Testicular Cancer: Self-Exams at Home
Who Gets Testicular Cancer?
Testicular cancer usually affects men from age 20 to 39. Testicular cancer is uncommon: about 8,250 cases were diagnosed in 2006, with about 370 deaths. This represents only 1 percent of all cancer diagnoses. However, testicular cancer is the most common cancer in men between the ages of 15 and 34.
Risk Factors for Testicular Cancer
Certain risk factors increase the chances of developing testicular cancer:
Although common sense suggests routine testicular cancer self-exams should catch it earlier, this has not been definitively established.
"There is no evidence that self-exams detect testicular cancer at an earlier stage," says Durado Brooks, MD, director of colon and prostate cancer prevention programs for the American Cancer Society. Large clinical trials on this issue have simply not been done.
Self-exams also carry risks, Brooks adds, including "increased anxiety, and the risk of undergoing unnecessary medical procedures." For these reasons, the American Cancer Society does not recommend self-exams for testicular cancer detection, says Brooks.
The U.S. Preventive Services Task Force also does not recommend testicular cancer self-exams. At the same time, "we don't state that men should not do self-exams," says Brooks.
Some experts consider testicular cancer self-exams beneficial. "Self-exam is, I think, an important aspect of early detection," according to Joel Sheinfeld, MD, deputy chief of the urology service at Memorial Sloan-Kettering Cancer Center in New York City.
Most important, experts say, is to recognize and respond to possible symptoms of testicular cancer. "Men are usually aware there's something wrong," says Lance Pagliaro, MD, a medical oncologist with M.D. Anderson Cancer Center in Houston, Texas. "The problem comes in how the man reacts to it."
Recognizing the Symptoms of Testicular Cancer
Most testicular cancers are discovered by the men who have them. The most common symptom of testicular cancer is a painless mass (lump) in one testicle. Other symptoms to look for:
Testicular Cancer: Delay Can Be Dangerous
Many men delay seeking a doctor's evaluation after first noticing the symptoms of testicular cancer.
"There's often a significant lag time, sometimes a very long time, between the first symptoms and when men come in," says Brooks.
"And that's sad," says Pagliaro, because "their chance of cure is not as good as it could be."
In one study, most men with a delayed diagnosis of testicular cancer gave one of several reasons for the delay:
Testicular Cancer: How to Perform a Testicular Self-Exam
Perform the exam after taking a warm shower, so the scrotal skin is more relaxed.
If you do feel something abnormal on a testicular cancer self-exam, don't wait--let your doctor know!
Testicular Cancer: Diagnosis
Simple tests at a physician's office can quickly and accurately determine if testicular cancer is likely.
Doctors frequently perform this test for any abnormal symptoms in the testicle. Ultrasound allows a view inside the scrotum and testicles. Testicular cancer usually looks different (more solid) than other causes of testicular swelling.
Blood Tests: AFP, hCG, LDH
Most testicular cancers release chemicals at abnormal levels into the bloodstream. These tumor markers include:
A biopsy is the only way to reach a definitive testicular cancer diagnosis. In a biopsy, a surgeon removes tissue and a pathologist examines it under a microscope. This usually requires removal of the entire testicle (orchiectomy). Orchiectomy is done because taking only a small tissue sample could spread testicular cancer elsewhere.
Treatment for Testicular Cancer
Treatment for testicular cancer varies widely, depending on the exact type of cancer and the extent of spread.
Orchiectomy, done for diagnosis, removes most or all testicular cancer. What comes next depends on the stage (spread) of cancer. The stage is determined by further tests, and possibly additional surgery.
Treatment can include:
Survival Odds for Testicular Cancer
Sheinfeld provides the best news of all for testicular cancer patients. "Fortunately, this is a highly curable disease, even in advanced stages, assuming timely and appropriate treatment," he says. Keep in mind these facts:
Lance Armstrong's Story
When world-class cyclist Lance Armstrong announced he had testicular cancer in 1996, doctors found it had already spread to his lungs and brain. After rigorous treatment including brain surgery and chemotherapy, Armstrong returned to cycling and won seven Tour de France titles.
Armstrong is the poster guy for surviving testicular cancer. But Armstrong himself points out that he's also an example of what not to do.
Lance told an interviewer he believed he might have had testicular discomfort as early as three years before his diagnosis. At the press conference announcing his diagnosis of testicular cancer, Armstrong had this to say:
"Had I been more aware of the symptoms, I believe I would have seen a doctor before my condition had advanced to this stage."
Listen to Lance. Know the symptoms of testicular cancer. Perform regular testicular cancer self-exams, if you choose. And if you notice anything abnormal, see your doctor right away.
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