobilize sperm appears to effectively kill
immature sperm cells in the testes, according to results of a study
in mice. The experimental drugs, known as vanadocenes, may one day be
used to treat testicular cancer, researchers report in the August
issue of Toxicology and Applied Pharmacology.</P>

<P>"Previous research with vanadocenes has shown them to be potent
spermicides," according to Dr. Osmond J. D'Cruz of Parker Hughes
Institute in St. Paul, Minnesota. "This finding caused researchers to
consider their ability as an anti-testicular cancer agent."</P>

<P>The drugs are also known to kill many types of cancer cells in
laboratory culture dishes, including testicular, mammary, ovary,
lung, stomach, colon and skin cells.</P>

<P>In a new study, D'Cruz and colleague Fatih Uckun injected four
different types of vanadocenes into the testes of mice daily for 28
days. The investigators found that the drugs caused a preferential
loss of maturing sperm cells, mainly by inducing the cells to undergo
a naturally occurring cell suicide program. Other cells did not
appear to be harmed by the drugs.</P>

<P>The authors conclude that less toxic types of vanadocenes may be a
potential alternative to chemotherapy drugs currently used to treat
testicular cancer. However, much more study is needed to determine if
the drugs are safe and effective for humans, and if the drugs are
"likely to cause impaired fertility," they note.</P>

<P>"We still need to study the feasibility of whether or not this
treatment can be used in humans," D'Cruz told Reuters Health.</P>

<P>In about 90% of cases, the first signs of testicular cancer are a
painless or uncomfortable lump on a testicle, or testicular
enlargement or swelling. Men with testicular cancer often report a
sensation of heaviness or aching in the lower abdomen or scrotum,
according to the American Cancer Society. An estimated 6,900 cases
are expected to be diagnosed in the US this year.</P>

<P><FONT SIZE="-1">Source:: Toxicology and Applied Pharmacology
2000;166 by Keith Mulvihill </FONT><A HREF="/web/20150429165629/http://www.healthanswers.com/Centers/Disease/NewsStory.asp?newsid=8298&amp;id=testicular+cancer&amp;parent=cancer"><FONT SIZE="-1">www.healthanswers.com/Centers/Disease/NewsStory.asp?newsid=8298&amp;id=testicular+cancer&amp;parent=cancer</FONT></A><B>
</B><FONT SIZE="-1"><IMG SRC="/web/20150429165629im_/http://www.tcaw.org/logos/arrow1.gif" WIDTH=28 HEIGHT=15 ALIGN=bottom></FONT><BR>
</P>

<P><A NAME=cured></A><B>Testicular Cancer Likely to Be Cured, Even
When It Recurs<BR>
</B>

<HR>

Even though the treatment may be arduous, winning against testicular
cancer is becoming more common, both among world-class athletes and
the guy on the street.</P>

<P>Even if the unthinkable happens and testicular cancer returns for
Brewer or Armstrong, there is still a better than 50% cure rate for
recurrent disease, according to a paper published in the current
issue of the Journal of Clinical Oncology.</P>

<P>"For patients who come to me for the first time and require
chemotherapy to treat their disease, I tell them that there will be
certain problems associated with their therapy, but life will quickly
go back to normal," Lawrence Einhorn, MD, tells WebMD. "But even for
patients who relapse I can look them in the eye and say with a great
deal of confidence even though you weren't cured the first time we
still have over a 50% chance we'll cure you this time." Einhorn is
Distinguished Professor in the department of medicine, Indiana
University Medical Center in Indianapolis, and the study's senior
author.</P>

<P>Einhorn and colleagues reviewed the records of more than 60 men
treated for recurrent testicular cancer with therapy using high-dose
chemotherapy and bone marrow transplantation. "This approach is
possible in testicular cancer because we can escalate the dosage of
the drugs we use by five or six times the dosage normally given and
see something significant," Einhorn says. "This is not possible with
drugs used for other solid tumors, such as breast cancer."</P>

<P>But the high-dose chemotherapy kills many of the parent cells in
the bone marrow, which are necessary to make both red and white blood
cells. This requires that the bone marrow be repopulated with parent
cells using a technique called bone marrow transplantation.</P>

