Barrett’s esophagus is a serious complication of GERD, which stands for gastroesophageal reflux disease. In Barrett’s esophagus, normal tissue lining the esophagus — the tube that carries food from the mouth to the stomach — changes to tissue that resembles the lining of the intestine. About 10% of people with chronic symptoms of GERD develop Barrett’s esophagus.
Barrett’s esophagus does not have any specific symptoms, although patients with Barrett’s esophagus may have symptoms related to GERD. It does, though, increase the risk of developing esophageal adenocarcinoma, which is a serious, potentially fatal cancer of the esophagus.
Although the risk of this cancer is higher in people with Barrett’s esophagus, the disease is still rare. Less than 1% of people with Barrett’s esophagus develop this particular cancer. Nevertheless, if you’ve been diagnosed with Barrett’s esophagus, it’s important to have routine examinations of your esophagus. With routine examination, your doctor can discover precancerous and cancer cells early, before they spread and when the disease is easier to treat.
Celiac disease is a serious autoimmune disorder that can occur in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine. It is estimated to affect 1 in 100 people worldwide. Two and one-half million Americans are undiagnosed and are at risk for long-term health complications. Celiac disease can be difficult to diagnose because it affects people differently. There are more than 200 known celiac disease symptoms which may occur in the digestive system or other parts of the body. Some people develop celiac disease as a child, others as an adult. The reason for this is still unknown. Some people with celiac disease have no symptoms at all, but still test positive on the celiac disease blood test. A few others may have a negative blood test, but have a positive intestinal biopsy. However, all people with celiac disease are at risk for long-term complications, whether or not they display any symptoms
Colorectal cancer often begins as a growth called a polyp inside the colon or rectum. Finding and removing polyps can prevent colorectal cancer. Colorectal cancer also known as bowel cancer and colon cancer. Most colorectal cancers are due to old age and lifestyle factors, with only a small number of cases due to underlying genetic disorders. Some risk factors include diet, obesity, smoking, and lack of physical activity. Dietary factors that increase the risk include red meat, processed meat, and alcohol. Another risk factor is inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis. Colorectal cancer (cancer of the colon or rectum), when discovered early, is highly treatable. Even if it spreads into nearby lymph nodes, surgical treatment followed by chemotherapy is highly effective. In the most difficult cases — when the cancer has spread to the liver, lungs or other sites — treatment can help make surgery an option for many, as well as prolonging and adding to one’s quality of life. Research is constantly being done to learn more and provide hope for people no matter what stage their cancer is in. Colorectal cancer survivors can be affected by a number of health problems, but often a major concern is facing cancer again. Cancer that comes back after treatment is called a recurrence. But some cancer survivors develop a new, unrelated cancer later. This is called a second cancer. Unfortunately, being treated for colorectal cancer doesn’t mean you can’t get another cancer. People who have had colorectal cancer can still get the same types of cancers that other people get. In fact, they might be at higher risk for certain types of cancer. People who have had colon cancer can get any type of second cancer, but they have an increased risk of cancers
Gall bladder and Biliary Disease
Gall bladder and Primary biliary cholangitis, previously called primary biliary cirrhosis, is a chronic disease in which the bile ducts in your liver are slowly destroyed. Bile is a fluid made in your liver. It aids with digestion and helps your body get rid of cholesterol, toxins and worn-out red blood cells. When the bile ducts are damaged, bile can back up in your liver and sometimes lead to irreversible scarring of liver tissue (cirrhosis).Primary biliary cholangitis is considered an autoimmune disease, which means your body’s immune system is mistakenly attacking healthy cells and tissue. Researchers think a combination of genetic and environmental factors triggers the disease. It usually develops slowly. Medication can slow liver damage, especially if treatment begins early. The liver produces bile, a greenish yellow, thick, sticky fluid. Bile aids digestion by making cholesterol, fats, and fat-soluble vitamins easier to absorb from the intestine. Bile also helps eliminate certain waste products (mainly bilirubin and excess cholesterol) and by-products of drugs from the body. The biliary tract consists of small tubes (ducts) that carry bile from the liver to the gallbladder and then to the small intestine. The gallbladder is a small, pear-shaped sac located beneath the liver. It stores bile. When bile is needed, as when people eat, the gallbladder contracts, pushing bile through the bile ducts into the small intestine. The liver produces bile, a greenish yellow, thick, sticky fluid. Bile aids digestion by making cholesterol, fats, and fat-soluble vitamins easier to absorb from the intestine. Bile also helps eliminate certain waste products (mainly bilirubin and excess cholesterol) and by-products of drugs from the body. The biliary tract consists of small tubes (ducts) that carry bile from the liver to the gallbladder and then to the small intestine. The gallbladder is a small, pear-shaped sac located beneath the liver. It stores bile. When bile is needed, as when people eat, the gallbladder contracts, pushing bile through the bile ducts into the small intestine.
Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus. Many people experience acid reflux from time to time. GERD is mild acid reflux that occurs at least twice a week, or moderate to severe acid reflux that occurs at least once a week. Most people can manage the discomfort of GERD with lifestyle changes and over-the-counter medications. But some people with GERD may need stronger medications or surgery to ease symptoms. Gastroesophageal refers to the stomach and esophagus. Reflux means to flow back or return. Therefore, gastroesophageal reflux is the return of the stomach’s contents back up into the esophagus. In normal digestion, the lower esophageal sphincter (LES) opens to allow food to pass into the stomach and closes to prevent food and acidic stomach juices from flowing back into the esophagus. Gastroesophageal reflux occurs when the LES is weak or relaxes inappropriately, allowing the stomach’s contents to flow up into the esophagus.
Hepatitis B is an infection of your liver. It can cause scarring of the organ, liver failure, and cancer. It can be fatal if it isn’t treated. It’s spread when people come in contact with the blood, open sores, or body fluids of someone who has the hep B virus. The good news is that most cases of the disease don’t last a long time. Your body fights it off within a few months, and you’re immune for the rest of your life. That means you can’t get it again. Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). For some people, hepatitis B infection becomes chronic, meaning it lasts more than six months. Having chronic hepatitis B increases your risk of developing liver failure, liver cancer or cirrhosis is a condition that permanently scars of the liver. Most adults with hepatitis B recover fully, even if their signs and symptoms are severe. Infants and children are more likely to develop a chronic (long-lasting) hepatitis B infection. A vaccine can prevent hepatitis B, but there’s no cure if you have the condition. Hepatitis B is a disease caused by the hepatitis B virus (HBV) which can lead to serious health problems in the liver, which include liver cirrhosis and liver cancer. Transmission of the HBV occurs when an individual comes into contact with the blood, semen, or other body fluid of an infected person. Many people that are infected with the HBV do not have any symptoms, so it is important that high-risk individuals, including those at risk of coming into contact with HBV, get screened and vaccinated according to CDC recommendations. While there is no specific treatment for individuals that are infected, a vaccine is available to protect individuals against a HBV infection. In April 2018, the Centers for Disease Control and Prevention (CDC) recommendations were updated to include a two-dose series of HepB-CpG as an option for hepatitis B vaccination for individuals age 18 years and older
Hepatitis C is a liver infection caused by the hepatitis C virus. Hepatitis C can range from a mild illness lasting a few weeks to a serious, lifelong illness. Hepatitis C is often described as “acute,” meaning a new infection or “chronic,” meaning lifelong infection.
- Acute hepatitis C occurs within the first 6 months after someone is exposed to the hepatitis C virus. Hepatitis C can be a short-term illness, but for most people, acute infection leads to chronic infection.
- Chronic hepatitis C can be a lifelong infection with the hepatitis C virus if left untreated. Left untreated, chronic hepatitis C can cause serious health problems, including liver damage, cirrhosis (scarring of the liver), liver cancer, and even death.
IBS and Chonic Constipation
Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. IBS is a chronic condition that you’ll need to manage long term. Only a small number of people with IBS have severe signs and symptoms. Some people can control their symptoms by managing diet, lifestyle and stress. More-severe symptoms can be treated with medication and counseling. IBS doesn’t cause changes in bowel tissue or increase your risk of colorectal cancer.
