Testicular cancer (TC) is the most prevalent type of cancer in men between the ages of 15 and 35. Additionally, the American Cancer Society (ACS) predicts about 9,310 new cases of TC will be diagnosed in the United States this year. ACS also estimates roughly 400 TC-related deaths will occur in the United States in 2018.
Although thousands of men are diagnosed with TC annually, there are still many instances in which the disease is not addressed. But for men who understand TC, its risk factors, and other aspects of this type of cancer, they can take the necessary steps to diagnose and treat the disease before it’s too late.
What Is Testicular Cancer?
TC affects the testicles, which produce male sex hormones and sperm used for reproduction. In most instances, there is no clear-cut cause behind TC. The problem occurs when healthy cells in the testicle are altered and start growing and dividing rapidly, to the point where no new cells are needed. This causes accumulating cells to form a mass in the testicle.
There are two types of TC:
- Seminoma: Refers to a tumor that occurs in all age groups but is most common in older men.
- Nonseminoma: Refers to a tumor that commonly develops early in a man’s life and spreads rapidly. Nonseminoma tumors are classified into several different types, and these include choriocarcinoma, embryonal carcinoma, teratoma, and yolk sac tumors. They also tend to be more aggressive than seminoma tumors.
Virtually all types of TC begin in germ cells, i.e. cells in the testicles that result in immature sperm. But what causes these cells to develop into TC is still unknown.
Am I at Risk of Testicular Cancer?
There are many risk factors associated with TC, and these include:
- Undescended Testicle: Men who have a testicle that never descended are at greater risk of TC than men whose testicles have descended normally.
- Abnormal Testicle: Klinefelter syndrome and other conditions sometimes cause the testicles to develop abnormally as well as increase an individual’s risk of TC.
- Family History: An individual with a father, brother, or another blood relative who experienced TC may be more susceptible to the disease than others.
- Age: TC can occur at any age, but it is most common in men between the ages of 15 and 35.
- Race: Research shows TC is more common in white men than in black men.
Men need to consider the aforementioned risk factors closely. Otherwise, they risk developing TC without even realizing it.
What Will I Experience If I’m Dealing with Testicular Cancer?
TC generally affects only one testicle, and there are many signs and symptoms associated with the disease. These include:
- Enlarged scrotum
- Mass in the testicle
- Groin pain and/or pain in the testicles
- Reduced energy
- Back pain
- Breast enlargement or tenderness
If you experience one or more of these signs or symptoms, you should visit a doctor right away. Remember, the longer you wait to receive a TC diagnosis, the more problematic the cancer may become. If you consult with a doctor as soon as you notice any TC signs or symptoms, you can receive proper diagnosis and treatment.
Can I Prevent Testicular Cancer?
Unfortunately, there is no way to prevent TC, but a self-examination allows a person to identify TC in its earliest stage.
The Testicular Cancer Society (TCS) recommends a monthly testicular self-examination to identify any changes in the testicles. This self-check includes the following steps:
- Check the scrotum. Examine the scrotum and look for any swelling on the skin. This should be done in front of a mirror, if possible. Also, it may be best to check after a warm shower or bath, as the scrotum likely will be relaxed at this point.
- Examine each testicle. Use both hands to examine each testicle. First, place the index and middle fingers under the testicle and place the thumbs on top of it. Next, firmly but gently move the testicle between the thumb and fingers; this allows you to feel for any irregularities on the testicle’s surface or texture.
- Evaluate the back of the testicle. Locate and examine the epididymis; this is a soft, rope-like structure on the back of the testicle. During your evaluation, check for anything that does not look or feel right.
A monthly TC self-check doesn’t take long to complete. If you notice any testicular irregularities during a self-examination, contact your doctor. There is no guarantee that a testicular irregularity is cancerous, but it is always better to err on the side of caution. If you meet with a doctor, you can find out whether a testicular irregularity is cancerous or not and determine the best way to treat it.
How Is Testicular Cancer Diagnosed?
Men sometimes discover TC during a self-check. In other instances, a doctor may find a lump on a man’s testicle during a physical examination. A doctor may also recommend one or more of the following tests to provide an accurate TC diagnosis:
- Ultrasound: An ultrasound involves the use of sound waves to visualize the scrotum and testicles. During an ultrasound, you’ll be required to lie on your back and keep your legs spread apart. Then, a doctor applies a clear gel to the scrotum, and he or she moves a small, handheld probe over the scrotum to produce an ultrasound image. A doctor may use an ultrasound to determine if a testicular lump is present. If a testicular lump is discovered, an ultrasound can be used to determine whether the lump is solid or fluid-filled and if it is located inside or outside the testicle.
- Blood Tests: Blood tests enable a doctor to assess the levels of tumor markers in the blood; these markers are substances that occur naturally in the blood but may be elevated due to TC or other factors. If you have a high level of a tumor marker in the blood, it does not necessarily mean that you have TC. It may, however, help a doctor provide a correct TC diagnosis.
