Brian's Song (1971) and Germ Cell Cancer

The film tells the true story of Chicago Bears running backs Gale Sayers and Brian Piccolo, who in 1967 became the NFL's first Black and white roommates. It starts as a competitive rivalry, with Piccolo the undrafted grinder and Sayers the prodigy, and turns into a friendship as Piccolo drags Sayers through rehabilitation after a knee injury, only to find himself pushed back down the depth chart once Sayers recovers. In 1969 Piccolo starts coughing, losing weight and struggling to breathe; during one game he takes himself off the field, something he has never done. Tests find a tumour in his chest, and he has surgery that includes removal of part of a lung. He returns to hospital repeatedly through the winter and spring. Sayers, accepting an award for courage, dedicates it to Piccolo and asks the room to pray for him. Piccolo dies in June 1970 at twenty-six. The closing narration insists he be remembered for how he lived.

Spoilers throughout. Discussing the cancer storyline means discussing how this ends.

The broad facts hold up. Piccolo's illness did announce itself as breathlessness and weight loss during a season, he did have surgery including removal of a lung, the disease did return and spread, and he died in June 1970 at twenty-six. The film captures something real about how serious illness lands in a workplace: teammates who do not know what to say, a coach who quietly keeps him on the payroll, the awkward hospital visits. Sayers's award speech happened. Without commenting on it, the film also depicts how fast an extremely fit young man can go from full function to dying, which is genuinely characteristic of aggressive germ cell tumours in the era before effective chemotherapy. Its refusal to turn the interracial friendship into a lecture has aged better than most 1971 television.

The film sanitises the illness badly. Piccolo keeps a full head of curly hair and a wry composure throughout, while accounts from those close to him describe constant facial pain, feeling mutilated by repeated surgery, deep frustration, and a dying process one biographer's sources called torture. The cancer is never named, so a viewer learns nothing about germ cell tumours or about the painless testicular lump that is usually the first sign. There is also no sense of the treatment reality of 1969 and 1970, a punishing sequence of radical surgery and cobalt radiotherapy that could not control the disease, nor that this same cancer became one of the most curable within a few years.

Brian Piccolo had embryonal cell carcinoma, a type of germ cell cancer. Germ cell tumours usually start in a testicle, and his had grown into a large mass in the chest cavity behind the breastbone before it was found. The first sign of testicular cancer is typically a painless lump, swelling, or a change in the firmness or size of one testicle; some men notice a dull ache or heaviness in the scrotum or lower abdomen. Because the lump does not hurt, men often wait. Where the tumour has already spread to the chest, as Piccolo's had, the presenting symptoms can be breathlessness, cough or chest pain, easily mistaken for a training injury or a chest infection. The USPSTF recommends against screening for testicular cancer in adolescent or adult men, a grade D recommendation. It found no evidence that routine clinician examination or taught self-examination catches the disease earlier than men noticing it themselves, and the disease is uncommon while being highly curable at any stage, with the USPSTF noting that over 90 percent of newly diagnosed cases are cured. The practical message is therefore not screening but speed: any new testicular lump, swelling or persistent ache should be seen by a doctor promptly.

A film is not a diagnosis, and a dramatised illness is not a guide to your own. What a story like this is genuinely good for is lowering the barrier to a conversation you might otherwise put off.

If something in your body has changed and stayed changed for a few weeks, that is worth raising with a doctor — not because it is likely to be cancer, but because most of the time it will not be, and finding that out is the point. Where screening exists for a cancer, it is the one thing you can do before anything is wrong at all. See screening and possible warning signs.

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Brian's Song is worth watching as a film. It is not a guide to the disease it portrays. The gap between the two is what this page is for — and the thing worth carrying away is that a change which persists is worth a conversation, whatever a story led you to expect.

This page describes a work of film or television for education. It is not medical advice, and nothing here is a judgement of anyone's real medical care. Spotted an error? Please email [email protected].