Testicular Cancer

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Cancer of the testicles is rare, accounting for approximately 1 percent of all cancers in men, according to the American Cancer Society. However, it is the most common form of cancer among males age 15 to 35. With early diagnosis and treatment, testicular cancer is usually curable.
RISK FACTORS
The cause of testicular cancer is unknown. Certain risk factors, however, may increase your chance of developing the disease. Testicles normally move from the abdomen into the scrotum before birth. A testicle that remains in the abdomen -- an undescended testicle or cryptorchidism -- may become cancerous. Parents should make sure that their infant boys are checked at birth for undescended testicles. Notably, the increased risk of testicular cancer remains even after surgery to move an undescended testicle into the scrotum. Other birth defects of the urogenital system, including penis malformations, kidney malformations and a congenital inguinal hernia, may also increase your risk of developing testicular cancer. If a close relative has had testicular cancer, your risk may be increased. White males have a significantly higher risk of developing testicular cancer than black males.
EARLY DETECTION
Testicular self exam, or TSE, is one way to detect testicular cancer early in the course of the disease. TSE involves checking your testicles for unusual lumps, which may be the first sign of testicular cancer. Check each testicle separately for lumps by rolling it between your fingers and thumbs. Identify the epididymis; this is a normal rope-like structure on the top and back of each testicle. The epididymis is not an abnormal lump. During your regular medical exams, your doctor will check your testicles for abnormalities. Not all lumps in the testicles are cancerous, so don't panic if you find a lump. Call your doctor right away and schedule an appointment to have the lump evaluated.
SYMPTOMS
In the early stages, testicular cancer often causes no symptoms. The most obvious symptom of early testicular cancer is a painless lump in the testicle. Because it's painless, many men mistakenly think it is harmless and delay seeking medical treatment. In some cases, a discrete lump is not felt, but the testicle is enlarged or excessively firm. You may experience a feeling of heaviness in the scrotum or groin. Some men report dull pain in the lower back, abdomen or groin. Although uncommon, some men experience moderate testicular pain. The sudden accumulation of fluid in your scrotum may signal the presence of testicular cancer.
DIAGNOSIS
The first step in the diagnosis of testicular cancer is a physical examination. Blood tests may be used to look for tumor markers, substances that may indicate the presence of testicular cancer. Your doctor may order an ultrasound test of the scrotum and testicles to help rule out noncancerous abnormalities. If there is a suspicious mass, the testicle is generally removed and the diagnosis is confirmed by examining the tissue under the microscope.
TREATMENT AND PROGNOSIS
Testicular cancers are divided into two types, seminomas and nonseminomas. The treatment for testicular cancer depends on the type of tumor and whether the disease has spread to other organs. Treatment begins with removal of the affected testicle. Radiation therapy, chemotherapy or both may be used after surgery.

Testicular cancer is one of the most curable forms of cancer for men with early-stage disease. Men with cancer that has not spread outside of the testicle have a cure rate of 99 percent, according to the American Cancer Society. With spread to the lymph nodes, the cure rate remains high at approximately 96 percent.
FERTILITY AND SEXUAL FUNCTION
Fertility can be adversely affected by testicular cancer treatment. Men who want to father children may consider preserving semen in a sperm bank prior to cancer treatment. Surgery for testicular cancer may affect normal ejaculation. However, nerve-sparing surgery reduces the likelihood of this complication. Testicular cancer surgery usually does not interfere with a man's ability to get an erection. If both testicles are removed, supplemental testosterone may be needed to support normal sexual function.

Testicular Cancer

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