<P>"The technology surrounding bone marrow transplantation has
greatly improved," says Einhorn. "We look at three things: death from
treatment, which did not occur in this study; long-term toxicity such
as ringing in the ears or tingling in the hands and feet, which also
did not occur; and short-term toxicity. We can tell patients, who are
for the most part young men, 'Look, you're looking at a very tough
six to eight weeks with a high probability of cure.'"</P>

<P>Although Einhorn is convinced that this treatment regimen offers
the highest possibility of cure for men with recurrent testicular
cancer, Bruce Roth, MD, is a little more cautious. Roth tells WebMD,
"I don't think we can say yet that this is the standard regimen that
ought to be followed when someone has recurrent testicular cancer.
Even though bone marrow transplantation is much better than it used
to be and we don't usually kill anybody anymore, it is still
extremely difficult for the patient and is quite expensive. The
burden of proof is on us to prove that it's better than standard
therapy." Roth is professor of medicine and urologic oncology and
section chief of solid tumors at Vanderbilt University in
Nashville.</P>

<P>Both Roth and Einhorn call themselves quite optimistic about the
outlook for men with testicular cancer. "How many solid tumors are
there where you can say to the patient on day one, you have a 90%
chance of cure?" says Roth. "With any other solid tumor we'd be
thrilled to give those odds. One thing I think is necessary, however,
is for men with the disease to be treated by someone who regularly
deals with this tumor, not someone who sees one or two cases a year.
It's really necessary to understand the disease process."</P>

<P>Einhorn agrees, saying, "I really do think that when you're
dealing with a rare, curable disease there are subtle nuances in its
treatment. Large, central academic medical centers with a great deal
of experience offer advantages related to having an entire
infrastructure in place to support treatment. This is why we're
always going to do better."<B> </B></P>

<P><FONT SIZE="-1">Source: Greater Than 50% Cure Rate Reported in
Recurrent Disease By Elizabeth Tracey, MS. Reviewed by Dr. Gary D.
Vogin</FONT><BR>
</P>

<P><A NAME=survivalhigh></A><B>Survival High with Early Treatment<BR>
</B>

<HR>

Glenn Knies wasn't thinking the worst when he felt the abnormality in
his groin area 11 years ago. It was probably a hernia, he
guessed.</P>

<P>He had just finished working out. In the shower, he noticed his
right testicle seemed enlarged.</P>

<P>"I thought I had strained something," says Knies, an insurance
adjuster in Schwenksville, Pa. He was 23 and barely out of college at
the time.</P>

<P>"I wasn't having any discomfort or symptoms to speak of," he says.
"I was strong as ever, and there was nothing else to indicate a
problem."</P>

<P>He mentioned the condition to his mother, a nurse, who urged him
to see a urologist quickly. She suspected something more serious than
a hernia was bothering her son.</P>

<P>His doctor determined the enlargement was cancer, and he removed
Knies' right testicle, the standard first-line treatment for
testicular tumors. Later, after tests showed that cancer may have
spread to the lymph nodes deep within the abdomen where the testicles
drain, doctors also removed the nodes.</P>

<P>But the lymph nodes were "clean," free of cancer, Knies says. It
was the first sign that he probably was going to be OK, that his
doctor likely had gotten all the cancer after removing the testicle.
To make sure, a regimen of regular examinations followed--monthly at
first, tapering off to annually after five years. Eleven years later,
he still has a yearly exam but considers himself a cancer
survivor.</P>

<P><B>Most Common Cancer in Young Men</B></P>

<P>Cancer of the testicles--egg-shaped sex glands in the scrotum that
secrete male hormones and produce sperm--accounts for only about 1
percent of all cancers in men, according to the National Cancer
Institute. About 7,000 Americans were expected to get the disease in
1995, with an estimated 325 deaths. Compared with prostate cancer,
estimated to kill 40,400 of its 244,000 victims in 1995, testicular
cancer is relatively rare. However, in men aged 15 to 34, it ranks as
the most common cancer. For unknown reasons, the disease is about
four times more common in white men than in black men.</P>

