Why testicular cancer self-examinations matter

Testicular cancers are the most common tumors of men in the age range of 20-35 years. Then there is another peak of testicular cancer in men who are age 60 and older.

Testicular cancer is not extremely common. There are only about 5-6 cases per 100,000 men per year in the US. That’s about 10,000 cases diagnosed per year. What is alarming, is that these numbers have steadily increased over the past few decades and are still increasing. Between about 1990 and 2000, the incidence of testicular cancer increased by 100%.

The incidence varies by ethnicity, as well. White males have the highest incidence of testicular cancers at about 6.3/100,000 men. Then, in decreasing order, American Indians > Hispanics > Asians > African Americans. Interestingly, in Europe there are differences in neighboring countries (Finland 2.5 cases/100,000. Denmark almost 10 cases/100,000), and in different areas in the same country (in France, the rate varies from 2.8 cases to 7.9 cases/100,000 depending on the region.)

There's an excellent video, below, that walks you through how to do a self-exam for testicular cancer.

There’s an excellent video, below, that walks you through how to do a self-exam for testicular cancer.

It seems that there are higher rates of testicular cancer in the more industrialized areas of North America and Europe. There are also some genes that are involved. Testicular cancer occurs more commonly in closely related male relatives of men with testicular cancer. Brothers and sons of affected men have a significantly elevated risk. Men with a history of previous testicular cancer, who had an undescended testicle, infertility, patients with genetic diseases (like Down’s syndrome) are at increased risk. There may be increased risk to men exposed to diethylstilbestrol (DES) while in utero, and men exposed to Agent Orange.

Fortunately, these types of tumors are treatable and often curable. The cure rate depends on several factors: the type of tumor (e.g., seminoma, non-seminoma), stage at diagnosis, metastasis (whether or not the tumor has spread) and a few other factors. However, in spite of the relatively good prognosis for many patients with testicular tumors, some men still die from them each year.

Often cancer of the testicle(s) presents with a painless lump in one or both testicles. Or the testicle may be swollen. Some men complain of a dull, achy feeling in the testicle, a feeling of ‘fullness” in the scrotum, pelvis or abdomen. There may be fluid in the scrotum. Sometimes there may be breast enlargement, depending on the tumor type and if it is secreting a hormone that can stimulate breast growth. If the cancer has spread, there may be symptoms referable to the site of the metastasis (cough, neck mass, gastrointestinal symptoms and others.)

You may be asking why it’s important to be aware of testicular cancer. After all, the incidence is relatively low, and it often can be cured, so it doesn’t seem like a major risk to you. It probably isn’t. But it could be.

As mentioned previously, the incidence of testicular cancer is rising. A 100% increase in testicular cancer in a little over 10 years is alarming. The reasons for that are not completely understood. Some men still die from it. Since it is more common in the younger age group, those men who die, die young. Additionally, for advanced (metastatic) disease, the treatments are more radical. Them may include: orchiectomy (removal of the testicle), chemotherapy, adjuvant chemotherapy, radiation therapy, stem cell transplant, possible additional surgery to resect metastatic tumor that has migrated elsewhere. Those are all good reasons for checking for testicular cancer, and catching it as soon as possible.

Doing a testicular self-exam is one way to check for testicular cancer and catch it early. A testicular self-exam is painless, quick and easy to do. It can easily be done monthly in under two minutes. Here’s a description of how to do it.

And here’s an overview of testicular cancer from the Mayo Clinic.

Here’s a video that may also be helpful for those doing the self-examination, which you all should do.


Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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  • 4th Turning

    Either way, the prospect of a happy ending…

  • 4th Turning

    Nothin’ much about not getting things done in accord with some elementary logic and compassion is making a whole of sense these days.
    The worst has been those states which have probably in too many cases
    caused the unnecessary deaths of 1,000′s by sanctimoniously rejecting
    federal medicaid coverage for the written off 47%-all Obama voters(?).

