The Barons’ Brandon Davidson and Testicular Cancer

The Oklahoma City Barons have released a short press release indicating that rookie defenseman Brandon Davidson has been diagnosed with testicular cancer and will undergo treatment immediately.

Updates on his condition will be provided by the Barons; otherwise the club has asked that his privacy be respected.

The Hockey Writers joins the entire hockey community in passing along our hopes, thoughts and prayers to Davidson, his family, and the Barons/Oilers organization for a successful outcome. What follows is a brief primer on testicular cancer so that fans can better understand the disease. For a nice write-up on Davidson’s background, check out the Edmonton Journal.

A PRIMER ON TESTICULAR CANCER

According to the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) statistics, testicular cancer is an extraordinarily rare disease, with less than 9,000 diagnoses made in the U.S. annually (compare that with lung cancer’s 226,000 annual diagnoses). At 21 years old, Davidson falls into the age group most frequently diagnosed with testicular cancer, men between 20 and 34; this age group represents almost half of all diagnoses.

STAGING & PROGNOSIS

For all the fear testicular cancer inspires in men, it is in fact a disease that’s highly amenable to treatment. Although Davidson and the Barons have not released any details regarding the specifics of his diagnosis, the disease is typically discovered early, either stage I or stage II. When the disease is localized like this, the patient has a 99% chance of being ‘cured’ (in oncology, ‘cure’ is measured by a 5-year survival rate; the percentages given reflect the number of patients expected to be alive 5 years after initial diagnosis if they undergo standard treatment). If the disease has spread to local areas (like nearby lymph nodes) but no further than that, the prognosis is still outstanding, with a 95.8% cure rate. Even in worst-case scenarios, where the disease has metastasized to distant regions of the body (as Lance Armstrong’s had), the success rate with treatment is 72.5%.

Compare those figures with oncology’s most dismal prognosis, that of metastatic pancreatic cancer. There, the 5-year survival rate is not even 2%.

TREATMENT

When testicular cancer is found in the early stages, the most common treatment option is not only the oldest cancer treatment option but also the one with the highest success rate: surgery.

In early-stage testicular cancer, a procedure called a radical inguinal orchiectomy is often performed. This invasive surgery removes one (unilateral) or both (bilateral) affected testicles.  In some instances, the nearby lymph nodes are removed in what’s called a retroperitoneal lymph node dissection if the oncology team suspects they are affected.

Sometimes, following surgery, a patient will undergo a ‘mop up’ round of radiation therapy. Called either ‘adjuvant therapy’ or ‘consolidation therapy’, this is designed to catch and kill any wayward cancer cells not removed during surgery. Radiation may also be used by itself to treat some cases of early-stage disease.

In cases of metastatic testicular cancer where the disease has spread to distant parts of the body (and in other cases, depending on the disease and the judgement of the phsyicians), the most common treatment option is combination chemotherapy. According to the standard oncology treatment guidelines for testicular cancer published by the National Comprehensive Cancer Network, two combination chemotherapy regimens are known to be effective.

OUTCOME

Testicular cancer spreads or metastasizes in the body following a highly predictable path; this is one reason why it is so treatable. However, all the good percentages and success rates mean nothing to a person who has been diagnosed with the disease. Nor does it make any treatment option any easier to undergo.

That said, with some 170,000 survivors of testicular cancer in the US today (including Phil Kessel as noted by USA Today), Davidson’s prognosis is extremely good. The entire hockey community wishes him well and looks forward to his return- both to good health and to the ice.