What men should know about testicular cancer

It is estimated there are 8,000 new cases of testicular cancer each year.

Testicular cancer is more common among white males than blacks, Asian, Hispanic or Native American males.

Overall, about one in 280 American men will develop testicular cancer at some time in their lives. It can occur in men at any age and is most common cancer in men between 20 and 35.

The stage of the disease at the time of diagnosis and treatment is an important predictor of the cure rate. If testicular cancer is treated before it has spread to the lymph nodes, the cure rate is greater than 96 percent.

Risk factors

• Anything that increases the chance of getting a disease is called a risk factor. Risk factors for testicular cancer include:
• Having had an undescended testicle
• Having had abnormal development of the testicles
• Having a personal or family history of testicular cancer

Early detection

Most testicular cancers are found by the men themselves, either by accident or by self-examination. Some are found on routine physical exams by a doctor. However, no studies have been done to determine the effectiveness of testicular self examination (TSE) in reducing the death rate from testicular cancer. The benefit of TSE is not known.

Screening would be unlikely to decrease the death rate very much, since therapy is so effective, even for advanced stages of the disease. Early detection may have a practical impact on therapy, however. Testicular cancer in more advanced stages requires more courses of chemotherapy and more extensive surgery. This results in more complications. Patients with early testicular cancer require less treatment thus having fewer complications. For this reason, instructions on how to do TSE are included.

How to do TSE

Testicular self-examination is best performed once a month, during or soon after a warm shower or bath when the scrotal skin is most relaxed.

While standing, each testicle should be gently examined with the fingers of both hands. Place the index and middle fingers on the underside of the testicle and thumb on the top. Gently roll the testicle between the thumb and fingers, feeling for lumps, swelling, or other changes. The process is repeated with the other testicle.

The normal testicle feels smooth, egg-shaped, and rather firm.

Warning signs

Testicular cancer can have many symptoms or there may be no symptoms at all.

Most testicular cancers are found by men themselves. Also, doctors generally examine the testicles during routine physical exams. Between regular checkups, if a man notices anything unusual about his testicles, he should talk with his doctor. Men should see a doctor if they notice any of the following symptoms:

• A painless lump or swelling in a testicle
• Pain or discomfort in a testicle or in the scrotum
• Any enlargement of a testicle or change in the way it feels
• A feeling of heaviness in the scrotum
• A dull ache in the lower abdomen, back, or groin
• A sudden collection of fluid in the scrotum

These symptoms can be caused by cancer or by other conditions. It is important to see a doctor to determine the cause of any of these symptoms.

Treatment

The current treatment of testicular tumors depends on the type and stage of the disease. The preferred treatment is usually an “orchiectomy” or surgical removal of the affected testicle. In some cases, it may be used together with radiation or chemotherapy or bone marrow transplant. Be sure and ask your doctor about possible clinical trials.

Removal of one testicle does not cause impotence. Chemotherapy or radiation therapy, treatment for this cancer, can cause infertility. Talk to your doctor about sperm banking. This would allow for the possibility of biological children in the future.

Follow-up

Treatment follow-up is a very important part of testicular cancer therapy, since most relapses occur the first year. Follow-up will include blood tests, chest x-rays and possibly CT scans.

Why men delay going to the doctor

Men often delay seeking medical attention because of the mildness of typical early symptoms. They may believe because the lump is painless that it is also harmless. They may feel that it will go away by itself. They may have concerns about loss of sexuality, or becoming sterile. They may fear the treatment, cancer, or death. Most often, early medical attention will lead to the assurance that cancer is not present. And when cancer is found early it usually leads to a higher cure rate.

Source: UI Cancer Information Services