Brian's Fight: Facing Testicular Cancer Twice

In June of 2025, Brian Carlson was diagnosed with testicular cancer for the second time.

His first diagnosis was in April of 2015; he was told that it was caused by an undescended left testicle - known as cryptorchidism - and the tumor was a pure non-seminoma tumor called embryonal carcinoma. Non-seminoma Germ Cell Tumors (NSGCT) are a rarer and more aggressive type of tumor, and embryonal carcinomas are a type of non-seminoma cancer present in about 40% of testicular cancer tumors. A pure embryonal carcinoma, as Brian experienced, is even more rare, occurring only 3-4% of the time.

Brian underwent an orchiectomy to remove both the tumor and testicle. Thankfully, there was no metastasis in the lymph nodes or lungs. Nevertheless, the oncologist recommended three rounds of BEP chemotherapy to further reduce his risk of recurrence.

Fast forward almost exactly 10 years later - Brian experienced no issues throughout his near-decade of remission. No issues, that is, until he noticed that his remaining right testicle was starting to slowly enlarge.

By the time it caused Brian pain and discomfort, it had reached the size of a goose egg. A visit to urgent care resulted in blood work and an ultrasound. Within an hour, the doctor there was almost entirely convinced it was cancer. Two days later he had an appointment with his urologist, who confirmed another testicular cancer diagnosis - though not the same type of cancer Brian had had ten years earlier. The elevated tumor markers the urologist saw indicated that he was not facing another round with embryonal carcinoma.

The following week, Brian’s oncologist told him that he would require another orchiectomy, which was done in July. After a four-week wait, Brian had another blood draw to see if his markers had reduced. The pathology came back as 98% seminoma and 2% non-seminoma with lymphovascular invasion.

Before surgery his hCG was over 5,000 mIU/mL; it was now 4 mIU/mL - a massive improvement, to be sure, but not quite normal. His care team wasn’t sure what the next course of action should be. Should Brian go through three cycles of BEP again, or continue with surveillance?

They decided to do one more round of blood work. He had just started Testosterone Replacement Therapy (TRT) five weeks post-op, and they thought the hCG might be slightly elevated from low testosterone.

Everyone was relieved to see that his hCG dropped below 2 mIU/mL upon the recheck!

Brian is now in observation for the next three years, after one of the best doctor’s appointments he’s ever had.

The remission period was one of the darkest and lowest moments of Brian’s life - there was so much uncertainty and anxiety. But no matter how hard it gets, there is always a light at the end, and an amazing support system in the TCAF group.

Thank you for reading Brian’s story. If you related in any way, please drop a comment - he’d love to hear yours.

Brian can be reached through his Instagram pages @briangetsbackup or @bd_carlson