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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