The Testicular Cancer Society recognizes April as Testicular Cancer Awareness Month. According to the American Cancer Society, approximately 9,310 new cases of testicular cancer will be diagnosed and approximately 400 men will die of the disease in the U.S. this year. While testicular cancer is relatively rare, accounting for just 1% of male cancers and occurring in about 1 in 250 males, the incidence of this type of cancer has been increasing over the past several decades. So far, cancer researchers have not identified causes of this increase.
What is testicular cancer?
Testicular cancer is a form of cancer that primarily affects young and middle-aged men, most commonly diagnosed in white men between the ages of 15 and 35. However, it can affect males of any race or age, including infants and the elderly. It occurs when germ cells (a type of reproductive cell) becomes cancerous, causing them to multiply and form a tumor that invades surrounding tissue. These tumors can grow rapidly, doubling in size within 10–30 days. Like other types of cancer, testicular cancer can metastasize, or spread to other parts of the body such as the abdomen, liver, lungs, bones, or brain via blood or lymph vessels, forming additional tumors.
How do I know if I have testicular cancer?
Not every case of testicular cancer shows symptoms in the early stages. Sometimes, the cancer is found when imaging tests are performed to investigate the cause of other conditions, such as infertility. However, the following symptoms could indicate the presence of testicular cancer:
- A lump on the testicle
- Testicular swelling
- Heaviness or aching in the scrotum or lower abdomen
- Breast growth or soreness (rare and associated with specific types of tumors)
- Signs of puberty at an abnormally young age (specific types of tumors)
Even cancer that has spread may not produce symptoms; however, these may be signs of metastasized testicular cancer:
- Low back or belly pain can indicate spread to lymph nodes or liver.
- Coughing or shortness of breath can suggest spread to the lungs.
- Headache or confusion can result from spread of cancer to the brain.
Note that conditions other than cancer, such as injuries or other illnesses, can cause swelling, pain, or a lump in the testicles.
If you notice symptoms that may indicate cancer, see your doctor promptly for evaluation. Testicular cancer is highly treatable with an overall relative 5-year survival rate of 95%. When caught at its earliest stages (as happens with 68% of patients), that rate reaches 99%. Patients whose cancer has spread locally see a 96% relative 5-year survival rate, and the rate for those diagnosed with distant metastases (11% of patients) is 73%. As you can see, getting testicular cancer diagnosed and treated as early as possible gives patients excellent odds of beating it.
Often, the first test done to check for testicular cancer is an ultrasound. This is a painless test that does not use ionizing radiation. Ultrasound can help doctors determine whether an area of concern is a solid mass that could be cancer. Blood tests can also help indicate the presence or extent of certain types of tumors.
If an ultrasound and/or blood tests indicate that cancer may be present, surgery is often performed to remove the tumor, the entire testicle, and the spermatic cord in order to minimize the chances of spreading the cancer. The tumor is then analyzed by a pathologist, who determines whether and cancer is present and if so, its type and extent. Sometimes, when the nature of a problem is less certain, the testicle may be examined during surgery to determine whether cancer is present before removal.
If cancer is found, then imaging tests will be performed to determine whether and where it has spread in the body. “Staging” (determining the degree and extent of cancer) is commonly done using a CT scan with a contrast solution, which can be administered either orally or intravenously. CT scanning can also be used to guide biopsy of areas where cancer appears to have spread. When the doctor suspects the cancer has spread to the brain or spinal cord, MRI is often used to assess these areas; when spread to the bone is suspected, then a bone scan (using X-rays) may be performed.
The American Cancer Society (ACS) advises that a testicular exam should be part of a man’s routine cancer-related checkup. Some doctors recommend that men also perform monthly self-exams; however, due to a lack of studies showing an impact on the death rate from testicular cancer associated with such exams, the ACS does not currently make a recommendation regarding testicular self-examination.
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