Cisplatin is one of the most powerful, life-saving drugs in testicular cancer treatment — but it comes with a lasting side effect that too few patients are warned about. In this episode of It Takes Balls, audiologist Dr. Pam Swartz unpacks how cisplatin damages hearing, why it's permanent, and what young survivors can do to protect their quality of life for the decades ahead.

Dr. Swartz starts with the basics of how we hear — from the eardrum and the body's three smallest bones to the roughly 30,000 hair cells in the cochlea — and explains a key truth: we hear with our brain, not our ears. She then breaks down why cisplatin is classified as highly ototoxic (a "class five" medication affecting hearing, balance, and tinnitus), how it accumulates around and kills the outer hair cells, and why that damage can't be reversed. Roughly 40% of patients on high doses experience some hearing loss, often in the high frequencies first — which is why voices can start to sound mumbled, women and children become harder to understand, and the TV keeps creeping louder.

This conversation is packed with practical, actionable guidance. Dr. Swartz explains why every patient should get a baseline audiogram before starting treatment (tested out to 20,000 Hz, not the standard 8,000) and a follow-up 6–8 weeks after finishing, how to protect the hearing you have from added noise damage, and how far modern hearing aids have come — now rechargeable, Bluetooth-enabled, and self-adjusting thousands of times per second. She also covers cochlear implants, listening strategies (sound bars, closed captioning, choosing the restaurant booth), and how partners and family can become better communicators.

A large part of the episode focuses on tinnitus — the ringing so many survivors live with. Dr. Swartz, who has tinnitus herself, explains what it is, why the emotion you attach to it makes it louder, and why sound therapy is the most effective tool we have. She shares how a simple air purifier changed her own experience, common triggers to watch (salt, caffeine, alcohol, stress), and why CBT, deep breathing, and mindfulness genuinely help. She also recommends the ReSound Tinnitus Relief app — the same sound-therapy tool used by the VA — which runs all night and layers multiple sounds to help mask the ringing.

Whether you're about to start chemotherapy, already noticing changes in your hearing, or supporting a survivor, this episode is an essential guide to advocating for your ears — because surviving testicular cancer means living well for the long haul.

Resources mentioned: ReSound Tinnitus Relief app | American Tinnitus Association (ata.org) | Find an audiologist through ASHA (American Speech-Language-Hearing Association) or the American Academy of Audiology

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Theme song: No Time Like Now - Tom Willner www.tomwillner.com

Bray Hansel thought he was done. After a swollen left testicle led to an orchiectomy and a pathology report showing an eight-centimeter pure seminoma contained to the testicle, the 37-year-old financial advisor, husband, and father of three from outside Philadelphia went on surveillance feeling like a survivor — proud of what he'd gotten through and ready to move on. But testicular cancer had other plans.

In this episode of It Takes Balls, Bray shares a story that captures just how unpredictable seminoma can be. What started as a borderline stage 2B diagnosis became months of confusing scans: a scan showing no active cancer, a blood test reading 0.00 cancer DNA, and normal tumor markers — all while a lone lymph node in his abdomen quietly kept growing. His care team's honest conclusion was that the cancer was declaring itself, landing Bray in the group of seminoma patients who need further treatment after an orchiectomy.

Faced with several paths — BEP chemotherapy, carboplatin plus radiation, or a robotic RPLND — Bray walks through one of the most difficult decisions of his life. He explains why he had concerns about the long-term risks of chemo and radiation, and chose a robotic retroperitoneal lymph node dissection Penn. Of the 15 lymph nodes removed, five contained cancer — more than expected, but still low-volume, with no adjuvant therapy needed and roughly an 80% chance of staying recurrence-free at two years.

Beyond the medicine, this is a conversation about perspective, humor, and community. Bray talks about coaching his undefeated soccer team through treatment, making an "RPLND playlist," showing his testicle to his buddies in a parking lot before surgery, and how a whole network — from his wife and friends Brandon, Alex, and Ryan to strangers who never knew they were helping — carried him through. He reflects on the phrase "a problem shared is a problem halved," how cancer deepened his marriage and relationships, and his desire to follow in the footsteps of TCAF's Jordan Jones by being a resource for the next guy.

Whether you're navigating a seminoma diagnosis, weighing treatment options after an orchiectomy, or supporting someone through testicular cancer, Bray's story is a moving reminder that survivorship can add depth, connection, and even joy — and that no one has to face it alone.

