“My priority is maintaining a focus on what can be done. Fortunately, with many male reproductive and urinary tract cancers, there’s quite a lot we can do.”
When Javier Hernandez, M.D., was a young doctor serving in the U.S. Army, he gained a passion for the early diagnosis and treatment of testicular cancer. Now one of the only dedicated experts on urological oncology in South Central Texas, the UT Health San Antonio MD Anderson Cancer Center physician recalls with gratitude the formative lessons he gained while serving at Brooke Army Medical Center.
“With all these young men in the service, you see [testicular cancer] more often,” says Dr. Hernandez. In the service, Dr. Hernandez says he gained a keen appreciation for the fear and stigma associated with male reproductive and urological cancers. He also learned how key early detection is to ensure the young men eventually lived long and satisfying lives.
While relatively rare, testicular cancer is the most common form of cancer among men aged 15-34. Highly treatable if detected early, the fast-moving cancer can be debilitating or deadly if untreated. Testicular cancer is usually discovered when a patient notices an unusual growth, firmness or discomfort in the scrotum or on the testicle during a self-exam. That’s the time to have it checked by a doctor, Dr. Hernandez says, rather than later.
“If we catch it at stage 1 (before it has moved to other areas of the body), the cure rate for testicular cancer is well over 90 percent,” he says. “Unfortunately, it’s still not uncommon to meet a patient who tells us it’s been weeks, months and, sometimes, a couple of years since they first noticed a lump or discomfort. By then, the problem has usually become much more threatening than it had to be.”
He shares the story of Malachi Fischer, an active, athletic, recently married 31-year-old patient from Del Rio. “Malachi did everything right. He checked himself, he paid attention to his body, and he sought medical advice only a few days later. Less than a week later, his right testicle and a small tumor were removed. His quick action saved his life, but, even then, the cancer had already spread to his lymph nodes and required chemotherapy.”
The good news, in Fischer’s case, is that he experienced a full recovery only a few months after initial diagnosis. Patients who wait, says Dr. Hernandez, aren’t usually so lucky. But, he stresses, there are still plenty of options even in those more advanced cases.
“My priority is maintaining a focus on what can be done. Fortunately, with many male reproductive and urinary tract cancers, there’s quite a lot we can do,” Dr. Hernandez insists.
He points to another patient, a teenaged boy whose cancer had migrated throughout his abdomen and into his heart by the time it was detected and diagnosed. Through rapid, aggressive chemotherapy, a succession of surgical interventions, and what Dr. Hernandez calls “a heroic team effort,” the team at UT Health San Antonio MD Anderson Cancer Center was able to reach a successful outcome. Currently, the patient is almost three years cancer-free and is living a healthy, active life.
“This story really illustrates that there’s a lot that can be done,” says Dr. Hernandez. “It also really underscores the importance of seeking out the right specialist, the right team, and the right facility.
“In my practice, I just try to treat people the way I’d like to be treated in the same situation. I want them to know that I can understand what they’re going through and that I’m committed to working with them to bring all possibilities to the table,” Dr. Hernandez adds. “My specialty is systematic surgical and collaborative approaches to overcoming all kinds of advanced urological cancers, so I’ve seen first-hand what can be done. The challenge is staying upbeat and helping patients and their families remain hopeful.”
Dr. Hernandez has served as a faculty member in the Department of Urology at UT Health San Antonio since 2011. In addition to his clinical duties, he is actively involved in various research endeavors on the early detection of prostate cancer. He has an interest in all aspects of general urology as well as a particular interest in the prevention, diagnosis and treatment of urologic malignancies, including tumors of the kidney, bladder, prostate, testis and male genitalia.
He earned his medical degree from Duke University School of Medicine before completing his residency with the San Antonio Uniformed Services Health Education Consortium. Dr. Hernandez completed his internship while serving at Brooke Army Medical Center. He is board certified by the American Board of Urology.
To learn more about the family of experts at UT Health San Antonio, or to schedule an appointment, visit UTHealthsaMDAnderson.org or call 210-450-1000.
UT Health San Antonio MD Anderson Cancer Center has permission to share Malachi's story.