This interview has been conducted in partnership with the American Urological Association, a premier urologic association, providing invaluable support to the urologic community. Their mission is to promote the highest standards of urological clinical care through education, research, and the formulation of health care policy.

Oncology Data Advisor: Welcome to Oncology Data Advisor. Today, in honor of Testicular Cancer Awareness Month, I'm joined by Dr. Katie Murray.

Katie Murray, DO: I'm Katie Murray. I'm a urologic oncologist. I practice at the University of Missouri and Ellis Fischel Cancer Center. I see and treat patients with all urologic malignancies, including testicular cancer, which is a major focus in our younger population of patients. I practice oftentimes as the initial person who's seeing these patients and who may find abnormalities. I'm the person who's operating on these patients and then following them in the long term, along with my colleagues in medical oncology and radiation oncology if necessary.

Oncology Data Advisor: So for background, what are some of the most challenging aspects of treating patients with testicular cancer?

Dr. Murray: I think there are, of course, lots of complications or issues when you're treating any patient with cancer, but for testis cancer in particular, many of those issues come down to the age of patients that have testicular cancer. This is a cancer that turns lives upside down because it's young populations; we're talking 20- and 30-year-olds, sometimes even younger than that, and there are implications to the treatments. There are social implications. There are schooling implications and things like that. It really all goes back to the population.

When people think of cancer, they think of an elderly or older population. When you have a young child, essentially—in their twenties and thirties—with cancer, that's a challenge. This is at the same point in their life that things are changing, right? They're moving away to college. They're getting their first job. They don't know where that's going to be, and they're moving around the country. Follow-up is always one of our priority concerns, ensuring that they get that done.

Then also, some of the treatments that we use have implications in the long term. Chemotherapeutics, radiation therapy—and then of course the surgeries that we do—can have physical appearances cosmetically. For future fertility and other things, these can be impactful.

Oncology Data Advisor: With all these considerations, do you have any particular advice for members of the cancer care team who are treating these patients?

Dr. Murray: I think it's so necessary, with testicular cancer, for all of the necessary specialties to be involved. Who are those? I can't stress enough that a urologist needs to be involved to have some of these initial conversations, as well as a medical oncologist. I think those are probably the primary two people, and that may also then lead to things like talking to fertility specialists and oftentimes leading to social work and some of those other people that are definitely part of the team.

It's important to ensure that a urologist is involved to talk about "right now" expectations, as well as our implications and expectations down the road. You really just want to have very realistic conversations with the patient. What happens if you move away to your first job, and you don't do follow-up anymore for your testicular cancer? We need to be telling our patients exactly what the potential is to happen, both good and bad.

Oncology Data Advisor: In the coming years, what do you think some of the most significant advances will include in testicular cancer treatment and surgery?

Dr. Murray: Just like all of our cancers out there, there are so many things, and we're hoping for more personalized care for patients. There are trials ongoing to try to push surgical interventions. In the era of becoming less and less invasive as surgeons, the thing that is definitely on the forefront is pushing the limits to protect nerves for patients, ensuring that they're getting good operations and having good cancer control all at the same time.

That is really why it's necessary to have all parties involved at those initial conversations—urologists as well as a medical oncologist—and talk about the pros and cons of surgery, the pros and cons of chemotherapeutics, and the short-term and long-term implications. These are 20- and 30-year-olds. They're going to live for 60 and 70 years later, and we need to know what to worry about that many years down the road.

Oncology Data Advisor: Thank you so much for sharing all this advice with us.

Dr. Murray: No problem. Thanks.

About Dr. Murray

Katie Murray, DO, is an Assistant Professor in the Department of Surgery-Urology at the University of Missouri Health Care. She specializes in the treatment of patients with genitourinary malignancies, including testicular cancer, bladder cancer, and prostate cancer, with particular expertise in robotic surgery, laparoscopic surgery, urologic reconstructive surgery, and quality of life outcomes. Dr. Murray has authored, or coauthored numerous publications focused on improving outcomes for patients with genitourinary cancers.

Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of Oncology Data Advisor.