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Theme song: No Time Like Now - Tom Willner www.tomwillner.com

Attend the 2026 Testicular Cancer Conference: https://www.testicularcancerawarenessfoundation.org/tcc-indianapolis-2026

At just 24, personal trainer Andrejs Lejietis was building a business and living what he thought was a healthy, active life in Stockholm, Sweden — until a strange abdominal pain that kept returning after lunch led to one of the most confusing diagnoses in testicular cancer. In this episode of It Takes Balls, our first-ever Swedish guest shares a remarkable story about an extragonadal germ cell tumor: testicular cancer with no primary tumor in the testicles at all.

Andrejs describes months of uncertainty as recurring pain near his aorta sent him from ultrasound to CT scan to a bone marrow biopsy, with doctors ruling out lymphoma before finally landing on a testicular cancer diagnosis. Encouraged by his girlfriend Emily to stop putting it off, he learned the value of self-advocacy the hard way — and discovered that a "good cancer to have" still hits hard when you're 24 with corporate clients lined up and a future you'd just started building.

He opens up about four rounds of BEP chemotherapy at Karolinska University Hospital, an initial AFP tumor marker of 21,000, and stage 2C disease. Andrejs shares the realities of inpatient chemo, losing his hair, sperm banking and stem cell harvesting before treatment, and the unexpected gift of community — meeting other young men going through testicular cancer treatment at the same time.

The conversation also covers his open RPLND (retroperitoneal lymph node dissection), a surgery Sweden has centralized to two hospitals for the best outcomes. Andrejs recounts a tumor wrapped around a vein near his left kidney, a difficult six-week recovery, neuropathy, retrograde ejaculation, and being discharged on Christmas Eve. Fourteen lymph nodes were removed — all clear.

Andrejs and host Steven Crocker also dig into the Scandinavian healthcare system, where treatment, surgery, sperm banking, and even taxis to chemo are largely covered by taxes — and how testicular cancer, one of the most common cancers among young men, is treated across Europe.

Now cancer-free and back to work, Andrejs reflects on how the journey reshaped his path toward becoming a physical therapist, the scar he wears with pride, and his advice for anyone newly diagnosed: take it one day at a time, stay as physically active as you can, and don't wait to get checked.

Whether you're a testicular cancer patient, survivor, caregiver, or want to understand rare presentations like extragonadal germ cell tumors, Andrejs's story is a powerful reminder that early detection saves lives — and that you should never ignore symptoms that keep coming back.

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Theme song: No Time Like Now - Tom Willner www.tomwillner.com

Attend the 2026 Testicular Cancer Conference: https://www.testicularcancerawarenessfoundation.org/tcc-indianapolis-2026

When David Smith woke in the middle of the night with searing lower-back pain, he was two weeks out from the Beep Baseball World Series and in the best shape of his life. A legally blind wellness coach, nurse, and competitive adaptive-sports athlete, David assumed it was a kidney stone. Instead, an ER scan revealed a large mass near his kidney — and with no primary tumor found on ultrasound, doctors diagnosed him with testicular cancer at 41.

In this episode of It Takes Balls, David shares one of the most powerful stories of self-advocacy the podcast has featured. Determined not to miss the World Series, he delayed treatment two weeks, then began BEP chemotherapy that quickly went sideways: a wiped-out immune system, terrifying bone pain from shots no one warned him about, and a blood clot in his lung. When bleomycin proved too dangerous, David — drawing on his own nursing knowledge and relentless research — pushed his oncology team to change his regimen himself.

David doesn't hold back about the gaps in his care, from "factory"-like bedside manner to Googling his way to a nearby cancer center and an experienced surgeon he'd never been told about. His post-chemo RPLND removed 21 lymph nodes (all negative) but left him navigating a brutal recovery that nearly broke him.

But this episode is really about what comes after. David opens up honestly about survivorship — the fear of recurrence, the identity crisis of remission, faith, and the ongoing work of figuring out who he really is. His message to anyone facing a diagnosis: advocate for yourself, do your research without letting it consume you, and hang tight — because far more people survive cancer than don't.

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Theme song: No Time Like Now - Tom Willner www.tomwillner.com

Attend the 2026 Testicular Cancer Conference: https://www.testicularcancerawarenessfoundation.org/tcc-indianapolis-2026

In this episode of It Takes Balls, Taylor Woods shares one of the most extraordinary journeys ever featured on the podcast. What began with sitting on his enlarged testicle and doctors believing he was dealing with a bacterial infection ultimately became a diagnosis of advanced testicular cancer that had already spread throughout his body. After living with symptoms for more than a year, Taylor learned he had a 17-centimeter testicular tumor, cancer in his lymph nodes, multiple nodules in his lungs, and a tumor pressing against his brain.

