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Testicular Cancer: What Every Man Should Know

EphNotes

Testicular Cancer occurs most often in men between the ages of 20 and 35; in fact, it’s the most common cancer in this age group. Since most cases are first recognized by the patient himself, allowing early diagnosis and treatment that can cure this otherwise deadly disease, frequent self-examinations are recommended.

Who Gets Testicular Cancer?

While some studies suggest that a family history increases risk, and other researchers worry about environmental factors, the only well-established contributor to testicular cancer is cryptochicism, undescended testes. In about 3 percent of boys, one testicle fails to descend by the time of birth, as it should. If this is not repositioned surgically, usually between the boy’s first and second birthdays, testicular cancer is eleven times more likely to develop in this undescended testicle.

Diagnosis

A key feature of testicular cancer is a mass, or nodule, in the testicle. The lump is firm to the touch, but pressing on it does not produce any pain. Not all scrotal masses are cancerous: in fact, benign disorders are much more common. For example, in inguinal hernia can produce a soft swelling in the scrotum, but the testicle itself is normal. Doctors can often recognize benign problems by simple criteria.

If a doctor suspect cancer after examining a testicular mass, he will order a testicular ultrasound; it’s a simple test that is very good at identifying cancer. If the ultrasound suggests cancer, the patient should have blood tests for tumor markers, proteins produced by the cancer cells.

If clinical findings and ultrasound results suggest cancer, a biopsy is mandatory. In nearly all cases, it involves the surgical removal of the abnormal testicle through an incision in the lower abdomen rather than the scrotum. Although the operation, called a radical inguinal orchiectomy, is surgically straightforward, it’s psychologically threatening to many men. It is reassuring, however, to know that sexual function remains intact because the healthy testicle is not disturbed by the operation.

Treatment

Just 30 years ago, 90 percent of men with testicular cancer died from the disease; today more than 90 percent are cured. Most patients with mild, Stage 1 cancer, receive x-ray therapy to lymph nodes in the pelvis and abdomen. Patients with more advanced cases receive chemotherapy.

Do It Yourself?

Philosophers proclaim that all men should examine their lives; the American Cancer Society suggests that young men should examine their testicles. Men should establish a regular time for the exam; the first day of each month may be convenient. The exam is easiest after a warm shower or bath, when the muscles in the scrotum are relaxed. The procedure is easy to master: simply roll your testicle gently between your thumb and your first two fingers (see illustration). Examine one testicle at a time, using both hands. Normal testicles are smooth and slightly spongy; you are checking for a firm, pea-sized lump, an increase in size, or an abnormally firm texture. learn to recognize the normal ropelike tubular epididymis at the rear of each testicle so you won’t confuse it with an abnormal mass. Tell your doctor if you notice an abnormal mass, unusual firmness, or unexpected tenderness of the testicle.

Because early diagnosis simplifies treatment and facilitates care, all men should understand the disease, and young men should examine themselves monthly to detect the disease in its earliest stages, when it is easiest to cure.

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