<P>Only 15 years ago, a diagnosis of testicular cancer was grim news.
Ten times as many patients died then as now. But dramatic advances in
therapeutic drugs in the last two decades, along with improved
diagnostics and better tests to gauge the extent of the disease, have
boosted survival rates remarkably. Now, testicular cancer often is
completely curable, especially if found and treated early.</P>

<P>The Food and Drug Administration has approved several drugs to
treat testicular cancer, including Ifex (ifosamide), Vepesid
(etoposide), Velban (vinblastine sulfate), Blenoxane (bleomycin
sulfate), and Platinol (cisplatin).</P>

<P>Many medical professionals regard Platinol as the "magic bullet"
for treating certain forms of testicular cancer. FDA approved the
platinum-based drug for use after surgery or radiation. Platinol
almost always is used in combination with other chemotherapy
drugs.</P>

<P>"&#91;Platinum-based treatment&#93; is truly the great success
story for solid-tumor chemotherapy," says S. Bruce Malkowicz, M.D.,
co-director of urologic oncology at the University of Pennsylvania
Medical Center. These drugs have helped cut testicular cancer's death
rate and bolster its cure rate, he says, adding that many patients
"respond very nicely" to platinum-based drug treatments, which are
effective even when cancer has spread beyond the testicle.</P>

<P>"That is not a death sentence," Malkowicz says. About 70 percent
of men with advanced testicular cancer can be cured, according to the
National Cancer Institute.</P>

<P><B>Detection and Diagnosis</B></P>

<P>Most testicular tumors are discovered by patients
themselves--either by accident, as Knies did, or while performing a
self-examination on each testicle. "The usual presentation is of an
enlarged, painless lump," says Malkowicz. "Occasionally there can be
pain." The lump typically is pea-sized, but sometimes it might be as
big as a marble or even an egg.</P>

<P>Besides lumps, if a man notices any other abnormality--an enlarged
testicle, a feeling of heaviness or sudden collection of fluid in the
scrotum, a dull ache in the lower abdomen or groin, or enlargement or
tenderness of the breasts--he should discuss it with a physician
right away. These symptoms can be caused by conditions other than
cancer. But only a doctor can tell for sure, and it is critical to
seek attention promptly.</P>

<P>Physicians have various methods to help diagnose testicular
cancer. Often a physical exam can rule out disorders other than
cancer. Imaging techniques can help indicate possible tumors. One
such method is ultrasound, which creates a picture from echoes of
high-frequency sound waves bounced off internal organs. Malkowicz
calls this method "a painless, noninvasive way to check for a
mass."</P>

<P>But the only positive way to identify a tumor is for a pathologist
to examine a tissue sample under a microscope. Doctors obtain the
tissue by removing the entire affected testicle through the groin, a
procedure called inguinal orchiectomy. Surgeons do not cut through
the scrotum or remove just a part of the testicle, because if cancer
is present, a cut through the outer layer of the testicle may cause
the disease to spread locally. Besides enabling diagnosis, testicle
removal also can prevent further growth of the primary tumor.</P>

<P>Nearly all testicular tumors stem from germ cells, the special
sperm-forming cells within the testicles. These tumors fall into one
of two types, seminomas or nonseminomas. Other forms of testicular
cancer, such as sarcomas or lymphomas, are extremely rare.</P>

<P>Seminomas account for about 40 percent of all testicular cancer
and are made up of immature germ cells. Usually, seminomas are slow
growing and tend to stay localized in the testicle for long periods.
It was a seminoma that struck former Philadelphia Phillies first
baseman John Kruk at age 33 in 1994. His right testicle was removed,
and doctors say his prognosis is good.</P>

<P>Nonseminomas are a group of cancers that sometimes occur in
combination, including choriocarcinoma, embryonal carcinoma, and yolk
sac tumors. Nonseminomas arise from more mature, specialized germ
cells and tend to be more aggressive than seminomas. According to the
American Cancer Society, 60 to 70 percent of patients with
nonseminomas have cancer that has spread to the lymph nodes.</P>

<P><B>Cancer Stages</B></P>

<P>Physicians measure the extent of the disease by conducting tests
that allow the doctor to categorize, or "stage," the disease. These
staging tests include blood analyses, imaging techniques, and
sometimes additional surgery. Staging allows the doctor to plan the
most appropriate treatment for each patient.</P>

