Testicular cancer is the most common form of cancer in men age 15-35 and accounts for about one percent of all cancers occurring in men. It is most common in Caucasians, but can occur in men of any age or race. Luckily, it is also one of the most treatable forms of cancer, especially if caught early.
Know your risk factors
Undescended testicle(s), abnormal testicular development or a family history of testicular cancer can put men at higher risk of developing testicular cancer. However, many men have no risk factors at all. And there is no truth to the myth that activities such as biking or hiking are linked to the development of the disease.
Self exams are a must for all men
Monthly self exams are the key to finding abnormalities. In fact, most men or their partners are the ones to discover them–very few are found by a physician. Board certified radiation oncologist B. Oliapuram Jose, MD, explains, “We tell women to examine their breasts every month, and monthly testicular self exams are just as important for men. Unfortunately, 50 percent of men don’t perform self exams that can find problems in the early stages, when the cancer is confined to the testicles. The goal is catching cancer before it spreads to the lymph nodes and through the blood. Luckily, even treatments in the later stages of the disease are successful in the majority of cases.”
When performing a self-exam, men should check for abnormalities, including:
- A painless lump or hardening in the testicle
- Any enlargement of a testicle or lymph nodes
- A significant loss of size in one of the testicles
- A feeling of heaviness in the scrotum
- A dull ache in the lower abdomen, back or groin
- A sudden collection of fluid in the scrotum
- Pain or discomfort in a testicle or in the scrotum
- Enlargement or tenderness of the breasts
Dr. Jose continued, “If an irregularity is found, see your primary care physician or urologist right away. Treating it quickly and early is very important.”
When an abnormality is found, the urologist will surgically remove the affected testicle and send it to a pathologist for testing. There are two types of testicular cancer, seminoma and nonseminoma. Seminoma is the easier cancer to treat, and while nonseminoma is treatable, it can be much more aggressive. Board certified medical oncologist and hematologist Ajay Kandra, MD, explains, “We determine the stage of the disease with the help of tumor markers and CT scans. A tumor marker is a blood test that tells us the levels of certain proteins in the blood that correlate with tumor growth.”
Depending on the stage, treatment of seminoma may include close monitoring with periodic blood tests, x-rays and CT scans, radiation therapy to the lymph nodes in the abdomen and/or groin for two to three weeks or the use of three to four cycles of chemotherapy.
Treatment of nonseminoma is more aggressive and involves monitoring with blood tests and x-rays, and depending on the extent of the disease, the removal of the lymph nodes in the abdomen, along with chemotherapy and/or radiation.
Dr. Kandra added, “Our radiation and medical oncologists work closely together and meet weekly to discuss what types of treatment will be best suited to the patient. We keep the patient involved in the decision making process so they can make the best choices in their care. Cancer is an emotional diagnosis and we go to great lengths to lend our support and help them understand the treatment process.”
The potential for having children should be discussed prior to radiation or chemotherapy treatment. Having only one testicle usually doesn’t have a major impact on fertility, but some of the treatments can. Dr. Jose explains, “We do a sperm count prior to treatment to see if it is low. If so, counseling is recommended to go over options for banking sperm. We use a protective device to shield the unaffected testicle during treatment. Once treatment begins you cannot reverse the affects on fertility, so it is important to make an informed decision beforehand.”
“Many men are afraid to see a doctor if there is an abnormality, but they need to know that with testicular cancer, a low dose of chemotherapy and relatively short radiation therapy regimen can have an extremely high success rate. But the earlier it is treated, the easier the treatment will be on their body.” — Ajay Kandra, MD | Board Certified Medical Oncologist/Hematologist | Floyd Memorial Cancer Center of Indiana
“Athletes like Lance Armstrong, who was successfully treated for nonseminoma testicular cancer, are a great example of how effective treatments are, and how men are able to get back to the life they enjoy afterwards.” — B. Oliapuram Jose, MD | Board Certified Radiation Oncologist | Floyd Memorial Cancer Center of Indiana