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Even though testicular cancer is not very common, it is a serious concern for young men. It is the most common cancer among men aged 20–34. But if testicular cancer is found and treated early, it is usually curable.
Whether you think you may have testicular cancer, or are a concerned friend, family member, or partner, you may have many questions. Here are the answers to some questions people commonly ask about testicular cancer.
The testicles are two ball-like glands inside the scrotum. They produce sperm and hormones. They are also called testes.
Testicular cancer develops if abnormal cells in one or both of the testes grow uncontrollably.
Early detection is very important. Treatment is very effective and there is a high cure rate. If untreated or detected late, it can spread to other parts of the body — and it may cause death.
About 8,000 men are diagnosed with testicular cancer each year in the U.S. About 400 men die from it every year. One out of every 100 cancers in men develops in the testes. The rate of testicular cancer has been increasing —experts have not been able to find reasons for the increase.
Young men are most at risk — most cases occur in men 15–39. It is the most common cancer among men 20–34. Only nine percent of men with testicular cancer are older than 50.
White men are at the greatest risk of getting testicular cancer. They are 5–10 times more likely to get it than African-American men. Asian-American, Latino, and Native American men also have higher rates than African-American men — but they have lower rates than white men.
Other factors increase the risk of developing testicular cancer:
It is recommended that you have your testicles examined by a health care provider during your periodic checkups. Ask your health care provider how often you should have checkups. Men with risk factors for testicular cancer may be advised to have more frequent exams.
The most common symptom is a lump or a swelling in a testicle. Lumps can be as small as a pea. Swellings can feel like irregular thickening on a testicle. Symptoms are often painless. Some may cause discomfort.
Other symptoms may include
A rare type of testicular cancer can cause a man's body to produce the female hormone estrogen. In addition to other signs of testicular cancer, this type may cause a loss of sex drive or tenderness, swelling, or lumps in the area around the nipples.
Less serious conditions may also cause any of these symptoms. But you should still report any symptoms to your health care provider as soon as possible.
Don't let fear prevent you from seeking care. Only a health care provider can diagnose or rule out cancer. And the sooner cancer is diagnosed and treated, the less likely it is to spread to other parts of your body.
Health care providers examine the testicles with their hands and use other tests to either diagnose or rule out cancer.
Surgery is the only way to find out for sure if there is cancer. But it is only performed after other tests show cancer may be present and a health care provider is confident that there is cancer. Usually, the entire testicle is removed and tested. (One testicle can make enough hormones to maintain a man’s masculinity, beard, voice, sex drive, etc.)
Rarely, only a biopsy — removal of a small piece of the testicle for testing — is performed. Biopsy is usually only done if a man only has one testicle. Otherwise, health care providers avoid biopsy because testicular cancer is more likely to spread during biopsy than some other cancers.
Surgery is the most likely treatment. Chemotherapy and/or radiation therapy are often used as follow-up to the surgery. Treatment is extremely effective — especially when the cancer is treated early. Your health care provider may run more tests to determine which treatments are right for you. Talk with your health care provider about your options, and be honest about your concerns. Make a list of questions you would like to ask at each appointment. You also may find it helpful to seek a second opinion from another specialist when deciding the best treatment for you.
Nearly all — 99 percent — of men with testicular cancer have it only in one testicle. After treatment, the remaining testicle produces all the needed hormones that affect masculinity, beard, voice, sex drive, etc. And removal of a testicle does not affect the ability to have an erection.
Some men may have a problem if they worry about their sexual performance based on their appearance. They may feel uncomfortable about the look or feel of their scrotum. They may choose to have an artificial testicle — a prosthesis — put in the scrotum. Discuss this option with your health care provider if you are worried about how you will appear and feel.
The one percent of men with cancer in both testicles may take testosterone to maintain their sex drives and masculine attributes.
Certain treatments may temporarily or permanently reduce fertility. If you would like to have children biologically after treatment, talk with your health care provider. You may choose a treatment that is less likely to affect your fertility long-term. Or you may store some sperm in a sperm bank before treatment to use in the future to impregnate your partner if you do have fertility problems after treatment.
Q&A with Dr. Cullins