<P>There are three stages of testicular cancer:</P>

<P>Stage 1--Cancer confined to the testicle.</P>

<P>Stage 2--Disease spread to retroperitoneal lymph nodes, located in
the rear of the body below the diaphragm, a muscular wall separating
the chest cavity from the abdomen.</P>

<P>Stage 3--Cancer spread beyond the lymph nodes to remote sites in
the body.</P>

<P>Through blood tests, doctors can check for tumor-associated
markers, substances often present in abnormal amounts in cancer
patients. Comparing levels of markers before and after surgical
treatment helps doctors determine if cancer has spread beyond the
testicles. Likewise, measuring marker levels before and after
chemotherapy treatment can help show how well the chemotherapeutic
drugs are working.</P>

<P>FDA has approved a test that checks blood levels of
alpha-fetoprotein (AFP) as a tumor-associated marker. Other tests,
such as those that gauge levels of beta-human chorionic gonadotropin
(bHCG) or lactate dehydrogenase (LDH), are widely used as
tumor-associated markers, but FDA has insufficient data to approve
these tests.</P>

<P>Imaging techniques provide doctors with pictures of internal
organs, giving visual clues to cancer staging. Chest x-rays can tell
doctors if disease has spread to the lungs. Lymphangiography allows
the lymph nodes to be visualized on an x-ray. CT scans create
detailed views of cross sections of the body and can indicate
possible tumors at various body sites.</P>

<P>Surgery to remove the retroperitoneal lymph nodes, into which the
testicles drain, often is necessary for testicular cancer patients.
Doctors examine lymph tissue microscopically to help determine the
stage of the disease. Also, removing the tissue helps control further
cancer spread.</P>

<P><B>Cancer Treatment</B></P>

<P>No one treatment works for all testicular cancers. Seminomas and
nonseminomas differ in their tendency to spread, their patterns of
spread, and response to radiation therapy. Thus, they often require
different treatment strategies, which doctors choose based on the
type of tumor and the stage of disease.</P>

<P>Because they are slow growing and tend to stay localized,
seminomas generally are diagnosed in stage 1 or 2. Treatment might be
a combination of testicle removal, radiation, or chemotherapy. But
surgical removal of lymph nodes usually is not necessary for seminoma
patients because this type of tumor is what the University of
Pennsylvania's Malkowicz calls "exquisitely sensitive" to radiation.
Normally directed to the retroperitoneal lymph nodes but sometimes to
other lymph nodes, radiation can effectively remove cancer cells
there. Stage 3 seminomas are usually treated with multidrug
chemotherapy.</P>

<P>Though most nonseminomas are not diagnosed at an early stage,
cases confined to the testicle may need no further treatment other
than testicle removal. These men must have careful follow-up for at
least two years because about 10 percent of stage 1 patients have
recurrences, which then are treated with chemotherapy. Stage 2
nonseminoma patients who have had testicle and lymph node removal may
also need no further therapy. Some doctors opt for a short course of
multidrug chemotherapy for stage 2 patients to reduce the risk of
recurrence. Most stage 3 nonseminomas can be cured with drug
combinations.</P>

<P><B>Side Effects</B></P>

<P>Any kind of cancer treatment can cause undesirable side effects.
But not all patients react the same way or to the same degree. One of
the main concerns of young men is how treatment might affect their
sexual or reproductive capabilities.</P>

<P>Removing one testicle does not impair fertility or sexual
function. The remaining testicle can produce sperm and hormones
adequate for reproduction. Removal of the retroperitoneal lymph nodes
usually does not affect the ability to have erections or orgasms. It
can, however, disrupt the nerve pathways that control ejaculation,
causing infertility.</P>

<P>Modern "nerve-sparing" surgical techniques have increased the odds
of retaining fertility. Many surgeons are abandoning a "total
scorched-earth policy where you take out every single lymph node,"
Malkowicz says.</P>

<P>"We now can limit the amount of dissection necessary to get a good
therapeutic cure, but not overdissect to disrupt every bit of
nerves," he says, adding that "ejaculation can be preserved" in as
many as 80 percent of cases.</P>

<P>Testicular cancer patient Knies points to his twin sons as proof
that though his reproductive capacity was temporarily lost, it was
restored.</P>