Chronic constipation is a common condition that is characterized by difficult, infrequent, or perceived incomplete evacuation of bowel movements. Symptoms of constipation include having less than 3 bowel movements per week, straining, hard stools, incomplete evacuation and inability to pass stool. Patients with chronic constipation do not have diarrhea unrelated to using laxatives. The prevalence of chronic constipation ranges from 2-28%. Up to 63 million people in North America meet the diagnostic criteria for chronic constipation. Epidemiologic studies demonstrate that the prevalence of constipation increases with age and is more common in women than men.
Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a term mainly used to describe two conditions: ulcerative colitis and Crohn’s disease. Ulcerative colitis and Crohn’s disease are long-term conditions that involve inflammation of the gut. Ulcerative colitis only affects the colon (large intestine). Crohn’s disease can affect any part of the digestive system, from the mouth to the anus. People of any age can get IBD, but it’s usually diagnosed between the ages of 15 and 40. There are also some less common types of IBD, which you can find out about on the Crohn’s and Colitis UK website. The term inflammatory bowel disease (IBD) describes a group of disorders in which the intestines become inflamed. It has often been thought of as an autoimmune disease, but research suggests that the chronic inflammation may not be due to the immune system attacking the body itself. Instead, it is a result of the immune system attacking a harmless virus, bacteria, or food in the gut, causing inflammation that leads to bowel injury. Most commonly, though, it affects the last part of the small intestine or the colon or both. If you have an IBD, you know it usually runs a waxing and waning course. When there is severe inflammation, the disease is considered active and the person experiences a flare-up of symptoms. When there is less or no inflammation, the person usually is without symptoms and the disease is said to be in remission
Kidney and Pancreas Transplant
The main goal of pancreas transplantation is to ameliorate insulin-dependent diabetes mellitus (type 1 or type 2) and produce complete independence from injected insulin. Simultaneous pancreas-kidney (SPK) transplantation (see the image below) is the primary option if the patient also has diabetic nephropathy and qualifies for listing for a kidney transplant. The first successful human pancreas transplant along with a kidney transplant was performed at the University of Minnesota by Dr. William Kelly and Dr. Richard Lilleheiat the University of Minnesota. In 2015, 947 pancreas transplants were performed in the United States. An estimated 30.3 million people—9.4% of the total United States population—have diabetes mellitus. However, 1 in 4 affected adults are unaware they have diabetes, and of the 84.1 million US adults with prediabetes, only 11.6% are aware of their condition. Diabetic nephropathy is the leading cause of chronic kidney disease in the US, and each year, over 50,000 people develop end-stage renal disease (ESRD) with diabetes as the primary cause. This article focuses primarily on pancreas transplantation. For complete discussion of kidney transplantation, see Pediatric Kidney Transplantation and Renal Transplantation. The most frequent candidates for a simultaneous pancreas-kidney transplant (SPK) are people with diabetes whose kidneys are failing due to nephropathy (kidney disease). Often, they are on dialysis—hooked up several times each week to a machine that takes hours to completely filter their blood—and on a strict renal diet. Transplant candidates may also have hypoglycemia unawareness or be unable to control their blood glucose, even with careful monitoring. Some people with diabetes and renal failure have a kidney transplant without a pancreas transplant, but most go in for both, says endocrinologist Sue Kirkman, MD, professor of medicine at the University of North Carolina–Chapel Hill. Much less common are pancreas-after-kidney (PAK) transplants and pancreas transplant alone (PTA). PTAs are more controversial because people are, essentially, exchanging type 1 diabetes for lifelong immunosuppression
Liver and Instestine Transplant
Intestinal transplantation is relatively uncommon, with many of the surgeries taking place at UCLA. We have completed one of the largest volumes of intestinal transplants in the U.S. and the world, and hold more than 20 years of experience.
We support patients through the range of intestinal rehabilitation and care, including outpatient therapy with total parenteral nutrition (TPN). We also provide intestinal transplants for patients who transition to adult care from our pediatric program.When intestinal transplant is the recommended treatment for you, our expert physicians and surgeons offer benefits and experience other programs cannot provide:
- Outstanding outcomes combined with personal care: Intestinal transplantation at UCLA offers state-of-the-art care from world-renowned transplant experts, resulting in consistently excellent outcomes. Learn more about our approach to care.
