INTRODUCTION: Testicular cancer is a disease that occurs when cancerous (malignant) cells develop in the tissues of a testicle and is the most common cancer in men aged 20 to 35. It is most common among Caucasians and rare among men of African and Asian descent.
In the U.S., between 7,500 and 8,000 diagnoses are made annually. Over his lifetime, a man’s odds of developing the disease is roughly 1 in 250 (four tenths of one percent). Although it is found most commonly among men 15-40 years of age, it has three peaks: infancy, ages 25-40 years, and age 60.
Since it is curable (stage I can have a success rate of 95%) when detected early, experts recommend regular monthly testicular self examinations after a hot shower or bath, when the scrotum is looser. Blood tests are used by your physician to identify and measure tumor markers that are specific to testicular cancer.
CAUSE: Currently, there is no recognized method for preventing this disease because there is no known cause for it.
TYPE: Although testicular cancer can develop from any cell type found in the testicles, more than 95% of testicular cancers are germ cell tumors. The main forms of testicular germ cell tumors are seminomas and non-seminomas.
SYMPTOMS: Often include one or more of the following: A lump in one testes or a hardening of one of the testicles. Normally the testicle should feel smooth to the touch. Symptoms of late-stage testicular cancer may include: Dull pain in the lower back and abdomen, A sense of heaviness in the scrotum, A sudden collection of fluid in the scrotum, Pain or discomfort in a testicle or the scrotum, Enlargement or tenderness of the breasts, Unexplained fatigue or a general feeling of malaise. However each individual may experience symptoms differently. The National Cancer Institute suggests that a man see a doctor if any of the above symptoms lasts two weeks or longer.
RISKS: Risk factors for having testicular cancer include Klinefelter’s syndrome. This is a disorder in which a man has an extra X chromosome. This type of cancer is more common among white men than men of african descent. Hispanic, Asian, and American Indian males have a risk that is higher than black males but lower than white.
There are a number of factors that increase the risk for the disease. A major risk factor is cryptorchidism (undescended testicles). Surgery earlier in life reduces risk of testicular cancer among males with undescended testes.
According to an article recently published in the New England Journal of Medicine, surgery before the age of 13 for the treatment of undescended testes lowers the risk of cancer of the testes compared with surgery later on in life.
Other risk factors include inguinal hernia and mumps. Physical activity is associated with reduced risk and sedentary lifestyle is associated with increased risk. Also early onset of male characteristics is associated with an elevated risk.
Firefighters face increased risk of many cancers. According to the results of a study published in the Journal of Occupational and Environmental Medicine, firefighters have an increased risk of developing certain types of cancer. Others with occupational risks include Miners, gas workers, leather workers, food and beverage processing workers, utility workers.
Other genetic syndromes are also associated with higher risk. As mention previously white men are more likely to develop this cancer than are men of other races. Nevertheless many men with testicular cancer do not have the suggested risk factors.
TREATMENT: Treatment options are based on the results of staging. Correct diagnosis is needed to ensure the most effective and least harmful treatment. An error in diagnosis is made at the initial examination in up to 25% of person’s with testicular tumors and may result in delay in treatment or a less than optimal approach (scrotal incision) for exploration.
The 3 basic types of treatment are surgery, radiation therapy, and chemotherapy. As an adjuvant treatment, use of chemotherapy as an alternative to radiation therapy is growing, because radiation therapy appears to have more significant long-term side effects, for example, internal scarring, elevated risks of secondary malignancies etc.
Chemotherapy is the accepted treatment for non-seminoma when the disease has spread to other areas of the body (that is, stage II or III). An alternative, equally effective treatment involves the use of four cycles of Etoposide-Cisplatin (EP).
While treatment success depends on the stage, the average survival rate after five years is around 95%, and stage I cancers cases (if monitored properly) have essentially a 100% survival rate (which is why prompt action, when testicular cancer is a possibility is extremely important). Understanding treatment options, accessing new and innovative therapies through clinical trials, as well as understanding the role of supportive care and complementary and alternative medicine are essential.
CONCLUSION: Testicular cancer is cancer that develops in the testicles, a part of the male reproductive system. The exact cause is not known. Common symptoms include: A swelling and/or lump in one or both of the testes. It is important to understand that these symptoms may occur as a result of conditions unrelated to the disease.
Possible risk factors include the following: Age – Most testicular cancers occur in men between the ages of 15 and 40. It has one of the highest cure rates of all cancers, in excess of 90% and essentially 100% if it has not metastasized (spread).
It is diagnosed with the help of tests that examine the testicles and the blood. Specific treatment will be determined by your physician based on: your age, overall health, and medical history, extent of the disease, your tolerance for specific medications, procedures or therapies as well as personal preferences.