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Testicular CancerTesticular cancer is not common -- a man’s risk of getting it is 1 in 300; the risk of dying from testicular cancer is 1 in 5,000. Even if you have risk factors for testicular cancer, the chance of developing it does not rise significantly. About 90 percent of testicular cancers affect men between the ages of 20 and 54. This cancer is very treatable and usually curable. Early detection increases the likelihood of a good outcome. Keys to early detection of testicular cancer include having your doctor check out any unusual symptoms (such as lumps, swelling, or a sensation of heaviness or aching in the lower abdomen or scrotum); having your testicles examined by your doctor as examined as part of routine checkups; and can even include performing self-exams on a regular basis. Many conditions can cause symptoms similar to those caused by testicular cancer. If you’re experiencing any symptoms, talk to your doctor, who will likely schedule you for an ultrasound examination – a painless, non-invasive test that uses sound waves to create images of the tissue within your testes.
Several non-cancerous conditions may also cause symptoms in the testicles or scrotum (see the list below). If you notice anything unusual, it’s best to see your doctor.
Torsion (twisting) of the testicle: If one of the testicles becomes twisted within the scrotum, it cuts off the blood supply to the testicle, epididymis, and other structures. This happens most often in teenage boys, but can occur later in life. It often causes sudden intense scrotal pain, along with swelling and redness. It is very important to treat testicular torsion promptly. If not corrected surgically – within about six hours – it can lead to the loss of the testicle.
Injury: Physical injury can cause immediate pain to the area, or may cause gradually developing pain and swelling later on as the scrotum fills with blood (known as a hematocele). Testicular injury is not thought to cause cancer.
Infection: Infections in the scrotal area are usually caused by bacteria or viruses, many of which can be transmitted sexually. Gradually developing pain and swelling on one side of the scrotum are common, and the pain may spread to the side or back. Pain when urinating is also common. Fever and a milky discharge from the penis are other possible symptoms.
Inflammation: Inflammation of the testicle(s) causes painful swelling. The most common cause is mumps (a viral infection).
Hydrocele/varicocele: Sometimes, a testicle becomes enlarged because fluid has collected around it. This is called a hydrocele, and is usually painless unless it grows to certain size. Sometimes the pain can spread to the lower abdomen or back. Hydroceles have many causes, including infections, tumors, and anatomic abnormalities. In a separate condition, the veins within the scrotum can dilate and cause enlargement and lumpiness around the testicle. This is called a varicocele or varicose vein, and has been described as feeling like a "bag of worms." It is usually painless, but may be associated with a feeling of heaviness in the scrotum. These conditions may or may not require treatment, depending on their severity.
Epididymal cyst/spermatocele: This is a fluid-filled sac containing sperm cells within the fluid. It is usually a small, painless mass in the scrotum that is not connected to the testicle.
Inguinal hernia: Hernias occur when a separation in the abdominal wall allows structures in the abdomen (such as portions of intestines) to enter the scrotum. People with an inguinal hernia may notice a slight lump or bulge in the groin or scrotum, which is usually more obvious when they stand. It is sometimes painful, especially when straining (such as during lifting or during urination or a bowel movement). The pain can become intense, and is sometimes accompanied by nausea and vomiting, especially if part of the intestine becomes trapped in the groin. This strangulation can cut off the blood supply to the intestine. If this happens, it must be surgically corrected right away to prevent serious complications.
Kidney stone(s): Kidney stones are small crystals that form in the kidneys and can become lodged in the tubes leading to the bladder. Pain is usually felt in the back or side, and may extend down to the scrotum. The pain can be intense, and is often accompanied by nausea and vomiting. Blood is often in the urine, although it may not be visible to the naked eye. Large stones may need to be removed using surgery or other procedures. These are the more common causes of testicular symptoms, but they are not the only ones. Because it is hard to determine the cause based on symptoms alone, it is important to have any testicular or scrotal abnormality looked at by a health care professional.
A risk factor is anything that can increase your chance of developing a condition or disease. However, most men with testicular cancer do not have any of the known risk factors, which include:
Cryptorchidism: The main risk factor for testicular cancer is a condition called cryptorchidism, or undescended testicle(s). Before a baby boy is born, his testicles develop inside his abdomen and descend into the scrotum. But for about three percent of boys, the testicles stay in the abdomen or get stuck in the groin area. About 10 percent of testicular cancers affect men with a history of undescended testicle(s).
Family history: A family history of testicular cancer can increase your risk. For instance if your brother or father has had testicular cancer, you are at greater risk of developing it.
Cancer of the other testicle: If you’ve been treated for testicular cancer in one testicle, your have a three to four percent higher risk of developing cancer in the other testicle later.
Carcinoma in situ: Carcinoma in situ (CIS) in the testicles is a non-invasive overgrowth of cells that almost always progresses to cancer. This condition does not produce a mass or cause any symptoms. In some cases, CIS is found in men who have a testicular biopsy while they are being evaluated for infertility or men who have an undescended testicle removed.
Age: Most testicular cancers occur between the ages of 15 and 40. But this cancer can affect males of any age, including infants and elderly men.
Race and ethnicity: The risk for Caucasian men is about five times that of black men and more than three times that of Asian Americans and American Indians. The risk for Hispanics/Latinos falls between that of Asian and white men.
Multiple atypical nevi: If you have many pigmented spots or moles on your back, chest, abdomen, and face, you may be at increased risk of testicular cancer.
HIV infection: Some research has shown that men infected with the human immunodeficiency virus (HIV), particularly those with AIDS, have an increased risk. No other infections have been shown to increase testicular cancer risk.
Body size: A recent study from Sweden found that body size was a risk factor; the highest risk was seen in tall, slim men.
The American Cancer Society (ACS) recommends a testicular exam by your doctor as part of a routine cancer-related checkup, and recommends self-exams for men with risk factors. However, some doctors encourage all men who have reached puberty to perform monthly self-exams to increase the likelihood of early detection. The best time to perform a self-exam is during or after a bath or shower, when the skin of the scrotum is relaxed. To perform a testicular self exam:
You should be aware that each normal testis has an epididymis, which appears as a small "bump" on the upper or middle outer side of the testis. Normal testicles also contain blood vessels, supporting tissues, and tubes that conduct sperm. Other non-cancerous conditions, such as hydroceles and varicose veins, can sometimes cause enlargement or lumpiness around a testicle. Some men may confuse these with cancer. If you have any doubts, ask your doctor. You can find more information about TSE in our Health Library » |
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