Testicular Cancer: Most Common Cancer in Young Men

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Overview

Testicular cancer is a cancer that develops within the testicles (or gonads) of men.  It is the most common cancer in men aged 16 to 40.  In the U.S. about 8,000 men are diagnosed with testicular cancer each year. (Source: Cancer Facts and Figures 2007)

Symptoms of Testicular Cancer

Often, there are no symptoms.  In fact, a majority of testicular cancers are detected via a routine physical exam with your doctor.  Symptoms that may occur can include:

  • Discomfort or pain in the testicle

  • General enlargement of a testicle 

  • Lump or swelling in either testicle

  • Dull ache in groin or abdomen

Causes of Testicular Cancer

The precise cause of testicular cancer is unknown.  However, there are several known ‘risk factors’ that increase a man’s chances of developing testicular cancer.  These risk factors include:

  • An undescended testicle:  The testes form in the abdominal cavity during fetal development and usually descend into the scrotal sac before birth. Men who have a testicle that never descended are at greater risk of testicular cancer than are men whose testicles descended normally
  • Abnormal testicle development.Conditions that cause testicles to develop abnormally, such as Klinefelter’s syndrome, may increase your risk of testicular cancer.
  • Family history.If family members (such as father, brother) have had testicular cancer, you then have an increased risk of developing testicular cancer as well.
  • Age.Testicular cancer affects teens and younger men, particularly those between ages 16 and 40. However, it can be diagnosed at any age.
  • Race.Testicular cancer is more common in white men than in black or Latino men.

Diagnosis and Tests for Testicular Cancer

  • Physical examthe doctor will usually palpate a firm mass or lump on the testicle; he/she will then likely order the following test

  • Testicular Ultrasound: this will often differentiate between a benign versus cancerous lesion on the testicle

  • Blood tests: several blood tests can check for tumor markers

  • Chest xray: to check for spread of cancer to the lungs

  • If above tests are strongly suspicious for cancer, then the doctor will likely recommend complete removal of the testicle (orchiectomy), whereupon a biopsy test is done to confirm the cancer diagnosis

Treatment of Testicular Cancer

The specific treatment for a patient diagnosed with testicular cancer will vary, depending on its cell type, stage, and size.  To simplify, there are three mainstays of treatment:

  • Surgical treatmentremoves the testicle (orchiectomy) and nearby lymph nodes.
  •  Radiation therapyusing high-dose x-rays or other high-energy rays may be used after surgery to prevent the tumor from returning. 
  • Chemotherapyuses potent drugs such as cisplatin and bleomycin to kill the cancer cells. This treatment has tremendously improved the survival rate for cancer patients

(Source: Testicular Cancer Treatment, National Cancer Institute. 2009-01-15) 

Prognosis for Testicular Cancer Patients

Fortunately, testicular cancer is one of the most treatable cancers, and has a very high overall survival rate.  The survival rate for men with Early-Stage seminomas (most common type) is between 90 to 95%.

Prevention of Testicular Cancer

Although the U.S. Preventive Task Force does not recommend routine screening, this author does recommend Testicular Self Exam (TSE) monthly, as well as an annual physical exam (including testicular check) with your family doctor.  This is based on having personally diagnosed three testicular cancer cases in my career—all of whom came in because they felt a lump or mass on TSE.

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