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Testicular cancer is rare when compared to prostate or lung cancer. But it is also one of the faster growing cancers that can develop in men. Dr. Adeep Thumar, a urologist who specializes in urinary and genital cancers at SMG, answers common questions about this disease that strikes men in the prime of their life.
I’m a young, healthy guy in my 20s. Why do I need to know about testicular cancer?
Unlike prostate or colorectal cancer, testicular cancer is a disease that primarily affects young men. The American Cancer Society estimates that there will be about 9,560 new cases of testicular cancer diagnosed in 2019. It is the most common cancer in men ages 20 to 40, and the second most common cancer in men ages 15 to 19. Caucasian men are more likely to be affected than African American men.
What makes someone more susceptible to developing testicular cancer? Is there anything I can do to prevent it?
Most of the patients I see do not have any identifiable risk factors. However, men who had undescended testicles at birth, have a family history of testicular cancer, or have been diagnosed with HIV/AIDS are more likely to develop the disease.
There is nothing you can change about your lifestyle or behavior that will lower your risk.
How would I know if I had testicular cancer?
The most common symptom is a painless lump or enlargement in one of the testicles. These tumors tend to grow very rapidly—in only a couple of weeks one testis can be twice the size of the other. Some men feel slight pain or heaviness.
Women are advised to perform self-breast exams. Should men do the same?
There is not an official consensus regarding screening for testicular cancer, however I advise my patients to check their testicles once a month. This is best done in the shower because the warm water relaxes the scrotum. Examine each testis separately. Place your index and middle finger under the testis and your thumb on top. Roll the testis between your fingers and feel for any abnormalities—lumps, swelling, or discomfort. If something feels different, do not wait—make an appointment with your primary care physician or urologist that same week. Your doctor will examine the testis and may perform a scrotal ultrasound.
In the early stages of testicular cancer, the lumps may be too small to notice on a self-exam.
I felt a lump, but I am afraid and embarrassed to get it looked at.
This is a very common concern particularly in young men. Our physicians understand that it can be hard to talk about genital or urological problems. We also know that men often fear the worst and there is a lot of anxiety that comes with having cancer particularly at such a young age.
Remember not all lumps are cancerous and men that do have cancer and receive treatment typically make a full recovery. In fact, the five-year survival rate is more than 98 percent in stage 1 testicular cancer, 95 percent in stage 2, and between 71 and 94 percent in stage 3 (when the disease spreads to the lymph nodes).1 If you wait to seek medical attention, you increase the likelihood that the cancer will spread, and you will need more radical treatment.
Are there any other signs of testicular cancer?
Most men in the early stages of disease do not have other symptoms. Since testicular tumors tend to grow fast, the cancer spreads in around 10 to 30 percent of patients. In these more advanced cases, patients may experience weight loss, growth or tenderness in the breast tissue, and abdominal or back pain.
If I have testicular cancer will you need to remove one of my testicles?
Typically, yes. The most common presentation is a single tumor in one of the testicles. In these cases, we generally remove the affected testis to control the cancer. If the cancer is more advanced, we may also have to perform additional surgeries, administer chemotherapy or radiation therapy. When a patient only has one testicle or tumors on both sides we may be able to perform a testis-sparing surgery where we just remove the tumor itself.
I was recently diagnosed with testicular cancer and was told my testicle needs to be removed. Will this affect my ability to have children?
This is an important conversation I have with my patients. Typically, after surgery, the single testicle is enough to return to baseline fertility levels. However, before any surgical intervention, I always offer and recommend sperm banking. About half of my patients have some type of sperm disorder when they are diagnosed with testicular cancer.
Will having one testicle affect my sex life?
When surgery is performed to remove one testicle it should not affect your sex life. However, when the patient needs to undergo chemotherapy, radiation, or secondary lymph node surgery it may affect ejaculatory function.
What makes SMG’s Cancer Center the best place for cancer treatment?
With our integrated health system, patients have access to everything they need from the lab to pathology and radiology all in one place. A few months ago, I diagnosed a young man with an advanced form of testicular cancer. The next day he had an appointment with the medical oncologist. Our multidisciplinary approach across a wide range of specialties helps ensure there is no interruption in care.