Taylor walks through undergoing an orchiectomy (testicle removal surgery), four rounds of BEP chemotherapy, TIP chemotherapy, multiple rounds of radiation, and several brain surgeries after developing brain metastases. He shares the terrifying experience of seizures, kidney failure that delayed surgery, a stem cell transplant at Fred Hutch, and living with a titanium plate. Despite enduring more treatment than most typical testicular cancer survivors, Taylor continues fighting with remarkable optimism while managing an active brain tumor and ongoing surveillance.

The conversation also explores life after cancer, including adapting to permanent disability, returning to school to study graphic design after seizures changed the course of his career, and finding purpose through creativity. Throughout the episode, Taylor repeatedly comes back to one message: self-advocacy matters. Looking back, he wishes he had sought a second opinion sooner after being told his symptoms were caused by an infection, and he hopes others will trust their instincts when something doesn't feel right.

Although Taylor refers to himself as a "warrior" rather than simply a survivor, his story is ultimately one of resilience, hope, and perseverance. Whether you're navigating a testicular cancer diagnosis, facing recurrence, supporting a loved one, or learning about brain metastases, chemotherapy, stem cell transplant, and survivorship, this episode is a powerful reminder that every day is worth fighting for.

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Theme song: No Time Like Now - Tom Willner www.tomwillner.com

In this episode of It Takes Balls, internationally renowned urologic oncologist Dr. Axel Heidenreich joins the podcast for a fascinating conversation comparing testicular cancer treatment in Europe (focused on Germany) and the United States. Although both approaches produce exceptional cure rates, patients are often surprised to learn just how differently experts on opposite sides of the Atlantic make treatment decisions.

Dr. Heidenreich explains where the European Association of Urology (EAU), American Urological Association (AUA), and National Comprehensive Cancer Network (NCCN) guidelines align and where they take very different paths. From surveillance and chemotherapy to RPLND imaging, and follow-up care, he shares why there isn't always one "right" answer and how physicians balance curing cancer with preserving quality of life.

The conversation also dives into one of the most debated topics in testicular cancer today: the future of surveillance. Dr. Heidenreich discusses emerging blood tests that could reshape how recurrence is detected and monitored, offering his perspective. Rather than accepting the latest technology at face value, he explains why some innovations may hold more promise than others and what that could mean for the future of testicular cancer care.

Whether you're newly diagnosed, currently on surveillance, or simply interested in how leading experts think differently around the world, this episode offers an eye-opening look at the evolution of testicular cancer treatment and the questions that could shape the next generation of patient care.

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Theme song: No Time Like Now - Tom Willner www.tomwillner.com

Attend the 2026 Testicular Cancer Conference: https://www.testicularcancerawarenessfoundation.org/tcc-indianapolis-2026

In this episode of It Takes Balls, Nate Edwards shares how finding a lump the day after his 34th birthday led to a testicular cancer diagnosis in the middle of the COVID-19 pandemic. Although two people in Nate's life had previously been diagnosed with testicular cancer, including one of his best friends and a former robotics student, he still wasn't convinced it could happen to him. In fact, his primary care doctor initially doubted it was cancer before an ultrasound revealed otherwise.

After undergoing an orchiectomy, Nate learned he had 100% embryonal carcinoma, the same aggressive type of testicular cancer that affected Lance Armstrong. As a new father, he suddenly found himself navigating sperm banking, treatment decisions, and the uncertainty that comes with a cancer diagnosis.

One of the most fascinating parts of Nate's story is his treatment journey. Faced with choosing between chemotherapy and RPLND (retroperitoneal lymph node dissection), he sought multiple opinions before ultimately choosing surgery during the height of COVID. Doctors removed 23 lymph nodes during a nine-hour operation, and remarkably, every single one came back negative for cancer.

The conversation also dives deep into fertility after testicular cancer. Nate openly discusses sperm banking, retrograde ejaculation after RPLND, low semen volume, multiple miscarriages, and the emotional roller coaster he and his wife experienced while trying to grow their family. Despite numerous setbacks and fertility concerns, the couple eventually welcomed a second child, a milestone that makes this story especially meaningful.

Today, Nate is an active members of the online testicular cancer community, helping newly diagnosed patients navigate treatment decisions, fertility concerns, and survivorship. His story is a powerful reminder that testicular cancer can happen at any age, that self-exams matter, and that a strong support system can make all the difference.

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Theme song: No Time Like Now - Tom Willner www.tomwillner.com

In this episode of It Takes Balls, Tony Florio shares one of the most unusual testicular cancer stories featured on the podcast. An attorney, husband, and father of two young kids, Tony was on paternity leave when he developed a persistent ache in his lower abdomen. There was no lump, no testicular pain, and no obvious signs of testicular cancer, just a nagging discomfort that refused to go away.

