It’s November again. During this month every year, the global health community conducts a number of initiatives regarding men’s health. In this article, we will tell you about testicular cancer and its relation to male reproductive health. What is Movember? The beginning of this movement was in 2003, when the Movember Foundation was founded – a global charity whose goal is to help men live long and happy lives in good health. Over the years, millions of people have joined the men’s health movement, raising over €800 million and funding over 1,000 projects targeting prostate and testicular cancer, mental health and physical activity for the modern man. What is testicular cancer? Testicular cancer is the most common cancer in young men. Almost half of men with this diagnosis are under 35 years old. The good news is that in the vast majority of cases, the prognosis after therapy is excellent. As with any oncological disease, and with testicular cancer, early and correct diagnosis is most important. Which groups are predisposed to this disease? A major risk factor is the condition cryptorchidism. This is retention of the testicle in the inguinal canal as a result of problems in its descent – the descent of the testicle into the scrotum. This process must be completed in utero and by the time of birth, and if it has not proceeded properly, an operation should be performed to remove the testicle and fix it in the definitive place. The operation is called orchidopexy and it is desirable to perform it no later than 2 years of age of the child. Children born prematurely are more often prone to cryptorchidism than those born at term. In addition, there is a family burden, ie. if a man has a brother or father with testicular cancer, his risk is higher. In modern society, unfortunately, social ties are broken even at the family level, and people very often do not share their health problems with their closest relatives. What is the relationship between testicular cancer and male infertility? The relationship is two-way. On the one hand, the main disease can lead to disruption of spermatogenesis to varying degrees, which can manifest as infertility – attempts to get pregnant and lack of pregnancy in the partner. On the other hand, the treatment itself can be a damaging factor. It is a common fact that both chemotherapy and radiotherapy can lead to temporary or permanent infertility. What should a man know when he is diagnosed with this? When a man meets for the first time with an oncological problem, his whole mind is occupied with the fight for his life, and in the background, almost imperceptible, are the ideas of fatherhood. Here is the place of the doctor, who must explain correctly, in understandable language and with reliable facts, what can be expected from the progress of the disease, in what terms, what are the treatment options,what are the side effects of different types of treatments on spermatogenesis and, last but not least, what can be done to preserve reproductive capabilities. NEWS_MORE_BOX What are the options for sperm storage? The way to preserve male reproductive cells is called cryopreservation and is a simple, cheap and reliable laboratory procedure for processing and freezing spermatozoa for a very long period of time. In Bulgaria, it is offered in practically all medical facilities that deal with in vitro fertilization. Is this procedure routinely recommended for men with an oncological problem? Unfortunately, there is no practice in our country to include male reproductive health specialists in the clinical oncology committees to advise men in the specific situation which is the most appropriate method to preserve their reproductive capabilities. Therefore, it is often omitted to freeze spermatozoa before surgical treatment, and especially before chemotherapy or radiotherapy. This, in the long run, runs a very high risk of disqualifying a proportion of men from becoming biological fathers due to the fact that we have failed to give the right advice at the right time. Is there an indication for doctors to store sperm in men with testicular cancer? A good standard of medical oncology should also include guidelines for physicians on these reproductive health concerns, which are extremely important for the future of a man with testicular cancer. In our medical standard this is not included, but in countries with good health care, sperm storage advice has been included for many years as an element of good medical practice. Therefore, I often meet patients who after therapy have no chance of having their own child, and this creates emotional problems and sometimes leads to family separation. Moreover, they did not even have a spermogram before the treatment, so it is not clear what the state of spermatogenesis was before and after. Which requires us to do additional tests, some of which are quite expensive, to find out what has damaged the spermatogenesis – the treatment, the testicular cancer or are there other reasons for it, for example genetics. It is not right in the 21st century, when modern medicine offers so many options, that we do not provide them to patients.in our country, it is not a practice to include specialists in male reproductive health in the clinical oncology committees, who would advise men in the specific situation which is the most suitable method for preserving their reproductive possibilities. Therefore, it is often omitted to freeze spermatozoa before surgical treatment, and especially before chemotherapy or radiotherapy. This, in the long run, runs a very high risk of disqualifying a proportion of men from becoming biological fathers due to the fact that we have failed to give the right advice at the right time. Is there an indication for doctors to store sperm in men with testicular cancer? A good standard of medical oncology should also include guidelines for physicians on these reproductive health concerns, which are extremely important for the future of a man with testicular cancer. In our medical standard this is not included, but in countries with good health care, sperm storage advice has been included for many years as an element of good medical practice. Therefore, I often meet patients who after therapy have no chance of having their own child, and this creates emotional problems and sometimes leads to family separation. Moreover, they did not even have a spermogram before the treatment, so it is not clear what the state of spermatogenesis was before and after. Which requires us to do additional tests, some of which are quite expensive, to find out what has damaged the spermatogenesis – the treatment, the testicular cancer or are there other reasons for it, for example genetics. It is not right in the 21st century, when modern medicine offers so many options, that we do not provide them to patients.in our country, it is not a practice to include specialists in male reproductive health in the clinical oncology committees, who would advise men in the specific situation which is the most suitable method for preserving their reproductive possibilities. Therefore, it is often omitted to freeze spermatozoa before surgical treatment, and especially before chemotherapy or radiotherapy. This, in the long run, runs a very high risk of disqualifying a proportion of men from becoming biological fathers due to the fact that we have failed to give the right advice at the right time. Is there an indication for doctors to store sperm in men with testicular cancer? A good standard of medical oncology should also include guidelines for physicians on these reproductive health concerns, which are extremely important for the future of a man with testicular cancer. In our medical standard this is not included, but in countries with good health care, sperm storage advice has been included for many years as an element of good medical practice. Therefore, I often meet patients who after therapy have no chance of having their own child, and this creates emotional problems and sometimes leads to family separation. Moreover, they did not even have a spermogram before the treatment, so it is not clear what the state of spermatogenesis was before and after. Which requires us to do additional tests, some of which are quite expensive, to find out what has damaged the spermatogenesis – the treatment, the testicular cancer or are there other reasons for it, for example genetics. It is not right in the 21st century, when modern medicine offers so many options, that we do not provide them to patients.Which requires us to do additional tests, some of which are quite expensive, to find out what has damaged the spermatogenesis – the treatment, the testicular cancer or are there other reasons for it, for example genetics. It is not right in the 21st century, when modern medicine offers so many options, that we do not provide them to patients.Which requires us to do additional tests, some of which are quite expensive, to find out what has damaged the spermatogenesis – the treatment, the testicular cancer or are there other reasons for it, for example genetics. It is not right in the 21st century, when modern medicine offers so many options, that we do not provide them to patients.