Testicular Cancer: Who’s at Most Risk and How to Detect It

By: Albert DeNittis, M.D., M.S.

There 145,000 young men who live in the Philadelphia region who are between the ages of 25 and 34. They should know an important fact: Testicular cancer is young man’s disease.

Although it is relatively uncommon, developing in just one of every 250 men, when testicular cancer does strike, it most often does so early. It is the leading cancer in males ages 15 to 44, with the average age of men diagnosed being 33.

Learn more about testicular cancer

Thankfully, testicular cancer survival rates are extremely high, thanks to treatment innovations and the nature of the cancer. Only one in 5,000 men die from the disease, making it 96% to 99% curable when caught early.

But to survive testicular cancer, you have to know it exists. April is a good time to learn the symptoms and how to detect the disease. It’s Testicular Cancer Awareness Month, which is dedicated to getting the word out about this often unthought of disease.

How Testicular Cancer Develops and Its 2 Types

Cancer results from the uncontrolled division and growth of abnormal cells, eventually developing into a harmful tumor. With testicular cancer, almost all such abnormal activity, more than 90%, occurs in the cells that make sperm, called germ cells.

This explains why testicular cancer most often develops in younger men, because the testes make more sperm when men are young, requiring more cell activity.

There are two types of germ cell cancer:

Seminoma – Occurring primarily in men ages 25 to 45, this is a slower-growing and therefore less aggressive type of cancer that is highly treatable when caught early. A blood test can diagnose the disease by gauging the level of a certain protein, called human chorionic gonadotropin (HCG), which seminomas tend to raise.

Non-seminoma – More likely to develop in males in their late teens to early 30s, this cancer subtype grows faster than seminoma. The tumor is typically formed from a mix of four different types of abnormal cells, most of which produce cancer-marking proteins that can be measured in a blood test.

Noteworthy Risk Factors of Testicular Cancer

Researchers are still trying to determine the cause of testicular cancer, but believe certain conditions and characteristics contribute to its likelihood. These include:

• An undescended testicle or testicles
• Klinefelter syndrome, a genetic condition that results in more than one X chromosome, reducing testosterone production
• Abnormal testicular development
• Family history of the disease
• An HIV infection, particularly if it has developed into AIDS

Testicular Cancer Symptoms: What to Watch For

Whether or not you carry any of the above risks, if you are a male between the ages 15 and 45, you should know the symptoms. When diagnosed at Stage 1 (confined to the teste), testicular cancer can be cured up to 99% of the time.

These symptoms include:

• A lump in the testicle
• A testicle that is swollen or has changed shape
• Testicular pain
• Lower back and abdominal pain (in cases where the cancer has spread)
• Symptoms of hormone changes, such as breast tenderness and loss of sex drive

Many men can recognize some of these symptoms by performing self-examinations.

How to Perform the Monthly, 5-Step Testicular Self-Exam

More than one-third of men say they have never self-examined their testicles, according to one study, and 20% do so just once a year.

If you are among them, you should begin doing your own monthly self-exams now. This exercise can easily be knocked out in a minute or two, ideally after taking a shower or bath when the scrotum is relaxed. Here’s how:

1. Using both hands, cup one testicle.
2. Roll the testicle between your thumbs and fingers, using light pressure.
3. Locate the soft tube-like cords above and behind the teste (the vas deferens and epididymis). These tubes collect and carry sperm and are a normal part of your anatomy.
4. Now look and feel for lumps as well as changes in size, shape, or texture. It’s normal for one testicle to be a bit larger than the other.
5. Repeat these steps on the other testicle.

As you perform this self-exam each month, be alert to any changes.

What to Expect If You Have Testicular Cancer

If you experience any of the above symptoms of testicular cancer or notice a change in your testes during a monthly self-exam, you should schedule a urology exam. Your urologist can diagnose the presence of the disease through a blood analysis and imaging tests via CT scan, MRI, or ultrasound.

In most cases, testicular tumors require surgical removal through a small incision in the groin. Post-surgery treatment might include chemotherapy and/or targeted radiation, depending on the cancer stage and subtype. In early-stage cases of testicular cancer, follow-up care might be limited to surveillance.

Medication can manage potential hormonal-related changes in sex drive and sexual function, should you experience these, although your remaining testicle should produce enough testosterone to maintain your sex drive. As for appearance, ask your surgeon about a testicle prosthesis.

Treatment rates are so encouraging in part due two testicular cancer characteristics: first, the tumor markers enable more precise monitoring; and second, the tumors are highly sensitive to chemotherapy.

Further, clinical trials continue to advance treatment innovation.

Don’t Take Healthy Testicles for Granted

Remember that pain is not a typical symptom of testicular cancer, which is why self-exams and awareness are crucial. Ask a young friend, or any of Philadelphia’s 145,000 men between ages 25 and 34, if he is aware of the risk of testicular cancer today.

You can schedule an appointment with a MidLantic Urology specialist near you.To review all the male urinary conditions we treat, visit our Men’s Health web page.