After a CT scan revealed a large abdominal mass, doctors initially suspected a sarcoma or paraganglioma, two diagnoses with far different prognoses than testicular cancer. Even after a scrotal ultrasound came back normal, Tony continued searching for answers. Using AI tools to better understand his medical reports and advocating for additional testing, he pushed for tumor markers that ultimately helped point his medical team in a different direction.

Tony underwent major surgery to remove a retroperitoneal mass, entering the operating room knowing he could potentially lose part of his colon or even a kidney. Fortunately, the surgery was successful, and pathology revealed what nobody initially expected: a germ cell tumor consisting primarily of teratoma, embryonal carcinoma, and yolk sac tumor components. Even more unusual, doctors never found a tumor in either testicle, leaving questions about whether his cancer represented a burned-out testicular cancer or a rare extragonadal germ cell tumor.

The episode also explores the emotional side of facing cancer while raising two young children. Tony reflects on the fear of not being there for his family, the support he received from his wife, friends, and neighbors, and the faith that helped carry him through the most uncertain moments. He also discusses postoperative complications, including a painful pneumothorax that landed him back in the hospital, as well as the surprising recommendation from his tumor board.

This conversation is a powerful reminder that testicular cancer symptoms don't always start in the testicle, that self-advocacy matters, and that sometimes the most important part of the journey is simply getting the right diagnosis. Whether you're navigating a recent diagnosis, interested in rare presentations of germ cell tumors, or looking for hope during surveillance, Tony's story offers insight, perspective, and encouragement.

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Theme song: No Time Like Now - Tom Willner www.tomwillner.com

In this episode of It Takes Balls, recent law-grad Jack shares how a symptom many men might dismiss led to a life-changing testicular cancer diagnosis. Ironically, Jack describes himself as a lifelong "hypochondriac," someone who routinely worried about his health. Yet when this symptom first appeared, even he wasn't convinced it was anything serious.

Living alone in New York City while attending law school, Jack eventually trusted his instincts and went to the emergency room, where an ultrasound revealed a suspicious mass. What followed was a whirlwind of sleepless nights, frantic Google searches, and rapidly learning about orchiectomies, surveillance, sperm banking, and treatment possibilities. Determined to find the best care available, he connected with the team at Memorial Sloan Kettering and underwent surgery under the care of Dr. Rich Matulewicz.

Jack opens up about navigating cancer largely on his own, with family hundreds of miles away in Wisconsin (visiting after surgery) and friends helping him through recovery in New York. He shares the emotional moment when the reality of being a cancer survivor finally hit him—days after surgery, alone in a friend's apartment, when weeks of fear, uncertainty, and stress came pouring out all at once.

The conversation also explores survivorship, scanxiety, and what it's like to return to normal life while still living with uncertainty. As someone who loves data and analysis, Jack explains how understanding recurrence statistics helps him cope with follow-up scans, even as enlarged lymph nodes required additional monitoring after surgery.

More than anything, Jack's story is a reminder that testicular cancer symptoms don't always include a lump. Sometimes the warning signs are subtle. His message to listeners is simple: trust your body, advocate for yourself, and get checked when something feels off. Early detection saves lives.

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Theme song: No Time Like Now - Tom Willner www.tomwillner.com

In this episode of It Takes Balls, testicular cancer survivor Tony Salas shares how his cancer journey led him into one of the newest and most rapidly evolving areas of cancer surveillance: MicroRNA-371 testing and Signatera ctDNA monitoring.

Tony opens up about the symptoms and diagnosis that changed his life, including the whirlwind of appointments, surgery, and learning how quickly testicular cancer treatment decisions have to be made. But what makes his story especially unique is what came after treatment—navigating surveillance while trying to avoid chemotherapy and gain greater confidence in whether his cancer was truly gone.

Throughout the episode, Tony discusses using MicroRNA 371, an emerging blood test showing major promise in detecting active germ cell tumors, along with Signatera, a personalized circulating tumor DNA (ctDNA) test designed to monitor for residual disease and recurrence. He shares what it was like balancing traditional surveillance methods like CT scans and tumor markers with these newer technologies, and how the uncertainty of recurrence can weigh heavily on survivors mentally and emotionally.

The conversation also explores the emotional side of survivorship, including scannxiety, the fear of recurrence, and the challenge of moving forward after treatment while still feeling tied to constant monitoring. Tony speaks candidly about the importance of self-advocacy, staying informed about evolving cancer research, and finding ways to regain a sense of control during survivorship.

This episode is not only a powerful survivor story, but also an insightful look at the future of testicular cancer surveillance and personalized cancer monitoring. Whether you’re navigating a diagnosis, currently in surveillance, or interested in the latest advances in testicular cancer treatment and recurrence detection, Tony’s experience offers both hope and perspective.

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Theme song: No Time Like Now - Tom Willner www.tomwillner.com