Dr. Donnica with Scott Hamilton at the Research!American annual awards ceremony in Washington DC, March 2004.

By John Morgan, Spotlight Health
With medical adviser Stephen A. Shoop, M.D.

Olympic gold medalist Scott Hamilton has spent a lifetime skating circles around the competition. But testicular cancer almost put his career and his life on ice.

"The first thing I experienced was a big pain in my mid-abdomen," Hamilton recalls. "I couldn't standup straight and the pain just got worse and worse. I decided that if it affected my performance, which it did, I would have to find out. We were performing in Peoria so I went to the emergency room. After scans and a lot of questions, the doctors found a mass and advised me to get it taken care of it right away. I knew right then that the doctor was telling me I had cancer."

Five days later at the Cleveland Clinic, Hamilton was diagnosed with testicular cancer and began receiving chemotherapy.

The American Cancer Society estimates that this year about 7,600 new cases of testicular cancer will be diagnosed in the United States. Approximately 400 men will die of the disease in 2003.

Risk factors for testicular cancer include:

• Age -- Typically those affected are between the ages of 15 and 40
• Cryptorchidism (undescended testicle)
• Family History
• Previous testicular cancer
• Race and Ethnicity -- Whites are about five times more at risk than African-American men. The risk of testicular cancer is highest among men living in the United States and lowest among African and Asian men.

Symptoms include a painless lump, often about the size of a pea. Other signs can be:

• An enlarged testicle
• A feeling of heaviness or sudden collection of fluid in the scrotum,
• A dull ache in the lower abdomen or groin
• Enlargement or tenderness of the breasts

Curable cancer

Fortunately, most men do not die from testicular cancer.

"The most remarkable feature of this cancer is its curability," says Ronald Bukowski, Hamilton's cancer specialist and director of experimental therapeutics, Cleveland Clinic Taussig Center. "While testicular cancer grows very rapidly, it is still very treatable even when it's spread quite widely."

According to Bukowski, Hamilton's cancer was advanced, having spread to his abdomen. Even so, Hamilton experienced "a complete disappearance of his cancer with treatment."

Studies indicate the cure rate for testicular cancer surpasses 90%. The 5-year survival rate for stage I (disease confined to the testicle) and stage II testicle cancer (spread to regional lymph node) is more than 95%. The 5-year survival rate for stage III disease, in which cancer has spread beyond local lymph nodes, is 74%.

Several treatment options are available for testicular cancer, including:

• Surgical removal of the testes (radical inguinal orchiectomy)
• Radiation
• Chemotherapy

"Chemotherapy unfortunately kills cells - it kills more cancer cells than it does normal cells but because it affects the normal functions of cells people have side effects," Bukowski explains. "We're looking for the Holy Grail - therapies that only target the cancer cells. The belief is that targeted treatments will be better, have less side effects and ultimately be more acceptable to people."

The choices of chemotherapy that doctors use are based on previous experience and studies that have identified the medications that are the most effective for a particular cancer.

Hamilton underwent chemotherapy for 12 weeks, receiving two drugs cisplatin and etoposide intravenously.

"He had complete resolution of the cancer except for a small remaining tumor which then required some surgery to remove the residual mass which did not contain any cancer," Bukowski reports.

It was his chemotherapy experience that galvanized Hamilton to create a website resource called Chemotherapy.com. With financial help from Ortho Biotech, the firm that manufactures Procrit, the site demystifies treatments and helps patients better understand what chemotherapy entails.

"A survey of 500 chemotherapy patients a few years ago revealed that 32% feared death and 40% feared chemotherapy," Hamilton states. "I think that's because they didn't understand exactly what it was."

"When you get diagnosed with cancer, you kind of go into a panic mode," Hamilton adds. "My mother had chemotherapy and I didn't know what it was even after my own diagnosis. I felt a lot of people don't want to even self-examine for cancer because they're so afraid of even the thought of it. But once you describe chemotherapy and understand how it works, it seems very simple -- many times you're just on an IV drip."

"Sometimes the fear of the unknown is terrible," Bukowski adds. "Patients don't know what the chemotherapy is going to do to them because they've heard bad things about it."

Quality of life

Since the chemotherapy medicines are toxic to cells, side effects are not uncommon and may include:

• Nausea and vomiting
• A decrease or increase in appetite
• Temporary loss of hair
• Mouth sores
• Increased risk of infections (due to low white blood cell counts)
• Bleeding or bruising (due to low blood platelet counts)
• Fatigue (due to low red blood cell counts)
• Diarrhea or constipation

"Scott lost all his hair," Bukowski reports. "But it all grew back. It isn't permanent hair loss."

"I'm a big coffee drinker and couldn't stand its taste or smell going through chemo," Hamilton says. "Chemocare.com tells people what to expect and allows patients to share their experiences with one another in our chat community."

"Quality of life is key when undergoing chemo," Hamilton says. "The more things that help get you through chemotherapy the better, because it affects everyone differently."

According to Bukowski, chemotherapies are more manageable than 10 years ago.

"Supportive care medications can make the side effects more tolerable and prevent serious infections," Bukowski explains. "They can diminish the nausea and vomiting. They can diminish the low blood cell counts. They make the treatment more tolerable."

"From the second I was diagnosed I went through how I'd never skate again and be debilitated," Hamilton admits. "Chemotherapy.com is a new resource that gives you the power to help take control of your situation and the empowerment to know 'I can beat this.'"

Hamilton is happy to report he's cancer-free.

"Do tests like colonoscopies on time," Hamilton advises. "Do blood work every year; watch the sugar intake; and your cholesterol levels. It's important because if you find something early enough, it's less of a challenge. You can beat cancer. You can do it. I did."

• American Cancer Society

• Chemocare.com

Spotlight Health is the leading creator of celebrity-featured health-issue awareness campaigns, connecting consumers with impassioned celebrities whose personal health battles can open eyes, dispel myths and change lives. Spotlight Health helps sufferers and caregivers meet the challenges of difficult health circumstances with understandable, in-depth medical information, compassionate support and the inspiration needed to make informed healthcare choices.

Created: 3/21/2003  -  John Morgan & Stephen A. Shoop, M.D.