Testicular Cancer Targets Young Males

          Although testicular cancer is rare, it is the most common cancer occurring in young men between the ages of 15 and 34.  Because it targets a specific population in an anatomical location where it can be detected at an early stage, it can usually be treated successfully.  Nonetheless, the American Cancer Society estimates that approximately 380 men will die of testicular cancer in 2014.  Until recently, white males had the highest rate of testicular cancer in the United States, but data collected by the National Cancer Institute shows that the incidence of testicular cancer among Hispanic males rose by 58% from 1992 to 2010.

Signs and Symptoms of Testicular Cancer

          The scrotum is the musculocutaneous sac that contains the testes or testicles.  The scrotal sac is divided into two compartments, each containing a testis (testicle) with its attached epididymis and spermatic cord.  In most men, one of the testicles will hang lower than the other.  The testes are the male gonad, homologous to the ovaries in the female, and they have two main functions, to produce testosterone and to produce sperm.  Testicular cancer usually occurs in only one testis or testicle.  Signs and symptoms of testicular cancer include a lump or swelling in either testicle; sudden accumulation of fluid in a testicle; pain, discomfort or a feeling of heaviness in the testicle or scrotum; and sometimes enlargement of the breast tissue.

Risk Factors and Diagnosis

          Several factors may increase a man’s chance of developing testicular cancer.  These include an undescended testicle; congenital abnormalities of the testicles, penis or kidneys; history of previous testicular cancer; and having a father or brother with testicular cancer.  In addition to abnormal findings on physical examination, testicular cancer is diagnosed by blood tests looking for certain tumor markers; ultrasound of the scrotum to confirm the presence and size of a mass and to distinguish it from other pathology in the scrotum, including a collection of fluid and infection; and, finally, a biopsy of the testicle.  If the biopsy shows that cancer is present, then further tests are performed to determine if the cancer has spread.  These may include a chest x-ray and abdominal and pelvic CT scans.

Treatment and Prevention

          Once a diagnosis of testicular cancer has been made, further evaluation will determine the type and extent of the cancer.  Depending on these findings, treatment may include surgery, radiation and chemotherapy.  A regular physical examination by a health care provider should include examination of a man’s testicles.  Although there is some disagreement on whether testicular self-examination is effective, I recommend that my patients perform a monthly testicular self-examination after puberty.  

You Might Be Interested to Know

          Medical terms relating to the testes often begin with a prefix derived from the Greek word for testis, which is ‘orchis’, thus orchidectomy is removal of the testicle.  Interestingly, the orchid plant is so named because the shape of its root tubers resembles a testicle.