- Highly personalized attention: Before, during and after transplant, our team offers individualized treatment, along with unmatched surgical expertise. Learn more about what to expect from our patient education.
- Comprehensive intestinal rehabilitation and care: We understand how devastating and complex intestinal failure can be. We explore with you every avenue of rehabilitation and treatment for short bowel syndrome, short gut syndrome, and other illnesses and injuries that cause intestinal failure. Learn more about our intestinal rehabilitation and care.
- Full range of transplants: In some patients, intestinal failure creates the need for other organs, such as a liver transplant. UCLA is a complete transplant hospital. Our liver transplant physicians are among the world’s leading experts. In addition to specializing in other types of solid-organ transplant, we offer all four types of intestinal transplant:
- Isolated transplant of the intestine alone
- Liver/intestine transplant, usually provided with pancreas transplant
- Multivisceral transplant of the liver/pancreas/intestine, with or without the stomach and/or colon
- Modified multivisceral transplant, which does not include the liver
- Top-ranked patient care: Our patients benefit from the technology and sophisticated services of UCLA Health, which consistently ranks Best in the West and among the top 5 hospitals in the country, according to U.S. News & World Report’s Best Hospitals survey.
We humans are mostly microbes, over 100 trillion of them. Microbes outnumber our human cells ten to one. The majority live in our gut, particularly in the large intestine The microbiome is the genetic material of all the microbes – bacteria, fungi, protozoa and viruses – that live on and inside the human body. The number of genes in all the microbes in one person’s microbiome is 200 times the number of genes in the human genome. The microbiome may weigh as much as five pounds. The bacteria in the microbiome help digest our food, regulate our immune system, protect against other bacteria that cause disease, and produce vitamins including B vitamins B12, thiamine and riboflavin, and Vitamin K, which is needed for blood coagulation. The microbiome was not generally recognized to exist until the late 1990s. What does the microbiome have to do with health? The microbiome is essential for human development, immunity and nutrition. The bacteria living in and on us are not invaders but beneficial colonizers. Autoimmune diseases such as diabetes, rheumatoid arthritis, muscular dystrophy, multiple sclerosis, and fibromyalgia are associated with dysfunction in the microbiome. Disease-causing microbes accumulate over time, changing gene activity and metabolic processes and resulting in an abnormal immune response against substances and tissues normally present in the body. Autoimmune diseases appear to be passed in families not by DNA inheritance but by inheriting the family’s microbiome.
Minimally Invasive Gastrointestinal Cancer
Gastric cancer is a significant problem worldwide. In 2016, there were an estimated 26,370 new cases and 10,730 deaths from gastric cancer in the United States.1 The incidence is rising, particularly with respect to proximal tumors, and among whites under age 40, with a nearly 70% increase in incidence over the past few years.2 In addition, more early-stage gastric cancers are being identified, allowing for more minimally invasive surgical approaches. Minimally invasive surgery refers to both laparoscopic and robotic-assisted cases. Clear advantages of minimally invasive surgery have been demonstrated for some operations, such as cholecystectomy and colectomy, including decreased postoperative pain, morbidity, recovery time, length of hospital stay, and overall hospital cost.3 For other operations, such as appendectomy and hernia repair (both ventral/incisional and inguinal), the benefits are less clear. Compared with surgery for benign conditions, surgery for malignancy has additional factors to consider when discussing differences between open and minimally invasive surgery. Of utmost importance is the oncologic outcome. If a minimally invasive approach led to an unacceptable oncologic outcome, it should clearly not be performed. This may include well-established quality metrics, such as surgical margins and lymph node counts. In rectal cancer, for example, results from the ACOSOG Z6051 study demonstrated that the use of laparoscopic resection failed to meet criteria for non inferiority for pathologic outcomes. The study authors concluded that laparoscopic resection should not be used for these patients. For the multimodality care of patients with gastric cancer, is there a role for the minimally invasive approach? Theoretical advantages are shorter length of hospital stay, fewer complications (especially wound/incision-related), and possible earlier return to intended adjuvant therapy. Minimally invasive surgery may be beneficial if these advantages could be achieved with equivalent oncologic outcomes and without an unacceptable increase in cost. Minimally invasive gastrectomy has become standard of care in Asia, which has some of the highest gastric cancer incidence rates in the world.5 Many Asian countries have employed screening programs, allowing for the disease to be diagnosed at early stages when a minimally invasive surgical approach is most effective. Data are less robust in Western populations, where patients typically present with more advanced disease and studies on minimally invasive surgery are fewer.