  • oikos

    in the testicle itself

  • hamiseady

    Is it not also one more purpose younger people in the this age team need to reconsider
    if they have made the decision to perform the possibilities and take a successfully transfer medical proper care insurance?
    Seems like sufficient protection might motivate getting all issues examined out
    earlier than in the “old days” of time missing to complacency, individual failings
    procrastination, etc.?

    Incinerador de Grasa

  • Lawerence Collins

    I clicked the link. Read the info. Lumps on the skin or under the skin?

  • Stev84

    It’s one of the better cancers to have. If it’s detected early, the survival rate is well above 90%

  • Drew2u

    Funny how crowd-funding, fund-raising, and spaghetti dinners are acceptable ways to look for help affording health care costs but universal health care is derided..

  • bkmn

    Crowd funding bone marrow transplants is no easy task.

  • AnthonyLook

    Good article, important information.

  • docsterx

    It seems like the older we get, the more prone we are to almost every disease, syndrome, condition, need for rehabilitation, etc. This may sum it up:

    Deteriorata

    Go placidly amid the noise and waste,
    And remember what comfort there may be in owning a piece thereof.
    Avoid quiet and passive persons unless you are in need of sleep.
    Rotate your tires.
    Speak glowingly of those greater than yourself,
    And heed well their advice, even though they be turkeys.
    Know what to kiss and when.
    Consider that two wrongs never make a right,
    But that three lefts do.
    Wherever possible put people on “HOLD”.
    Be comforted that in the face of all aridity and disillusionment,
    And despite the changing fortunes of time,
    There is always a big future in computer maintenance.
    Remember the Pueblo.
    Strive at all times to bend, fold, spindle and mutilate.
    Know yourself. If you need help, call the FBI.
    Exercise caution in your daily affairs,
    Especially with those persons closest to you;
    That lemon on your left for instance.
    Be assured that a walk through the ocean of most souls,
    Would scarcely get your feet wet.
    Fall not in love therefore; it will stick to your face.
    Carefully surrender the things of youth: birds, clean air, tuna, Taiwan,
    And let not the sands of time get in your lunch.
    For a good time, call 606-4311.
    Take heart amid the deepening gloom that your dog
    Is finally getting enough cheese;
    And reflect that whatever fortunes may be your lot,
    It could only be worse in Sioux City.
    You are a fluke of the Universe.
    You have no right to be here, and whether you can hear it or not,
    The Universe is laughing behind your back.
    Therefore make peace with your God whatever you conceive him to be,
    Hairy Thunderer or Cosmic Muffin.
    With all its hopes, dreams, promises, and urban renewal,
    The world continues to deteriorate.
    Give up.
    –From the National Lampoon Radio Dinner Album

  • docsterx

    Good point. There are other forms of cancer that are more common in this age group and they affect both men and women. Accidents (from sports, car crashes and others), suicide attempts and other things can also happen in this age range. The costs can be devastating for people who aren’t insured. I’m seeing campaigns at least weekly on social media sites about someone who had an accident or developed an illness and is uninsured and looking for help.

  • Elijah Shalis

    Doctors should employee hot guys and girls that carry out the testing lol

  • 4th Turning

    Is it not also one more reason young folks in the this age group need to reconsider
    if they have decided to play the odds and take a pass on health care insurance?
    Seems like adequate coverage might encourage getting all concerns checked out
    earlier than in the “old days” of valuable time lost to complacency, human failings
    procrastination, etc.?

  • emjayay

    Good job Victor.

  • Indigo

    Oh! That’s how you do that. Okay . . . I can do that, thanks!

  • oikos

    I am a TC survivor (19 years now). Caught it early and it saved my life. So important to do the self exam.

  • bkmn

    Another great article, thanks Doc! I used to work with a guy that had testicular cancer – luckily it was caught fairly early and with removal of the affected testicle, some chemo and radiation he is alive today.

    I was not aware of the increase in testicular cancer above age 60. My partner and I will start checking each other regularly!

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