According to the American Cancer Society, one out of every 250 men will develop testicular cancer at some point in his life. It is a relatively uncommon disease that, unlike most cancers, tends to develop at a younger age. The average age of diagnosis is 33. The good news is there is a relatively high cure rate, especially when caught early.
In this video, San Diego Health host Susan Taylor talks about testicular cancer with Ramdev Konijeti, MD, a urologic oncologist and robotic surgeon with Scripps Clinic Torrey Pines and Scripps MD Anderson Cancer Center.
The primary risk factor is present at birth: Boys who are born with an undescended testicle have a higher risk of developing testicular cancer later in life.
“Even if an undescended testicle has been surgically corrected, the risk of developing growths on the testicle remains and men should continue to be closely monitored,” says Dr. Konijeti. “Men who have a family history of the disease also have an increased risk. Beyond that, we don't have a lot of good risk factors that we can target.”
Testicular cancer cases are most common among men in their early 20s and early 40s. Dr. Konijeti explains that the testes are more actively producing testosterone and sperm in men when they are younger, thus raising the risk for cancer. White men also may have a higher risk than other racial groups.
The first sign of testicular cancer is often a lump or bump on the testicle. The growth is usually painless but increases in size quickly over a few weeks. This often prompts a visit to the doctor.
“If a patient comes to us with an abnormal growth on their testicle, we'll order an ultrasound to evaluate it further,” says Dr. Konijeti. “If that indicates a concern for cancer, we then do some blood tests to look for tumor markers, which are signs of cancer.”
If testicular cancer spreads, it commonly affects the lymph nodes, lungs or liver. Other diagnostic exams may include an imaging test, such as a CT scan to examine the abdomen for enlarged lymph nodes, and a scan or X-ray of the chest to evaluate the lungs.
The most common treatment for testicular cancer is removal of the affected testicle. This is generally an outpatient procedure performed in the doctor’s office. Dr. Konijeti explains that the testicle is removed through an incision in the groin and sent to a pathologist to determine the need for further treatment. Most men recover from the surgery within a week and are told to avoid heavy lifting or straining for up to six weeks.
If the pathologist finds that additional treatment is needed due to concerns about the cancer spreading, chemotherapy is usually recommended.
As with most cancers, the earlier testicular cancer is detected, the better the outcome. Survival rates are high: Overall, more than 80 percent of men are cured.
In some cases, men who want to be able to have children are concerned about how testicular cancer treatment may affect their fertility. Dr. Konijeti says removal of one testicle should not affect fertility, but chemotherapy is a concern.
“You should be able to father children with a perfectly good testicle on the other side, but if you have to go through additional treatment such as chemotherapy, that can be toxic to your sperm,” he says. “We talk to people about banking their sperm ahead of time in the event that they want to have kids in the future.”
A testicular exam is part of an annual wellness exam, but if men notice a lump between exams, they should contact their physician. Periodic self-exams may be recommended, especially for men who have a higher risk due to an undescended testicle.
“It’s an easy thing to identify if you regularly check yourself and it’s a very curable disease,” says Dr. Konijeti. “So, there’s a lot of optimism, even if you’re someone who suffers from this.”