A real-world case of a young man with a painless testicular mass sets the stage for a practical, nuanced discussion of modern testicular cancer management. Drs. Adra, Bagrodia, and Matulewics walk through key decision points, from pre-orchiectomy counseling and staging to interpreting risk factors like tumor size and rete testis invasion. The group makes a strong case for why active surveillance remains the preferred strategy for most stage I seminoma patients, while also exploring how they think about relapse risk and what happens when surveillance fails. This case-based discussion highlights the clinical judgment that goes into balancing overtreatment with safe, evidence-based care.
Contributors:
Dr. Nabil Adra is a hematologist and Associate Professor of Clinical Medicine and Urology at Indiana University Health in Indianapolis, Indiana.
Dr. Aditya Bagrodia is an associate professor of urology and genitourinary oncology team leader at UC San Diego Health in California and adjunct professor of urology at UT Southwestern.
Dr. Richard Matulewicz is a urologic oncologist and surgeon at Memorial Sloan Kettering Cancer Center in New York City.
