April Awareness: For the Men

Boris Gershman, M.D.

Did you know testicular cancer is the most common cancer in men between the ages of 20 and 34? Last year, it affected nearly 9,000 men.

April is Testicular Cancer Awareness Month. Although testicular cancer is relatively rare compared to other urologic cancers, it generally occurs in otherwise young, healthy men. It can have a substantial impact on both the patient and his family.  Over the years, there has been increasing awareness of testicular cancer in part due to high-profile patients and improved advocacy efforts.

Testicular cancer most commonly arises from germ cells (the cells that make sperm within the testicle).  Risk factors for developing testicular cancer include a history of undescended testicles at birth, abnormal development of the testicles, or having a personal or family history of testicular cancer.

The Signs

Testicular cancer is usually associated with a painless lump, mass, or swelling in the testicle.  In some cases, it can cause discomfort in the affected testicle or groin.  It is uncommon to have systemic symptoms unless the cancer has become very advanced. 

Evaluation includes a physical examination, an ultrasound, and blood work to look for compounds that can be produced by the cancer, called tumor markers.  Additional testing typically includes a CT scan of the abdomen and X-ray of the chest.

The Good News

Testicular cancer has become a very treatable cancer, and survival rates have improved tremendously over the last 40 years.  Currently, the overall five-year survival for men diagnosed with testicular cancer is approximately 98 percent, although it is lower for men with cancer that has spread beyond the testicle. 

Treatment

The first step in treatment is surgical removal of the testicle.  This serves to establish the diagnosis of testicular cancer, and provides important information regarding the type and extent of cancer.  Depending on the stage of the disease, additional treatment may include close surveillance, chemotherapy, radiation or surgery. 

Testicular Self-Examination

Testicular self-examination is one way to detect abnormalities. It is important to note that self-examination has not been proven to reduce the chance of dying from testicular cancer, and there is disagreement on whether men should be recommended to perform it. Although it is quick and easy to perform a self-examination, the main risk is that it may lead to unnecessary follow-up testing.

Testicular self-examination is easiest to perform during a shower when the scrotal skin is relaxed.  To perform a self-examination, hold each testicle between the thumb and fingers. Roll the testicle between the fingers, feeling for any lumps, bumps, or irregularities in the consistency, shape, or size of the testicles.  If you feel an abnormality, you should be evaluated by your doctor.

Early diagnosis is always important with cancer. Talk to your doctor about anything you think may be abnormal for you.

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