Noncolorectal Gastroinstestinal Cancer
Gastrointestinal (GI) tumors are among the leading cause of death in cancer patients worldwide. Particularly, gastric cancer (GC) is the third cause of cancer deaths, whereas esophageal neoplasm is the eighth leading most common cancer worldwide and its incidence, especially adenocarcinoma type, is continuously increasing. Also, Hepatocellular carcinoma, Cholangiocarcinoma and pancreatic cancer represent a very interesting model to multidisciplinary approach and recently new drugs are used in their treatment. Currently, new clinical trials are designed including classic chemotherapy in association with either small molecule inhibitors (i.e. Tyrosine Kinase inhibitors) and/or monoclonal antibody (i.e. anti-EGFR antibody). Moreover, a comprehensive list of new molecules for target therapy is included in this issue. The development of new treatment modalities (multidisciplinary approach) and targeted therapy approaches have contributed to improving the outcome in these cancer diseases. During the past few years, remarkable progress in molecular biology of malignancy, the discovery of specific targets, and the resulting development of systemic drugs that block critical kinases and several molecular pathways have all contributed to progress in cancer treatment, also in GI non-colorectal cancer treatment.
Peptic Ulcer Diseases
Peptic ulcer if you get open sores in the lining of your stomach or the upper part of the small intestine. That happens when your stomach acids etch away your digestive tract’s protective layer of mucus. You may have no symptoms, or you may feel discomfort or burning pain. Peptic ulcers can lead to internal bleeding, which sometimes can mean you’ll need blood transfusions in the hospital. You can have two types of peptic ulcer disease. Gastric ulcer. You get this on your stomach lining. Duodenal ulcer. This appears at the top end of the small intestine, an organ that digests and absorbs much of the food you eat. Peptic ulcer disease (PUD) is a break in the inner lining of the stomach, first part of the small intestine or sometimes the lower esophagus. An ulcer in the stomach is known as a gastric ulcer while that in the first part of the intestines is known as a duodenal ulcer. The most common symptoms of a duodenal ulcer are waking at night with upper abdominal pain or upper abdominal pain that improves with eating. With a gastric ulcer the pain may worsen with eating. The pain is often described as a burning or dull ache. Other symptoms include belching, vomiting, weight loss, or poor appetite. About a third of older people have no symptoms. Complications may include bleeding, perforation and blockage of the stomach. Bleeding occurs in as many as 15% of people. Common causes include the bacteria Helicobacter pylori and non-steroidal anti-inflammatory drugs (NSAIDs). Other less common causes include tobacco smoking, stress due to serious illness, Behcet disease, Zollinger-Ellison syndrome, Crohn disease and liver cirrhosis, among others. Older people are more sensitive to the ulcer-causing effects of NSAIDs. The diagnosis is typically suspected due to the presenting symptoms with confirmation by either endoscopy or barium swallow. H. pylori can be diagnosed by testing the blood for antibodies, a urea breath test, testing the stool for signs of the bacteria, or a biopsy of the stomach. Other conditions that produce similar symptoms include stomach cancer, coronary heart disease, and inflammation of the stomach lining or gallbladder inflammation.
Control of bladder function involves the somatic efferent as well as autonomic sympathetic and parasympathetic systems. Bladder filling as well as emptying is organized by 3 centers along the central nervous system, which act through peripheral nerves on receptors in the neuromuscular junctions of the muscles in the bladder, bladder neck, urethra, diaphragm, abdomen, and pelvic floor.
The sympathetic nervous system regulates the process of urine storage in the bladder. In contrast, the parasympathetic nervous system controls bladder contractions and the passage of urine. The somatic efferent system permits voluntary control over the external periurethral sphincter.
Parasympathetic nerve impulses travel from S2-S4 ventral gray matter via the pelvic nerves to the ganglia near the bladder wall. Postganglionic nerve impulses then travel to the smooth muscle cholinergic receptors to produce bladder contraction.
