You are more likely to develop cancer the older you get. But for reasons scientists still don’t understand, testicular cancer is most likely to affect men in their 20s and 30s. Although relatively rare, testicular cancer often progresses quickly. This fast growth rate makes early detection and prompt treatment crucial.

“While testicular cancer can spread rapidly, it’s also one of the most treatable forms of cancer when caught early,” says Dr. Louis Plzak III at Beaufort Memorial Urology Specialists. “The 5-year survival rate for all stages of testicular cancer is 95%.”

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The Facts About Testicular Cancer

Testicular cancer is a type of cancer that is caused by abnormal cells in the testicles. Most often this cancer starts in the germ cells, which are the cells that produce sperm. There are two types and several subtypes of germ cell cancers: seminomas and non-seminomas. Non-seminomas are more likely to spread quickly and become aggressive.

Around 1 in 250 men develop testicular cancer. Around 8% will be older than 55, and around 6% will be children or teens, but most cases affect men between 20 to 34.

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Signs and Symptoms of Testicular Cancer

Recognizing the signs and symptoms of testicular cancer is essential for early detection. The most common signs and symptoms of testicular cancer include:

• A painless lump or swelling in one testicle
• Changes in the size or shape of your testicles
• Dull ache or pain in your groin or lower abdomen
• Feeling like your scrotum is heavier than usual
• Fluid buildup in your scrotum
• Pain or discomfort in your testicle or scrotum
• Tenderness in your chest tissue

“If you notice a lump or swelling that has not disappeared after two weeks, call your primary care provider,” Dr. Plzak says. “Any unusual changes should be evaluated by a healthcare professional promptly.”

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Risk Factors for Testicular Cancer

While the exact cause of testicular cancer is unknown, certain factors may increase a person’s risk:

• Age: Testicular cancer is most common in men between 15 and 35 years old.
• Family history: Having a close relative with testicular cancer increases your risk.
• Germ cell neoplasia in situ (GCNIS): Also known as carcinoma in situ, GCNIS is a precancerous condition sometimes detected during fertility testing. GCNIS can develop into testicular cancer but does not always do so.
• History of testicular cancer: Men who have had cancer in one testicle have an increased risk of developing cancer in the other testicle.
• HIV infection: Having HIV may slightly increase your risk for testicular cancer.
• Race: Testicular cancer is more common in white men than in men of other races.
• Undescended testicle: Men born with an undescended testicle, a condition called cryptorchidism, have a higher risk. Only around 3% of male babies experience this condition.

 If you have GCNIS, you will need regular monitoring.

You may not know if you had cryptorchidism, as most cases resolve by the time babies turn one. You may want to ask your parents about whether you had any unusual issues at birth. It’s also always a good idea to discuss your family history of all cancers and let your primary care provider know what you find.

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How to Screen for Testicular Cancer at Home

Regular self-exams are crucial for early detection of testicular cancer. A monthly self-exam may help identify any changes or abnormalities early on, potentially leading to earlier diagnosis and treatment. The Testicular Cancer Society recommends that you:

• Check for swelling on the scrotum in front of a mirror if possible.
• Roll each testicle between your fingers, looking for unusual lumps or changes in appearance.

“It is normal for each testicle to be slightly different in size, and they may feel slightly lumpy due to blood vessels and tissues inside them,” Dr. Plzak says. “The more you practice your self-exam, the more likely it is that you will notice if an abnormal mass appears.”

Diagnosing Testicular Cancer

If your doctor thinks you could have testicular cancer is suspected, you will need a series of tests, including:

• Blood tests: A blood test may show certain tumor markers that indicate testicular cancer.
• Physical exam: Your doctor will examine the testicles and surrounding areas for lumps or swelling.
• Ultrasound: This imaging, which uses sound waves to create a picture of your tissues, can help determine if a lump is solid or filled with fluid.

If cancer is suspected, your provider may perform a procedure called orchiectomy, which surgically removes the entire affected testicle to examine and biopsy it. Unlike other types of tumors, your doctor cannot take a small tissue biopsy from your testicle without increasing the risk of cancer cells spreading elsewhere.

If cancer is confirmed, you will need additional imaging such as CT scanning and X-rays to see if your cancer has spread to other parts of the body. Some people may need lymph node biopsies or removal.

Treatments for Testicular Cancer

Treatment for testicular cancer depends on the type and stage of the cancer, but all types of treatment are often highly effective. Depending on the type of cancer you have and whether it has spread, you may need:

• Chemotherapy: Powerful drugs are used to kill cancer cells throughout the body.
• Radiation therapy: High-energy rays are used to destroy cancer cells.
• Surgery: Removal of the affected testicle is typically the first step in treatment. Some men may need additional surgery to remove affected lymph nodes.
• Surveillance: For some early-stage cancers, close monitoring may be recommended after surgery.

In some cases, a combination of these treatments may be used.

Treatment for testicular cancer can affect your fertility. If you have not had children or plan on having additional children, you may want to consider sperm banking. This simple procedure involves freezing and storing sperm before you start cancer treatment. Your healthcare team will discuss your fertility preservation options and explain other risks of treatment before you begin radiation or chemotherapy.

If you’re experiencing unusual symptoms, find a primary care provider at Beaufort Memorial who can help.