<P>Chemotherapy can cause increased risk of infection, nausea or
vomiting, and hair loss. Not all patients experience these. Some
drugs may cause infertility, but studies have shown that many men
recover fertility two to three years after therapy ends. Radiation
patients may experience fatigue or lowered blood counts. Infertility
may also occur, but this usually is temporary.</P>

<P>Doctors emphasize that even though the cure rate is very high for
all types and stages of testicular cancer, many of the drastic
measures taken to cure later-stage disease can be avoided if the
tumor is caught early enough. The best way to do this is through
regular self-examination, a message that Knies says might be
difficult to convey to the prime risk group.</P>

<P>"You have a real sense when you're in your late teens and early
20s of invincibility," he says. "The last thing you're thinking then
is that something can stop you. But as I know, it can."</P>

<P><FONT SIZE="-1">Source: John Henkel is a staff writer for FDA
Consumer</FONT>.<BR>
</P>

<P><A NAME=fertilityproblems></A><B>Male Fertility Problems Linked to
Testicular Cancer<BR>
</B>

<HR>

Like many professional couples, Tim and Elizabeth delayed
childbearing until their late 20s. "We had a lot of trouble getting
pregnant," says Elizabeth, who spoke to WebMD on condition that her
full name not be used. "Our bathroom started looking like a chemistry
lab with all the kits we had in there, and all the fun was certainly
out of it."</P>

<P>After several months of trying, the Baltimore-area couple sought
medical help -- and learned that Tim had a low sperm count. In spite
of this, Elizabeth became pregnant a few months later and eventually
delivered a healthy baby girl.</P>

<P>When couples have infertility problems, it is usually the woman
who first seeks help, but her partner may be tested as well. He is
asked to provide a sample of semen, which is examined for certain
characteristics that may indicate problems. Although many couples in
which the man has such semen abnormalities will go on to conceive a
child, some may end up with something else to worry about: A study
recently published in the British Medical Journal shows that men with
these abnormalities run a higher risk of developing testicular cancer
and some abdominal cancers than other men.</P>

<P>"We are certainly not suggesting that every man with a semen
abnormality needs to be aggressively screened for testicular cancer,"
says Rune Jacobsen, MS, the study's author. "But we do feel that this
study points to an association between the two conditions, suggesting
a common cause," perhaps something that happened while the man was
still in his mother's womb. Jacobsen is a researcher at the Centre
for Research in Health and Social Statistics, Danish National
Research Foundation in Copenhagen.</P>

<P>It's not clear what kind of prenatal event might cause these
conditions. But the idea that things that happen during pregnancy may
affect the baby's life later is not new. Research on maternal
consumption of alcohol, drug use, and cigarette smoking clearly shows
that they affect the baby's health. Now research is starting to show
a connection between more subtle events during pregnancy and the
offspring's ultimate health.</P>

<P>Christopher Coe, PhD, professor of psychology at the University of
Wisconsin, has been studying the effects of the intrauterine
environment on offspring in rhesus monkeys. "We have been studying a
50-year-old colony of monkeys, encompassing five generations and more
than 15,00 births, and have been examining systematically the effects
of the mother's gestational experience on her offspring," he tells
WebMD. "Such factors do indeed play a role in the size of the
offspring, the age at which they reach puberty, their risk of
pregnancy complications, and their ability to handle glucose
&#91;sugar&#93;. All of these associations have also been suggested
in humans.</P>

<P>"We're now starting to examine the effects of maternal nutrition
and stress on the health of the offspring," Coe says. "We know the
placenta isn't a perfect barrier, but the question remains, which
factors are important and how long during pregnancy do they have a
consequence? There appears to be some wisdom to our grandmothers'
advice that, during pregnancy, a woman wants to be more careful and
moderate her lifestyle."</P>

<P>The current study by Jacobsen and colleagues looked at the results
of semen analysis in more than 30,000 Danish men, and correlated them
with the development of various cancers. Men who had abnormal
semen-analysis results were roughly twice as likely to develop
testicular cancer. "We think this association may be due to a
disruption in the mother's hormonal status during pregnancy,"
Jacobsen says. But researchers don't yet know what might cause such a
disruption. "The next step is to study that association," Jacobsen
says.</P>