- Radical Orchiectomy: A radical orchiectomy is an outpatient procedure designed to help a doctor provide a definitive TC diagnosis. During a radical orchiectomy, a doctor will make a small incision in the groin. This enables a doctor to analyze and remove the testicle suspected of harboring cancer cells. If cancer cells are indeed discovered, the doctor will perform additional analysis to determine the exact cell type or types and optimal treatment option.
If you receive a TC diagnosis, a physician will likely order additional tests to determine the stage of the disease. These tests help a doctor find out whether cancer cells have spread to other areas of the body.
While a TC diagnosis is serious, it doesn’t always mean it is a hopeless situation. Many cancer treatments are available, and you and your doctor can work together to overcome TC.
How Is Testicular Cancer Treated?
There is no shortage of TC treatments, and common treatment options include:
- Surgery: During surgery, a doctor removes a patient’s cancerous testicle. After surgery is completed, the healthy testicle will produce more testosterone and sperm to make up for what was lost. Most men can still have an erection following surgery, and surgery has no effect on a man’s ability to procreate or his sexual performance. However, if certain nerves are damaged during surgery for testicular cancer or removal of the lymph nodes, a patient may experience dry orgasm. In this instance, orgasm may not be as strong or as pleasurable as it was prior to surgery.
- Chemotherapy: Chemotherapy is used to treat many different types of cancer. It involves the use of a medication or series of medications to slow down or stop the growth of cancer cells. Chemotherapy is a type of systemic therapy, and it may impact different areas of the body. This means men may experience infertility or feel little to no desire to have sex after chemotherapy treatments. Moreover, the higher the dose of chemotherapy, the greater the risk of infertility. In some cases, a doctor may recommend a patient store sperm prior to undergoing chemotherapy treatments as preventative measures, too.
- Radiotherapy: Radiotherapy involves the use of high-energy rays to destroy cancer cells in the lymph nodes in the back of the abdomen. It may be used in addition to or as an alternative to chemotherapy, and in most instances, does not affect a man’s ability to engage in sexual intercourse or cause infertility.
Meeting with a doctor is essential before you pursue any of the aforementioned TC treatment options. By doing so, a doctor can learn about you, provide an accurate TC diagnosis, and offer a personalized plan to provide long-term TC treatment.
The Bottom Line on Testicular Cancer
Receiving a TC diagnosis can be difficult, and sometimes, it helps to have a plan in place before you visit a doctor. This plan can help you prepare for the best- and worst-case scenarios.
If you receive a TC diagnosis, it is important to remember that you’re not alone. To date, many men have been diagnosed with TC and received safe, effective treatments to address their cancer symptoms. You also may want to try any of the following to cope with TC during your treatment and recovery:
- Learn as much as you can. TC is complicated, and it may be helpful to write down questions about TC to ask your doctor. Knowledge is power, and if you learn about all aspects of TC, you can make informed decisions about how you and your doctor treat this disease.
- Make healthy choices. A healthy diet that includes plenty of fruits and vegetables can make a world of difference for those who are about to begin a TC treatment program. You should also try to exercise regularly, avoid smoking, and do whatever you can to alleviate stress. With a healthy lifestyle, you’ll be better equipped than ever before to overcome TC.
- Get in touch with other TC survivors. Let’s face it – TC is scary, and it may be tough to share your cancer experiences with family members, friends, and other loved ones. Fortunately, many TC survivor groups are available in cities and towns nationwide. The ACS can provide full details about the local TC support groups in your city or town. And once you meet with a support group, you can share your cancer experiences with fellow TC survivors.
- Keep loved ones up to date. Your loved ones are there for you in good times and bad, and they want to help you in any way possible. Therefore, you should not hesitate to ask loved ones for assistance and keep them informed as you undergo treatment for cancer.
Lastly, if you believe you are dealing with TC, don’t wait to get help. Schedule a doctor’s appointment immediately, and you can take the first step to receive TC diagnosis and treatment.
About Dr. Kia Michel
Dr. Kia Michel is a nationally acclaimed urologist and a founding member of the Comprehensive Urology Medical Group in Los Angeles. He was a Presidential Scholar for four years at Whitman College and graduated with Honors from the University of Washington School of Medicine. Dr. Michel completed his residency at UCLA, where he was recognized as a national Pfizer Scholar. Today, Dr. Michel uses traditional, laparoscopic, minimally invasive, and robotic surgical techniques to help patients address urological conditions.
“Companies like Tommy John are not only trying to spread awareness about testicular cancer, but they’re also encouraging men to be more on top of and talk more openly about their health. During the month of April, they’re partnering with the Testicular Cancer Foundation and are donating a percentage of sales of their special edition underwear line to further fund research and care.”