Testicular Cancer

Testicular cancer is rarely in the news, but it’s a health topic that all men, especially younger men, need to be aware of. Like many cancers, the sooner testicular cancer is detected, the easier it is to treat, and the cure rate for this form of cancer is extremely high — greater than 95 percent.

The American Cancer Society estimates that nearly 10,000 males will be diagnosed with testicular cancer in the United States this year. About 1 in 260 American men will develop testicular cancer in their lifetimes. While it can occur at any age, including during childhood, it is the most common cancer in men between ages 20 and 35. White males are more likely to develop this form of cancer than black or Asian-American males.

A closer look
The testicles are two walnut-shaped glands inside the scrotum (the sac of skin that lies below the penis) that produce sperm and the hormone testosterone.

Cancer occurs when healthy germ cells in a testicle develop abnormalities that continue dividing and accumulate until they form a mass. Little is known about what causes this to occur. Although cancerous cells can develop in both testicles, it is rare.

Symptoms & Risk Factors
Most often, a lump or swelling on the testicle is the first symptom; however, some testicular cancers might not cause symptoms until they’ve reached an advanced stage. Other signs to look for include:
• Swelling or a sudden build-up of fluid in the scrotum
• Feeling of heaviness in the scrotum
• Dull ache, pain or discomfort in the groin, lower abdomen, scrotum or a testicle
• A change in testicle size

Scientists aren’t sure what causes testicular cancer and have found few risk factors that make someone more likely to develop it.

However, the American Cancer Society advises that one of the main risk factors is an undescended testicle. This condition occurs when one or both testicles fail to move from the abdomen into the scrotum before birth. In about three percent of boys, the testicles do not descend all the way into the scrotum before birth; sometimes, one or both testicles remain in the abdomen. Other times, the testicles start to descend, but stay in the groin. If the testicle hasn’t descended by the child’s first birthday, it probably isn’t going to do it on its own, and surgery may be recommended to move it. Physicians have concluded that there is likely another factor that leads to both testicular cancer and abnormal position of the testicles, but the condition alone doesn’t actually cause testicular cancer.

A prior germ cell tumor in one or both testicles, an HIV infection or a family history may also increase the chances of developing testicular cancer.

Diagnosis & Treatment
Testicular cancer is usually diagnosed after a lump or other change in a testicle is detected. An ultrasound will more clearly show whether cancer is evident. (Biopsies, which remove small amounts of tissue using a needle or medical tool, are not performed on testicles because the procedure could penetrate the testicle, making it more difficult to treat a cancer, if found.)

Surgery to remove the testicle, called orchiectomy, is the most common and successful initial treatment. Some patients may need additional treatment with chemotherapy or radiation to kill any remaining cancer cells, or if tumors have spread to other areas of the body.

Detection the Best Prevention
Because there is no way to prevent testicular cancer, early detection is important.

Examination of the testicles is often performed during annual physicals and routine wellness checks. Many doctors agree that regular self-checks after puberty are a good idea to help individuals become familiar with their own anatomy, so they will be better able to recognize any changes. Talk with your health care provider for guidance. Instructions for performing a self-examination of testicles can be found on the American Cancer Society website at www.cancercare.org.

Notify your doctor if you notice any changes, such as lumps, nodules or an increase or decrease in testicle size, or if you experience any persistent pain in your groin or abdomen.

Doctors report that many men delay reporting concerns with their genitalia due to fears about potential impacts on sexuality or fertility, which are largely unfounded. Health professionals emphasize that swift evaluation and diagnosis greatly increase the chances of successful treatment and the opportunity to continue living life to its fullest.

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