What to Know About Telehealth for Testicular Cancer

Testicular cancer affects one or both of the testes, organs that are part of the male reproductive system. The testes are located in the scrotum, which hangs at the base of the penis. Testicular cancer is most commonly found in young men aged 20 to 39 years old. It is often treated with a combination of chemotherapy, radiation, and surgery. In addition to these regular treatments, many doctors are now conducting certain follow-up appointments via telehealth, thanks in part to the COVID-19 pandemic.

Telehealth utilizes technology such as smartphones, tablets, and computers to provide care and can make keeping up with your cancer treatment easier and more convenient. It can also provide those who live in remote areas with access to care with a specialist. However, testicular cancer also requires in-office visits for thorough screenings, lab tests, biopsies and treatment.

Telemedicine - Asian man video chatting with doctor at home

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When to Use Telehealth for Testicular Cancer

Telehealth appointments are not meant to replace scheduled testicular cancer treatments but rather fill in the gaps between those in-person appointments.

Follow-Up Appointment

Individuals undergoing treatment for testicular cancer require regular follow-up care with their oncology team. Telehealth services may be an appropriate option for many of your follow-up appointments. The first follow-up visit is usually about six weeks after diagnosis. Testicular cancer treatments like chemotherapy or radiation therapy require in-person care.

Fertility Appointment

The treatments for testicular cancer can lead to infertility. If you plan to have children, it may be helpful to sit down with your medical team to discuss sperm banking. This appointment is often conducted with a reproductive urologist or representatives like a physician assistant or nurse practitioner. Sperm banking allows you to store your sperm for future use. This is usually offered before cancer treatment begins. During the appointment, your provider will discuss the process, benefits, risks, and costs.

Cancer Survivorship Appointment

Testicular cancer is very treatable, and the 10-year survival rate is 95%. Because the average age of diagnosis is relatively young for testicular cancer, survivorship care is especially important. Once you have completed treatment for testicular cancer, your doctor will recommend continued monitoring to address any complications or possible relapses. Much of the needed monitoring can be done via telehealth.

Survivorship care for testicular cancer may involve the following specialists:

Start With a Self-Exam

In most cases, the earliest sign of testicular cancer is a small lump in one or both of the testes. You may also notice swelling in one of the testes. To perform a self-exam, hold your testicle between your thumbs and fingers and roll it gently, feeling for any hard lumps. Then repeat on the other side. If you detect a lump or hard nodule, see your primary doctor or urologist right away.

Therapy Appointment

Studies have found that men with testicular cancer are more at risk of experiencing anxiety and depression than healthy individuals. Patients have reported feelings of anxiety concerning their treatment, finance, treatment side effects, alcohol use, and sexual concerns. You may be more at risk of experiencing depression during testicular cancer treatment if you have less social support, more physical symptoms, or already have children. If you are concerned about your mood, talk with your doctor about being referred to a therapist. Many mental health providers offer therapy over the phone or video call.

You May Need to Be Seen In Person If...

  • You discover a new lump in your testis.
  • Your doctor orders a testicular ultrasound.
  • Your doctor orders a lab test to measure serum tumor markers.
  • You are scheduled for magnetic resonance imaging (MRI).
  • You have a scheduled radical orchiectomy.
  • Your treatment includes chemotherapy or radiation.
  • Your surgical incisions appear red and swollen or are oozing.
  • Your pain is not controlled with medication.
  • You develop a high fever.

Benefits and Challenges

Testicular cancer telehealth screenings and appointments are starting to become more common because of their convenience and efficiency. They certainly offer many benefits, but they are not without challenges.

Patient Preference

Due to its ease and convenience, many individuals undergoing urological care prefer telehealth visits to in-person appointments. A 2020 study found that 85% of patients being treated in urology clinics preferred a telehealth option for care, with younger patients favoring telehealth more. There was no difference in preference between patients with or without urologic cancer such as testicular cancer.

Improved Appointment Availability

Testicular cancer needs to be treated as soon as it is diagnosed, and the treatments require in-person care. Because many urologists had limited availability at the COVID-19 pandemic, moving follow-up appointments to telehealth frees up clinic time for those who have just been diagnosed. Most follow-up appointments can safely take place over phone calls or video chats. Ask your doctor about follow-up cancer care and monitoring via telehealth services.