Sympathetic efferent nerve fibers originate from the lateral gray column of the spinal cord between T11 and L2. The sympathetic system has a long postganglionic chain that runs with the hypogastric nerve to synapse with alpha and beta receptors in the bladder wall and the bladder neck or internal sphincter. Beta receptors are responsible for mediating relaxation of the bladder with filling. Alpha receptors are responsible for tonically contracting the internal sphincter during bladder filling.
The somatic efferent nerve fibers originate from the pudendal nucleus of S2-S4 and supply the external periurethral sphincter. The external sphincter is under voluntary control and normally contracts in response to coughing or the Valsalva maneuver or when a person actively tries to prevent or halt urine flow.
Therefore, when the bladder retains urine, alpha1 receptors on the trigone, bladder neck, and urethra activate contraction, while beta-adrenergic receptors in the bladder body relax the detrusor muscle to permit filling. Somatic efferent fibers from the cerebral cortex permit voluntary contraction of the external sphincter to provide extra support. Alpha-adrenergic receptors in the trigone, bladder neck, and urethra stimulate relaxation, while the muscarinic receptors in the detrusor body stimulate contraction to facilitate bladder emptying.
Central control of micturition is performed by 3 areas: the sacral micturition center, the pontine micturition center, and the cerebral cortex. The sacral micturition center is located at the S2-S4 levels and is responsible for bladder contraction. The pontine micturition center acts as a central relay and may play a role in the coordination of external sphincter relaxation with bladder contraction. The cerebral cortex plays an inhibitory role in relation to the sacral micturition center.
Urinary incontinence and OAB
Urinary incontinence is leaking of urine that you can’t control. Many American men and women suffer from urinary incontinence. We don’t know for sure exactly how many. That’s because many people do not tell anyone about their symptoms. They may be embarrassed, or they may think nothing can be done. So they suffer in silence. Urinary incontinence is not just a medical problem. It can affect emotional, psychological and social life. Many people who have urinary incontinence are afraid to do normal daily activities. They don’t want to be too far from a toilet. Urinary incontinence can keep people from enjoying life. Many people think urinary incontinence is just part of getting older. But it’s not. And it can be managed or treated. Learn more here. Talk to your doctor. Find out what treatment is best for you. Overactive bladder (OAB) is a common condition that affects millions of Americans. Overactive bladder isn’t a disease. It’s the name of a group of urinary symptoms. The most common symptom OAB is a sudden urge to urinate that you can’t control. Some people will leak urine when they feel the urge. Leaking urine is called “incontinence.” Having to go to the bathroom many times during the day and night is another symptom of OAB. There is another common bladder problem called stress urinary incontinence (SUI), which is different from OAB. People with SUI leak urine while sneezing, laughing or doing other physical activities.
Benign prostatic hyperplasia
Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss of bladder control. Complications can include urinary tract infections, bladder stones, and chronic kidney problems. The cause is unclear. Risk factors include a family history, obesity, type 2 diabetes, not enough exercise, and erectile dysfunction. Medications like pseudoephedrine, anticholinergics, and calcium channel blockers may worsen symptoms. The underlying mechanism involves the prostate pressing on the urethra thereby making it difficult to pass urine out of the bladder. Diagnosis is typically based on symptoms and examination after ruling out other possible causes. Treatment options including lifestyle changes, medications, a number of procedures, and surgery. In those with mild symptoms weight loss, exercise, and decreasing caffeine intake is recommended. In those with more significant symptoms medications may include alpha blockers such as terazosin or 5α-reductase inhibitors such as finasteride. Surgical removal of part of the prostate may be carried out in those who do not improve with other measures. Alternative medicine, such as saw palmetto, does not appear to help.
Testicular cancer occurs in the testicles (testes), which are located inside the scrotum, a loose bag of skin underneath the penis. The testicles produce male sex hormones and sperm for reproduction. Compared with other types of cancer, testicular cancer is rare. But testicular cancer is the most common cancer in American males between the ages of 15 and 35. Testicular cancer is highly treatable, even when cancer has spread beyond the testicle. Depending on the type and stage of testicular cancer, you may receive one of several treatments, or a combination