<P>Right now, no one is suggesting that abnormal semen
characteristics cause testicular cancer, since not all men with
abnormal results will develop the disease, but Jacobsen does say that
testicular cancer may be preceded by semen abnormalities.</P>

<P>"We see some interesting associations with semen abnormalities,"
Fady Sharara, MD, a reproductive endocrinologist with the Fertility
and Reproductive Health Center in Arlington, Va. "or example,
recently, a study reported such abnormalities in long distance truck
drivers. My feeling is that such abnormalities arise from both a
genetic component and an environmental one, and the hypothesis of a
factor operating during pregnancy makes sense."</P>

<P>Whether or not they have semen abnormalities, experts say, men
should do regular self-examinations for signs of testicular cancer.
They should also see their doctor or a urologist if they have
problems or questions about their risks.</P>

<P>For information about how to do a self-examination, see WebMD's
article "Many Young Men Unaware of Importance of Testicular
Exam."</P>

<P><FONT SIZE="-1">Source: Study Finds Men with Semen Abnormalities
Have Greater Cancer Risk By Elizabeth Tracey, MS. Reviewed by Dr.
Pamela R. Yoder</FONT><BR>
</P>

<P><A NAME=teenyears></A><B>Experts Raise Eyebrow at Link Between
Exercise in Teen Years and Testicular Cancer<BR>
</B>

<HR>

Two Canadian researchers say there seems to be a correlation between
frequent strenuous activity during the teen years and testicular
cancer. But experts who reviewed the study for WebMD say that there
is no evidence adolescent boys should cut back on exercise.</P>

<P>The Canadian researchers, Anil Srivastava and Nancy Kreiger, MD,
sent out a survey to more 200 men who had been diagnosed with
testicular cancer and asked a number of questions relating to
recreational exercise, occupational exercise, diet, marital status,
years of schooling, household income, smoking habits, and height and
weight. Out of this survey, the researchers found what appeared to be
a significant associated risk between frequent moderate (more than
five times a week) to strenuous recreational activity during the teen
years and testicular cancer.</P>

<P>From their results, published in the current issue of the American
Journal of Epidemiology, Srivastava and Kreiger theorize that this
associated risk factor could possibly be due to several factors. They
suggest a rise in hormone level during physical activity may have
more of an effect on younger men than on older, or that testicular
trauma associated with some sports such as cycling and horseback
riding may cause the increase risk. Their final hypothesis is that
muscle mass is associated with higher androgen (male sex hormone)
production. They point to androgen levels in relation to prostate
cancer for support.</P>

<P>"That hasn't been shown to be true for prostate cancer, so that is
why I doubt this paper," says Joseph R. Wagner, MD, who reviewed the
study for WebMD. Wagner is physician in charge of the
urology/oncology department at Beth Israel Medical Center in New
York.</P>

<P>Still, Srivastava and Kreiger conclude in their paper, "Important
insights might also be gained from further investigation of the
relation between hormone levels and physical activity, particularly
with respect to frequency of exercise."</P>

<P>Wagner and Craig Nichols, MD, who was also asked to comment on the
study, see major flaws in the study design.</P>

<P>"They just cast a broad net and something came out," Nichols
explains. "Statistically that will happen if you ask enough questions
-- something will be significant." Nichols is professor of medicine
at Oregon Health Sciences University and a leading authority on
testicular cancer.</P>

<P>Wagner says that a better-designed study might indeed give
credence to the researchers' claim, but he feels that based on this
study, high school athletes needn't cut back on activity.</P>

<P>"Are you going to tell all these young men not to exercise?"
Wagner asks. "There's probably greater risk in that than for getting
testicular cancer. The prevalence of &#91;testicular cancer&#93; is
only 0.5 in 100,000."</P>

<P>The known risk factors for testicular cancer are undescended
testicles and a family history of the disease. Too much exercise, on
the other hand, is so far not supported by the body of medical
literature, say Nichols and Wagner.</P>

<P>WebMD contacted Kreiger's office and was told that she would not
comment on either the study or Nichols' and Wagner's comments.</P>

