Testicular Cancer

Testicular cancer is a rare cancer and represents about 1% of all cancer affecting men. The cause of testicular cancer is unknown. It usually presents in men between 15-35 years of age. Over the past decades, public awareness of testicular cancer has grown as prominent athletes and celebrities became afflicted by this disease

Other additional risk factors include:

• Undescended testicle that remains intra-abdominal
• Family history
• Abnormal testicular development caused by genetic anomaly such as Klinefelter’s syndrome

Caucasians are greater risk of developing testicular cancer

• The most common sign of testicular cancer is the discovery of a lump within the testicle.
• Another common presentation is a rapid painless increase in the size of the testicle.
• On rare occasion, testicular cancer may also present as a painless shrinkage of the testicle as well.
• Cancer of the testicle often involves only one testicle on presentation.

A proper testicular self-examination should be performed during or after a bath or warm shower. The warmth from the water will relax the scrotum so that the testicles can be better palpated.

• Hold the penis out of the way and then visually inspect both testicles for symmetry
• Check each testicle by placing it between your thumb and fingers and gently press along the entire surface
• If a firm nodule or an irregular surface is detected, it’s important to see a urologist immediately for further testing

The two main types of primary testicular cancer are:

• Seminoma – Common in all age groups of men, but tend to occur in older men
• Nonseminoma – This tumor is more common in younger patients and there are several subtypes that can impact the prognosis. They include chroiocarcinoma, embryonal carcinoma, teratoma, yolk sac tumor and or any combinations the subtypes listed.

The workup for testicular cancer involves a detailed history and thorough physical examination. If an abnormality is detected then a scrotal ultrasound and laboratory studies to check tumor markers specific to testicular cancer is obtained.

If findings are suspicious for testicular cancer, the patient will undergo surgical removal of the testicle (orchiectomy).

After testicular cancer has been formally diagnosed, the patient will undergo staging. This usually includes a detail computerized tomography (CAT scan) of the chest, abdomen, and pelvis. There will also be serial checks of tumor markers as well.

Depending on the type and stage of testicular cancer, patients may require further intervention including radiation therapy and/or chemotherapy.

Patients will also need long-term follow-up with their urologist and possibly oncologists as well.

If testicular cancer is detected early then it is highly curable. Therefore, it’s important to contact a urologist immediately if you find anything unusual during a self-examination.