Men's Health

Testicular Cancer: The Subtle Signs

By Christine Haran

Whether they're fitness fanatics or couch potatoes, men in their 20s and 30s tend to feel invulnerable when it comes to their health. That's why it can be easy for them to ignore the subtle signs of testicular cancer. While testicular cancer is considered a rare cancer, it is the most common cancer in men between the ages of 15 and 34.

Testicular cancer affects the testis, the male sex glands in the scrotum that produce testosterone and sperm, but it can spread to the liver, brain and other parts of the body. As demonstrated by the comeback of champion cyclist and testicular cancer survivor Lance Armstrong, treatment is often very successful. Below, Jerome P. Richie, MD, the Elliott Cutler Professor of Surgery at Harvard Medical School and the chairman of the Harvard Program in Urology, provides an overview of testicular cancer.

Who is at risk for testicular cancer?
Testicular cancer is a rare tumor with an incidence of about 1 in 35,000 men. The common age range for testicular cancer is 15 to 34. It tends to be more common in the Caucasian population than in African Americans or the Asian population. The only risk factor that we know about for testicular cancer is a history of undescended testicle that has to be brought down surgically.

It's uncommon for testicular cancer to run in families. There are some sporadic cases reported of both father and son developing testis tumors, or brothers, but it's very uncommon. Trauma probably does not play a role in causing testicular cancer, although an injury may call somebody's attention to an abnormality in the testis.

What are the signs and symptoms?
Generally, about 70 or 80 percent have with some painless swelling or firmness to the testicle that's either picked up by the patient or by their sexual partner. Because it's painless, many patients may think it is harmless and there can be a long delay before they actually seek attention by their physician.

How should people screen for testicular cancer?
Because testicular cancer is fairly uncommon, even in patients who had an undescended testicle, I think the best screening is just teaching the patients testicular self-examination. Parents should encourage their sons to do testicular self-examination, especially if they're at a higher risk. People can learn the technique from their primary care physician or their pediatrician.

Ultrasonography can be used to look at the testicle but the number of cancers that would found would be fairly low even in a high-risk population, so it would not be applicable as a widespread screening method.

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