<P><B>Vital Information:</B></P>

<P>A new study shows that there may be an association between
frequent, moderate exercise during the teen-age years and the
development of testicular cancer later in life.</P>

<P>Researchers claim that a rise in male hormone levels or testicular
trauma could explain the increased risk.</P>

<P>Two outside experts question the design of the study, and say that
young men should continue to exercise, since the absolute risk of
testicular cancer is so low.</P>

<P><FONT SIZE="-1">Source: Association Not Completely Dismissed, but
More Study Needed. By Candace Hoffmann</FONT><BR>
</P>

<P>&nbsp;<A NAME=onehunglow></A><B>One Hung Low<BR>
</B>

<HR>

Q: One of my testicles hangs lower than the other. Also, I sometimes
get a pain down there. Is this something I should worry about?
--P.T., via the Internet</P>

<P>A: Whether you&#146;re a lefty or a righty, relax. Having one
testicle hang lower than the other one is not uncommon at all.</P>

<P>Now, about the pain you mentioned. It&#146;s most likely nothing;
you probably knocked your nuts a bit playing basketball. But be
careful -- any time you have pain in a testicle or feel a lump there,
it should be checked out by a doctor.</P>

<P>Don&#146;t panic; there are lots of testicle problems that can be
easily fixed. Even testicular cancer is highly curable when caught
early. It isn&#146;t common, but it can start in your teens. Your
best bet is to have an examination. Your doctor can tell what&#146;s
causing it, and he&#146;ll know what to do for treatment. Then, learn
how to do a <A HREF="getagrip.html#inenglish">self-exam</A> every
month. Your life may depend upon it.<BR>
</P>

<P><B><A NAME=spermbanking></A>Sperm banking aids fatherhood after
testicular cancer<BR>
</B>

<HR>

Testicular cancer is a disease that commonly strikes young men,
making the effects of treatment on fertility an important concern.
Now from Norway come results of a study looking at how well some of
these patients recover their ability to produce sperm and what
options are open to them. <A HREF="/web/20150429165629/http://www.healthcentral.com/news/newsfulltext.cfm?ID=46582&amp;src=n111">www.healthcentral.com/news/newsfulltext.cfm?ID=46582&amp;src=n111</A>
<FONT SIZE="-1"><IMG SRC="/web/20150429165629im_/http://www.tcaw.org/logos/arrow1.gif" WIDTH=28 HEIGHT=15 ALIGN=bottom></FONT><BR>
</P>

<P><A NAME=mountainbiking></A><B>Mountain Biking can be Rough on the
Testicles<BR>
</B>

<HR>

According to this Austrian study, mountain bikers have a high
incidence of scrotal injuries such as calcium deposits, cysts and
twisted veins. Fortunately, there are some ways to cut down on the
risk of these injuries.<BR>
<FONT SIZE="-1">Source: </FONT><A HREF="/web/20150429165629/http://www.healthcentral.com/drdean/DeanFullTextTopics.cfm?ID=43140&amp;src=n45"><FONT SIZE="-1">www.healthcentral.com/drdean/DeanFullTextTopics.cfm?ID=43140&amp;src=n45</FONT></A>
<FONT SIZE="-1"><IMG SRC="/web/20150429165629im_/http://www.tcaw.org/logos/arrow1.gif" WIDTH=28 HEIGHT=15 ALIGN=bottom></FONT><BR>
</P>

