Testicular Cancer, a “Young Man’s Disease”

The good news is that testicular cancer is one of the most curable cancers. The bad news? Research has not verified why this cancer targets young men.

Vincent Ortolano, M.D., F.A.C.S., is a board-certified urologist with over 30 years’ experience in treating patients with urological issues, including testicular cancer. “Various cancers attack patients at various times of their life, but the majority of cancers of the testicle occur in younger men less than forty. There is also a spike in men around age sixty, but that is relatively uncommon,” he shares.

Although testicular cancer can affect males of any age, about half of testicular cancers occur in men between the ages of twenty and thirty-four.

So what is testicular cancer and what should men be looking out for?

Testicular cancer can develop in one or both testicles, two egg-shaped glands (located in the scrotum) that produce testosterone (a male hormone) and sperm. “In its simplest terms, it is a growth in the testicle that is abnormal,” explains Dr. Ortolano. The symptoms of testicular cancer include a lump on the testicle, swelling or enlargement of the testicle, heaviness in the lower abdomen or scrotum, tenderness of the breasts and back pain. However, some cases of testicular cancer indicate no symptoms at all.

Like other cancers, testicular cancer can travel to other parts of the body. “The most common places that we see these tumors metastasize are the lymph nodes, either in the groin area or abdominal area. This type of cancer can also spread to other organs through the blood system, such as the lungs or the brain,” says Dr. Ortolano.

There are several risk factors that can increase a man’s likelihood of developing testicular cancer. “Men who have a history of undescended testicle at birth are at risk. This means that the testicle did not move down from the abdomen into the scrotum. Men who have had an undescended testicle identified early and have had surgery to correct it are still at an increased risk compared to the general population,” explains Dr. Ortolano. According to the American Cancer Society, family history and race can also increase a man’s risk of developing testicular cancer. White men are four to five times more likely to develop testicular cancer than African-American and Asian-American men.

The treatment of testicular cancer varies between patients.

If the patient or the patient’s partner identifies an abnormality of the testicle, the patient is encouraged to see their primary care physician, who will usually send a patient to an urologist. “It’s mostly a diagnosis based on physical exam, but there are important tests to be done to determine what kind of cancer it is,” states Dr. Ortolano.

“Initial treatment is the removal of the testicle, so that the cellular makeup of the tumor can be identified. That often drives treatment. There are two broad categories of tumors (also known as germ cell tumors): seminomas and non-seminomas,” says Dr. Ortolano. Seminomas grow and spread less quickly than non-seminomas. “Based on the histology of the tumor that the pathologist provides when the testicle is removed, along blood work, imaging studies, and a CAT scan, the patient’s clinical stage can be determined. With all tumors, observation and surveillance is sometimes an option. And that just means that the patient has periodic blood work and x-rays to determine if the cancer has spread to another part of the body. Sometimes the patient will need to go through chemotherapy and occasionally, an additional surgery or radiation is needed. The majority of patients who require treatment today often go through chemotherapy. Chemotherapy in many cases is very effective, allowing less use of invasive surgery or radiation. The cure rate is up to ninety percent. This is quite good,” shares Dr. Ortolano.

Because testicular cancer cannot be prevented, surveillance is key. “Just like breast cancer, self-screening is important. Anything that a patient believes is new, wasn’t there before or abnormal should be brought to the attention of your physician. He or she will determine if there is a problem or not. You don’t want to delay. In some patients, these tumors grow fast. And so, if you identify it early, you can potentially avoid the side effects of the other treatments that are sometimes necessary,” says Dr. Ortolano.

“Screening is the primary responsibility of the patients. Every month, men should perform a self-exam to look for any abnormalities.” Dr. Ortolano suggests men visit the American Cancer Society on how to do a testicular self-exam.

Due to the advances in the past few decades, testicular cancer us one of the most curable cancers if detected early. If something is off, take proper precautions and bring to the attention of your doctor. To schedule an appointment with a Lovelace provider, please call 505-727-2727.