Should I second guess my surgeon?

December 6, 2012 4:36 PM

I was recently diagnosed with testicular cancer and will be having surgery next week to remove the testicle with the tumor. Should I be thinking about preserving sperm yet?

When I asked my surgeon she said that that would be something to worry about later, when we know what exactly my chemo regimen is going to look like. We dont know because with this kind of thing biopses come after its been removed, not before. I've been reading that the timeline between surgery and chemo can be extremely short which makes me think that getting a deposit in before surgery might be a good idea.

Does anyone have experience with this kind of thing? Is there some other place I can look? I guess I'm looking for reassurance that I'm not jumping the gun before calling the fertility clinic.

posted by zrail to health & fitness (7 answers total)

I had cancer that was far away from my testicles, but i asked my doctor if i should preserve sperm just in case. She said she didn't really see the need, but didn't see the harm either. My dad thought it was a good idea, he paid for the storage for a year, but eventually stopped paying. I didn't really get tested before he stopped paying, because i didn't care that much, i'm sure it's a good idea to do so.

Is the concern financial? I'd say it's a good investment to pay it for a year or two if you can't live with the chance of not having kids. Especially in the case of testicular cancer, and any sort of chance of radiation. Radiation can really be a bitch, and it really kills everything, the hair in the back of my head still grows like crap, where it grows strongly at all (this is anecdotic, though).

I wonder if the clinics save the sperm even if you don't pay, in case you come back desperately decades later and they can charge you years of back fees.
posted by palbo at 5:03 PM on December 6, 2012

Honestly? You should be talking with your doctor(s) about this. If you are not satisfied with the answer you are getting from your surgeon, then press her on it: What reasons would there be for not doing it now? And you ought to be able to get some idea of what the interval between surgery and chemo is going to be.

As the patient, you are king here. You have a right to good information and shouldn't take any bullshit. Cancer is shitty enough as it is.
posted by rhombus at 5:10 PM on December 6, 2012

You could certainly call a local clinic and find out what the associated costs would be and how quickly they can get people in for appointments and get all the details. That would help you judge whether you thought it would be worth it, cost wise, for your peace of mind to do it now and maybe have at least one sample banked ahead of time. I mean yes, the timeline can be short, but then again, at least for most guys, it's possible to produce samples pretty quickly too...
posted by treehorn+bunny at 5:28 PM on December 6, 2012

Thanks for the responses. I've sent my doctor an email, and if I don't get a response back by tomorrow afternoon I'll call her and the fertility clinic.
posted by zrail at 7:03 PM on December 6, 2012

I work in a fertility clinic and we see patients like you frequently. We usually recommend patients come in sooner than later -- scheduling can be an issue, like you've said, and sometimes the physician will recommend another collection if the sample is sub-par (sperm counts may be low or absent as a result of the underlying cancer). I always like to look at the procedure like this: Having sperm frozen is like having an insurance policy. You pay the cryopreservation and storage fees, and if you end up needing the frozen samples, it's there. So my advice would be to give the fertility clinic a call. Best of luck to you.
posted by ohohcyte at 8:30 AM on December 7, 2012

So sorry you're having to go through this.

You should definitely contact the Livestrong Foundation and get more information: http://www.livestrong.org/What-We-Do/Our-Actions/Programs-Partnerships/Fertile-Hope

Livestrong does amazing work and can help (possible even provide financial assistance).
posted by ATX Peanut at 12:56 PM on December 7, 2012 [1 favorite]

Long term response: I went to the clinic today and did the deed. I haven't heard yet if it's viable so I may have to go back at some point, but the peace of mind is palpable around here. Thanks Metafilter!
posted by zrail at 6:52 PM on December 10, 2012 [1 favorite]