Re-diagnosis for professional footballer Boëtius: You can identify your risk of testicular cancer with two questions
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There is no genetic engineering in the plant
But don’t worry: they are genetically modified
Testicular cancer was discovered again in professional soccer player Jean-Paul Boëtius. This is the most common malignant tumor among young men. Why testicular cancer occurs so early, there is no prevention, what symptoms you need to pay attention to and who is particularly at risk. FOCUS online spoke to an expert.
Former Bundesliga professional Jean-Paul Boëtius has to undergo cancer treatment again. The 29-year-old Dutch professional footballer, who played for FSV Mainz 05 and most recently for Hertha BSC but is currently without a club, announced this on Instagram. Even though he once survived the cancer, it had spread to the retroperitoneal lymph nodes.
“This means I have to undergo chemotherapy followed by rehabilitation,” he wrote on Friday evening. He is eagerly looking forward to the day when he can play in a full stadium again. Boetius was diagnosed with testicular cancer in September 2022, and four weeks later he had already celebrated his comeback at Hertha.
Testicular cancer primarily affects young men between the ages of 28 and 35
When it comes to cancer, most people think that the risk only increases with advanced age. It’s completely different with testicular cancer. Here the age of onset is 28 to 35 years, so he meets men who are in the process of building their lives, pursuing a career, and starting a family.
In fact, testicular cancer is the most common cancer in the 30-year-old age group. Around 4,000 new cases are currently registered in Germany every year and they are increasing, especially in northern European countries.
The cause of the increase in testicular cancer dates back decades
The number of cancer cases is generally increasing, which can be explained by the ever-increasing life expectancy. But in the case of testicular cancer, as a cancer of young men, this justification is out of the question. “To explain the current increase in testicular cancer, we have to look back 30 years, because that’s how long it takes for this form of cancer to develop,” says Mark Schrader, head of urology at the Helios Klinikum Berlin-Buch and head of the testicular cancer center. Even before birth, in the uterus, it is determined whether this boy will later get testicular cancer or not.
Possible causes of testicular cancer: Estrogen from food, the pill or drinking water
But it is difficult today to find out in retrospect what triggered this fatal change, notes Mark Schrader. Scientists like him suspect that dietary estrogens could play a role in changing the primordial germ cells in the embryo. The same thing could have happened due to medications, such as some birth control pills.
Another hypothesis: The drinking water could have been heavily contaminated with female hormones from medications. Excess estrogen is therefore associated with a later risk of testicular cancer.
Cancer: prevent and reduce risk!
A PDF of FOCUS online – Around half a million people get cancer in Germany every year. But many factors can protect against tumor disease: preventive examinations, diet, exercise and much more. In this e-paper we summarize the most important knowledge about cancer and how to reduce the risk of developing the disease.
Men cannot prevent testicular cancer
“The risk of developing testicular cancer is established before birth,” the expert explains. From the time of birth, the clock starts ticking, so to speak, until testicular cancer develops after around 30 years.
So when men get sick, it’s not because they smoked too much or cycled too much. Prevention against testicular cancer is therefore not possible for men.
Two clear risk factors for testicular cancer
Men whose fathers already had testicular cancer are particularly at risk. “Your risk is increased sevenfold,” warns Mark Schrader. If the brother is affected, it increases 15 times. In any case, the family burden must be clarified: Is the father ill? Is the brother affected?
In addition to this genetic component of testicular cancer, undescended testicles are also an indirect indication. If the testicle does not move down into the scrotum after birth but remains in the groin, this is associated with an up to 20 times higher risk of testicular cancer.
“This applies to all men, regardless of whether the undescended testicles regulated themselves after birth or had to be treated by a doctor,” reports the expert.
Undescended testicles are the most common anomaly of the urogenital tract; around two percent of boys born full-term are affected, but almost one in three of premature babies are affected.
Take symptoms of testicular cancer seriously
It would be ideal if parents informed their affected son about this during puberty, along the lines of, ‘You had an undescended testicle, please be aware of signs of testicular cancer’.
These are:
Palpable change in the testicle, usually painless
Enlargement of the testicle
The feeling that one testicle has become heavier
“Whenever something is different from the second testicle, it can be a sign of a testicular tumor,” warns Mark Schrader and advises you to go to a doctor immediately, ideally a urologist.
Testicular cancer can be diagnosed quickly
Ultrasound can be used to detect cancer easily and painlessly. A blood test also identifies the tumor markers typical of testicular cancer. If the suspicion of testicular cancer is confirmed, MRI or CT can clarify whether the tumor has already formed metastases, for example in the abdomen, lungs, bones or brain.
Scanning testicles against cancer: Four steps every man needs to know
Therapy for testicular cancer is extremely successful
The first treatment option is to remove the diseased testicle, as stated in the new guidelines. The tumor will now be examined closely and a decision will be made as to whether further treatment is required.
“What is particularly positive here is that for more than 35 years, testicular cancer can be cured very well, even when metastases are already present,” emphasizes the professor. Chemotherapy with a combination of cisplatin, etoposide and bleomycin ensures a cure rate of over 95 percent.
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However, in order to avoid the burden of side effects, the therapy should be tailored precisely to the patient, as in the past there was often a risk of overtreatment. If you want to be on the safe side, you should ask your doctor to consult an expert from the national second opinion network for testicular tumors, the expert advises. One in three patients with testicular cancer tumors (a total of 1,400 testicular tumor inquiries in 2018) took advantage of this opportunity last year.
Before testicular cancer therapy, sperm are placed in the ice
It is well known that chemotherapy is highly effective, but is often associated with significant side effects. The number of sperm can decrease dramatically. Urologists therefore advise patients to have ejaculate frozen before chemo. Cryosperm or cryopreservation of the sperm can then later be used to fulfill the desire to have children. The sperm are frozen at almost 200 degrees below zero and can be preserved in this way for up to 30 years.
Previously, patients had to pay for this themselves. “Since 2019, statutory health insurance companies have been covering the costs of cryopreservation of ejaculate,” says Mark Schrader, describing this positive change.
Only with one testicle: only half a man?
The fact that one of the two testicles is usually removed in the case of testicular cancer does not play any role in fertility because the other testicle continues to produce hormones and sperm. Voice tone, sex and the ability to orgasm are not affected. And if – as in very rare cases – both testicles have to be removed and therefore hardly any testosterone is produced, the masculinity hormone can be taken as a medicine, as hormone replacement therapy.
By the way, the missing testicle can be replaced with a small silicone cushion that is implanted into the empty part of the scrotum. The testicular prosthesis is a cosmetic correction, but does not replace testicular function.
Men should examine their testicles regularly
But even if there are many new, positive developments in testicular cancer and the therapy is very successful, all of this only works if the cancer is discovered early and the earlier, the better. Men should therefore examine their testicles themselves from time to time. Urologists recommend this testicle check with palpation to all boys over 14 years of age. How important it is is shown by the fact that in around 80 percent of cases testicular cancer is discovered by the affected man himself, and even in an early stage.
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