Increased Access to Care

Another benefit of telehealth is that it can expand specialist care to those who live in rural areas or medically underserved communities. Studies have found significant differences between the cancer care offered by specialty cancer centers and community urologists in rural areas. These differences have been linked to poorer patient outcomes at community clinics. Telehealth can help bridge that gap by expanding access to specialty cancer centers.

Challenges

The benefits of telehealth services for testicular cancer care are many, but it’s important to acknowledge the drawbacks as well. A telehealth visit cannot replace a physical exam with your physician. It also cannot be used to conduct the treatments for testicular cancer, including chemotherapy, radiation, and surgery.

As soon as you detect a new lump in your testicle, see your doctor right away. Telehealth may be appropriate later on in your treatment, but not at the beginning.

How to Prepare for a Telehealth Visit for Testicular Cancer 

To schedule a telehealth visit for testicular cancer, call your urologist’s office to inquire about the appointment options and billing practices. If your doctor does not offer telehealth services, ask for a referral to one who does. 

Once you have scheduled the appointment, ask the clinic representative if the visit will take place over the phone or video chat and how long it should take. Your urologist’s office will need to obtain your consent to evaluate and treat you virtually before the appointment can take place. If you are seeing a new provider, such as a reproductive specialist to discuss sperm banking, the clinic may ask for more information about your insurance policy and past treatment. 

You may be asked to sign the following statement: "This encounter was performed as a telemedicine visit via secure two-way video and audio to minimize the risk and transmission of COVID-19. The patient and we understand the limitations of a telemedicine visit, including the inability to do a full physical exam, possibly missing subtle findings that would otherwise have been found. Alternative options were presented to the patient, and the patient elected to proceed with the visit."

On the day of your appointment, prepare a space at home where you will be able to meet with the doctor free from distractions. Charge your device and download any software needed for the call beforehand. Ask your urologist’s office for a direct phone number to call in case you are disconnected during the visit. Keep a written list of questions with you and a pen for taking notes.

Will Insurance Cover Telehealth for Testicular Cancer?

Billing policies for telehealth services for testicular cancer treatment and monitoring vary by state and insurance provider. A good place to check is the National Consortium of Telehealth Resource Center, which offers a database of telehealth billing policies by state. It’s best to call your provider directly to find out their current payment structure in your state. For example, a telehealth visit with a urologist to discuss erectile dysfunction could range from $26 to $70 depending on the provider.

What Happens During the Visit

Once you and your provider have both logged on to the telehealth appointment, the meeting will feel very similar to an in-person appointment. For follow-up appointments after testicular cancer treatment, your doctor will ask about healing and how you have been feeling. They will also ask if you have developed any new symptoms such as a fever or pain. This is a good opportunity to ask any questions about treatment and future procedures.

For appointments with a new provider, such as a psychologist or reproductive specialist, your provider will ask more about your history and what treatments you have undergone. For any type of telehealth appointment, keeping a list of questions with you will be helpful. Grab a pen and paper as well if you decide to take notes during the appointment.

It’s possible that your doctor will prescribe a new medication or order additional tests during a telehealth visit. Most treatments for testicular cancer need to be done in person. If your doctor ordered an imaging study or lab test, ask about when to schedule your test and how long the results usually take.

During an in-person visit for testicular cancer, you are entitled to the protection of your health information, and the same goes for virtual visits. Providers offering telehealth visits must comply with the Health Insurance Portability and Accountability Act (HIPAA) and protect your health information during and after the appointment. Healthcare providers may use any non-public-facing remote communication tool to communicate with patients.

A Word From Verywell

Using telehealth services for your testicular cancer management can be a convenient way to access the care you need at any time. Virtual visits may be especially helpful for follow-up appointments following treatment. Consider using telehealth visits for referrals to new providers, such as psychologists, reproductive specialists, and cancer survivorship providers. However, always keep in mind that regular physical exams and testicular cancer treatment require in-person care.

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Article Sources
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