Testicular Cancer In a Nutshell

Two things happened recently: a local celebrity went public about his recent encounter with testicular cancer and a pamphlet, published by the Canadian Testicular Cancer Association (TCTCA), arrived in my mail box. I thought it was a good topic to discuss and put the subject in a nutshell (no pun intended).

Testicular cancer is rare but it is the most common cancer in young men between the ages of 15-35, says the TCTCA pamphlet. A young man has a one-in-300 chance of developing it sometime in his life. In the last 30 years, rates in Ontario have increased by 60 per cent. The incidence of this disease has been increasing in developed countries throughout the world for several decades. We should not forget that testicular cancer can occur in older men as well.

According to a document released by Alberta Cancer Board (Cancer in Alberta: A Regional Picture 2007) the incidence of cancer of male genital organs (testicles, scrotum and penis) in 2004, excluding prostate cancer, was 8.2 per 100,000 population. Total number of cases was 124 for all three male genital organs compared to prostate cancer the total number was 1986 (138.8 per 100,000 population). The document does not give a separate figure for testicular cancer. But these statistics give you an idea that the number of testicular cancer is not very high.

Who gets testicular cancer?

There are several risk factors. These are: delayed drop of the testicles into the scrotum at birth, a family history of testicular cancer, abnormal testicular development, some rare genetic condition or one testicle is significantly smaller than the other. But some men get the disease with none of these risk factors.

Early detection of cancer is important. And this can be done by self-examination after a hot shower when the scrotum is completely relaxed. Check for any swelling on the scrotum. Examination of the testicles should not be painful. You should feel the size and weight of each testicle. It is common for one testicle to be slightly bigger than the other and one may hang lower than the other. Examine yourself at least once a month.

What are the signs and symptoms of testicular cancer?

If you notice any change in size, shape or consistency of the testicle then you should talk to your doctor. Quite often (but not always) there is a painless hard lump. You should be concerned if there is any swelling or pain in the scrotum, if you notice any heaviness or dragging in the lower abdomen or scrotum or a dull ache in the lower abdomen and groin, unusual backache that doesn’t go away or you have unexplained weight loss. Any soreness or sudden unexplained enlargement of the breast should be checked out. It could be secondary to testicular cancer. TCTCA warns that some males get testicular cancer without any of these signs or symptoms.

First line of investigation for a suspected lump in the scrotum is an ultrasound. If cancer is suspected then additional blood tests are done to look for tumour markers. The tumour markers for testicular cancer are AFP (alpha-fetoprotein), beta-HCG (beta-human chorionic gonadotropin) and LDH (lactate dehydrogenase).

A definitive diagnosis of testicular cancer is made by removing the testicle and sending it for biopsy. Then the cancer is checked for any spread to lymph glands or other organs. Treatment may include surgery, radiation therapy or chemotherapy. The cure rate for testicular cancer is greater than 90 per cent for all stages. In men, whose cancer is diagnosed in an early stage, the cure rate is nearly 100 per cent. Even those with advanced disease have a cure rate of greater than 80 per cent.

For more information visit: www.tctca.org.

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