When you’ve just finished law school and are about to celebrate your 26th birthday, you don’t expect your doctor to tell you that you have cancer. But that’s exactly what happened to Larry Calli of Glen Rock in July 2005, when he was diagnosed with testicular cancer by John Theurer Cancer Center urologist Richard A .Watson, M.D.

Today, three years after undergoing two successful cancer surgeries at the Cancer Center, Larry is an attorney specializing in land use law for the Morristown firm of Porzio, Bromberg & Newman, P.C. After long, stressful days and nights at work, he enjoys lifting weights and doing carpentry projects. The cancer has not recurred.

Early Detection Saves Lives

Larry first called Dr. Watson’s office in the Department of Urology at Hackensack University Medical Center after experiencing a dull ache in his right testicle and then finding a small lump. Although an ache or pain in the scrotum can be a sign of testicular cancer, the disease can be “silent” and produce no noticeable symptoms.

Larry is fortunate that he found the lump and sought medical treatment right away because when testicular cancer is detected early, before it has spread, it is 96-percent curable with treatment.

“Self-examination of the testicles is key to early detection and successful treatment,” says Dr. Watson. “We recommend that all men gently examine their testicles at least one a month. It can be done easily in the shower or when dressing.”

After seeing Dr. Watson, Larry underwent a sonogram, a simple, painless imaging test that uses sound waves to detect lumps and masses in the body. The sonogram revealed a pea-sized solid tumor in the testicle. Tumor markers found in his blood confirmed the cancer. Within one week, he was scheduled for surgery.

“Dr. Watson has a great bedside manner and told me that he would do the surgery right away,” recalls Larry. “I would have listened to whatever he told me to do because I had complete confidence in him.”

During a surgical procedure called radical ochiectomy, Dr. Watson, director of residency education in the Department of Urology, removed the entire right testicle while Larry was under general anesthesia. Removal of the entire testicle was necessary to eradicate the cancer and minimize any spread of cancer cells.

The testicles contain several types of cells, each of which can develop into a different kind of cancer. A biopsy of the testicle revealed a combination of cancer cells, a type of cancer called mixed germ-cell cancer.

Preventing the Return of Cancer

In order to find out if the cancer had metastasized and to guard against any recurrences of the disease, Dr. Watson and Larry’s medical oncologist, Robert Alter, M.D., co-chief of the Division of Urologic Oncology at John Theurer Cancer Center, recommended a second surgical procedure to remove lymph nodes behind Larry’s intestines and near his kidneys. These nodes are a common site for the spread of testicular cancer. The procedure – called a radical retroperitoneal lymph node dissection – is highly specialized and was performed by Ihor S. Sawczuk, M.D., chairman of the Department of Urology at Hackensack University Medical Center and co-chief of the Division of Urology Oncology at the John Theurer Cancer Center.

“One of the nodes revealed some microscopic traces of cancer so it had spread beyond the testicle and potentially could have caused further damage,” explains Dr. Sawczuk.

The two surgeries removed the cancer and prevented it from spreading any further.

“Larry did not require follow-up chemotherapy as some patients do,” says Dr. Alter. “Although he did bank his sperm as a precaution, his fertility has not been compromised so he probably will not need to use the banked sperm should he desire to father a child in the future.”

According to Dr. Watson, advances in platinum-based chemotherapeutic medications over the past 30 years have turned testicular cancer from a disease that was routinely lethal to one that is now highly curable.

“Take cyclist Lance Armstrong as an example: Here is a young man whose testicular cancer had even spread to his brain, and yet his physicians were able to treat him successfully,” observes Dr. Watson. “He went on to win seven Tour de Frances. It is rewarding to see that Larry Calli is also a man who is more than a survivor. He has excelled in his life after cancer treatment.”

Larry continues to see Dr. Alter at least four times per year for follow-up care. He undergoes a CT scan and blood tests to check for any tumor markers of the cancer.

“Every day that there is no evidence of disease takes a patient further and further away from the risk of recurrence,” says Dr. Alter. “Once Larry reaches his five-year anniversary, we can feel confident that his risk of recurrence will be nominal. Larry’s optimistic approach to his treatment and his positive attitude have made it a delight to have him as a patient. I expect a full life expectancy for him.”