<P><B><A NAME=unwilling></A>Men "Unwilling" to Discuss Cancer</B><BR>

<HR>

The charity found that women are more than twice as likely as men to
call its nurses for general advice about cancer. A breakdown of calls
made to Cancer Research UK information nurses between 1999 and 2001
shows that men made an average of 2,531 calls each year, while 5,617
were made by women. Women were also responsible for 45 per cent of
calls about prostate cancer and 40 per cent of calls about testicular
cancer. Cancer Research UK's psychological oncology group, which is
based at the University of Sussex, says the findings highlight a
common communication problem between the sexes. Group director
Professor Lesley Fallowfield said, "Feelings can be quite hard for
men to discuss, particularly if it's about things like male cancers
which are threatening to their masculinity and manhood. "There's also
a cultural expectation that big boys don't cry' and many men do not
actually ask about things that trouble them - even if it's
anonymously and over a phone line. So we have to find new ways of
reaching them because sharing concerns can be a real help," she
added. Cancer Research UK has designated June as Men's Cancer Month
and is launching a message board on its website to encourage men to
discuss their experiences. Radio 5 Live sports presenter Russell
Fuller, 29, who was diagnosed with testicular cancer in 1999, will be
one of the first to post a message on the site. He discusses the
uncertainty he experienced in the days leading up to diagnosis and
urges other people to get unusual signs checked out. "Men generally
don't like talking about their feelings as much and losing a
testicle, like I did, can be embarrassing and almost like a loss of
face," he said. "But I'm a very open person and talking about it was
an invaluable help. My friends and family were very supportive, made
a few jokes and did wonders for my state of mind!" The Cancer
Research UK Men's Cancer Awareness Month message board can be reached
at <A HREF="/web/20150429165629/http://www.cancerresearchuk.org/menscancermonth">www.cancerresearchuk.org/menscancermonth</A>
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<P><A NAME=new></A><B>New Testicular Cancer Warning<BR>
</B>

<HR>

The latest issue of the <I>Lancet</I> features the case of a
17-year-old who died four days after a road accident in which he had
sustained only minor injuries. He was killed by a blood clot in the
lung, which a post-mortem found was not linked to the accident, but
to a testicular tumour which had probably been present for months.
Another example of the importance of men reporting any worrying lumps
to their GP.<BR>
<FONT SIZE="-1">Source: BBC News Online</FONT><BR>
</P>

<P><A NAME=fewerdying></A><B>Doctors Say Fewer Men Dying of
Testicular Cancer</B>

<HR>

Early diagnosis and more effective treatments mean that deaths from
testicular cancer are decreasing worldwide, despite a rise in the
number of new cases of the illness, researchers reported on
Friday.</P>

<P>Their study, published in The Lancet medical journal, showed that
chemotherapy treatment could help to reduce death rates for the most
common cancer among men aged 25 to 29.</P>

<P>"Testicular cancer is a classic example of cancer that is
generally curable when the right treatment is given," said Professor
Peter Boyle of Britain's Imperial Cancer Research Fund, a co-author
of the report.</P>

<P>"In spite of the number of cases increasing, deaths from
testicular cancer have been declining in North America and Western
Europe since the late 70s," he added.</P>

<P>Death rates from the disease in men younger than 45 fell by about
a third in the late 1980s compared to the 1970s.</P>

<P>Cases of testicular cancer, which affects one in 500 men, had been
increasing since the 1930s. Denmark, Switzerland and Norway have the
highest rates in the world.</P>

<P>After peaking in the United States in the 1960s, deaths from the
illness have dropped by over 70%. In most of Europe deaths have
declined by 67% since the 1970s. But in Eastern European nations the
decline is only 22%--behind the United States, Japan and most of the
rest of Europe.</P>

<P>"We must find out why testicular cancer death rates are so
different in central and Eastern Europe," Boyle said, "otherwise
there will continue to be several hundred preventable deaths
occurring every year."</P>

<P>The researchers said their results indicate widespread
inconsistencies in adequate treatments in central and Eastern Europe.
If money is the problem, they suggested that urgent measures are
needed to ensure that the best treatment is available to
everyone.</P>

<P>Testicular cancer is curable in 90% of cases if it is caught and
treated early. Symptoms include a lump or sore on the testicle, pain
or soreness, a persistent cough, blood in the urine and stomach and
bowel problems.</P>

<P>Scientists suspect exposure to high levels of the female hormone
oestrogen in the womb could be part of the reason for the increase in
the disease.</P>

<P>Familial testicular cancers account for an estimated 20% of
cases.</P>

<P>There are also more cases among first-born sons and non-identical
twins.</P>

<P><FONT SIZE="-1">Source: </FONT><A HREF="/web/20150429165629/http://news.excite.com/printstory/news/r/010608/17/health-cancer"><FONT SIZE="-1">news.excite.com/printstory/news/r/010608/17/health-cancer</FONT></A><FONT SIZE="-1">
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<CENTER><B>*&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;*&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;*<BR>
</B>The dead might as well try to speak to the living as the old to
the young. - Willa Cather<BR>

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