Movember Week 3 with Dr. Aly-Khan Lalani: Understanding Testicular Cancer

Dr. Aly-Khan Lalani is a medical oncologist at the Juravinski Cancer Centre and an Assistant Professor at McMaster University. He specializes in the clinical care and treatment for patients with genitourinary cancers. His other roles as an academic physician include research, medical education, and administrative roles to advocate for patients diagnosed with cancer. As cancer care often requires a multi-disciplinary approach, he often works closely with surgeons, radiation oncologists and allied health team members on a day-to-day basis.

Background:

During internal medicine residency as Chief Resident, Dr. Lalani developed an interest in oncology. He was particularly interested in the growing nature of the field and the ability to combine clinical and preclinical research. Dr. Lalani summarizes that:

“oncology bridges curiosity and discovery, and offers an exciting potential for a curious mind to provide compassionate care.”

During his oncology training, his mother was unfortunately diagnosed with colon cancer.

“I experienced the behind the curtain view that families are experiencing every day with a member who has cancer – it often is a team journey in one’s home”

This first-hand experience shapes his approach with patient conversations, providing a compassionate and empathetic approach. He hopes that these personal connections that many share in Canada will help support young, curious minds, to work together and leverage talents to cure as many cancers as possible.

FAQs Testicular Cancer:

The most common origin site for germ cell tumours are in the male testes – also known as testicular cancer. It accounts for 1% of all new cancers in men and when looking at the age-standardized incidence rate, estimates are 6.5 per 100,000 men in Canada. It is the most common type in adolescents and young adults aged 15 to 29.

“ It is estimated that new testicular cancer diagnoses in Canada in 2020 will total approximately 1200 across the country.”

While there aren’t specific demographics affected by the disease, there are established risk factors such as;

1. someone’s personal history of testicular cancer

2. family history of testicular cancer

3. having an undescended testicle at a young age

After a diagnosis is made, the next steps are staging and providing treatment. Treatments beyond chemotherapy can also include:

1. Surgery to remove testicle found to be cancerous: this is typically a “day” procedure, and potency and ability to have a family is generally not limited by this surgery. Post surgery care often includes active surveillance to follow for any chance of recurrence.

2. Radiation: side effects are both short-term and long-term but generally well tolerated.

Chemotherapy can be given after surgery (adjuvant treatment) or as the primary therapy for a spread (metastatic) disease. Treatment is often curative. Although chemotherapy may reduce sperm count during and after treatment, sperm banking is advocated for patients for future family planning.

Awareness and Advocacy:

Dr. Lalani believes that part of our collective role in society is to advocate for public health in situations that can prevent or ideally recognize disease very early on. It is important to encourage young men to seek out primary care regularly and, for example, in situations of a new lump or pain in the testicles. It is important to reduce the stigma or shyness about seeking assistance in a young man’s health.

“We're trying to reassure young men that there's nothing to be shy about and in fact, it is in their best interest to seek out care in these situations. The healthcare community is well prepared to recognize and provide care for these issues in young men.”

Awareness is key as if caught early, germ cell tumors are highly curable. Young adults should feel very reassured that as the health care system will guide them and provide curative intent treatment whenever possible.

“We want to show them the opportunity they have to still have a very long and meaningful life.”

Key Takeaways:

Oncologists also place a key emphasis on the importance of quality care after initial treatment of patients, as survivorship is a key multidisciplinary component of long term well-being. This approach can help optimize the care during and after cancer treatment to assure that adolescent and young adults can continue to live fulfilling lives.

Dr. Lalani added:

“I derive so much joy from my career, working with and advocating for patients and their families. That is what really drives me to excel at these different levels but it starts primarily with the interaction between patient and physician.”

It is important to continue to advocate for young men to seek early primary care in order for early detection of these issues. One can support these programs through the Juravinski Cancer Center Foundation and Movember that helps provide opportunities for researchers across the spectrum.

So let’s work together to raise awareness and support cancer initiatives. Let’s make testicular cancer and cancer in general something that people should no longer be afraid of thanks to the amazing physicians and health care system working day and night to provide the best multidisciplinary care for their patients!