April is Testicular Cancer Awareness month as designated by the Testicular Cancer Society. But how much do most people know about this disease? And why should everyone be aware of it?
While testicular cancer is a rare form of cancer, it is the most common type in men between the ages of 15-35 years of age. It can, however, occur in men of any age. In the US in 2017, an estimated 8,850 new cases of testicular cancer were diagnosed. Over a man’s lifetime, his risk of developing this cancer is 1 in 263. Approximately 1 out of every 5,000 men with this disease will die. Currently, most cases are diagnosed relatively early or the fatality rate would be much higher.
While many men who develop testicular cancer do not have any known predisposition for developing this malignancy, certain risk factors have been identified. Age, as previously noted, is a strong risk factor with 90% of cases developing in men under the age of 54 years. Race and ethnicity also plays a role, with Caucasian men having a five times higher rate of this cancer than black men and three times higher rate than Asian-American and American Indian men. The rate of malignancy in Latino/Hispanic men falls between the rates of Caucasian and Asia-American men. It has also been noted that testicular cancer occurs more frequently in the US and Europe than in Africa or Asia. Genetic factors seem to play a slight role with 3 percent of those diagnosed have a relative who have also had the disease, especially if it is a brother or father. Undescended testes (otherwise known as cyrptorchidism) also appears to be a risk factor. Of men who have been diagnosed, 3-4 percent will go on to develop testicular cancer in the other testicle.
What are warning signs of testicular cancer?
- A small lump or hardened area on one of the testicles. It is usually described as being pea-sized.
- Unexplained change in the size of one of the testicles.
- Usually, the lump associated is painless but pain can also be a sign of cancer.
- A change in the feeling of one testicle, such as a feeling of heaviness.
- Pain in the lower abdomen. It is usually described as a dull ache.
- Development of a deep venous thrombosis (DVT).
- Gynecomastia and breast tenderness due to an imbalance of the hormones, estrogen and testosterone.
- Sudden signs of puberty due to increased hormones released by some tumors.
- Lower back can occur, usually after the cancer has spread to the abdominal lymph nodes.
- Symptoms due to spread of cancer to other regions, such as difficulty breathing, cough, chest pain, headache, and abdominal pain. Testicular cancer has been known to spread to the lungs, brain, and liver.
The treatment depends on the stage of cancer and unfortunately some of the treatments may cause infertility. A very important part of the treatment process is finding the stage of cancer. Treatment usually includes some form of surgery to remove the tumor and affected lymph nodes. Depending on the cell type, radiation therapy may also be utilized. Additionally, chemotherapy medications also are used depending on the stage of cancer. Fortunately, most malignancies are detected early and patients usually do well. Any man who finds a lump in their testes should be examined as soon as possible by their doctor. Typically, a man should do a self exam of their testes to feel for any lumps about once a month. They should have an exam by a doctor at their annual physical.
In preparation of the coming awareness month, Tommy John spoke with Testicular Cancer foundation for more awareness about this malignancy. Here is what they said:
Tommy John Q&A with the Testicular Cancer Foundation
Tommy John: We talk a lot about early detection and the time leading up to surgery, but
what does the post-surgery and recovery process look like to most patients?
Testicular Cancer Foundation: When Testicular Cancer is caught early, the surgery (inguinal
orchiectomy) to remove the cancerous testicle can be minimally invasive. Generally speaking
the patient returns home the same day of surgery and recovery time is rather short. This is why
early detection is crucial. A simple surgery and the patient is back to daily life. When testicular
cancer metastasizes not only do your chances of survival decrease, but more invasive surgery,
radiation, and chemotherapy are likely to follow – all of which have their own risks and side
effects.
What type of lifestyle changes do survivors need to make post-surgery/treatment (diet,
exercise, work, etc.)?
We urge men to be advocates for their own health. This includes living a healthy lifestyle – a well
balanced diet and exercise. Additionally, we urge men to take their time and be patient when
jumping back into work and daily life.
How often do survivors follow-up with their doctors/oncologist/urologist after the
surgery/treatment?
No one follow up regimen is appropriate for every TC survivor, but standard protocol would be a
doctors visit every 3-6 months the first year, 6-12 month the 2nd and 3rd year, and annually for
year four and five. Each of these visits would include some or all of the following tests; blood
work, CT Scans, Chest X-rays and Testicular Ultrasound.
After having a testicular cancer diagnosis, there is a slightly higher risk for a re-occurrence of
cancer, so survivors are advised to become advocates of their own health, and look for any
changes they see/feel.
What are some of the biggest difficulties that survivors face post-surgery and possible
treatment?
Life after cancer can be one of the biggest struggles for some after a cancer diagnosis. This is
another reason why we emphasize early detection. If caught in stage one, often there is no
need for additional treatment which minimizes some of the struggles guys often face after
surgery and additional treatment (additional surgery, chemotherapy, radiation).
Some TC survivors go through what can be an extremely traumatic experience, and after
treatment are given the “all clear” from their doctor. They are then expected to jump back into
daily life like nothing happened. For some, healing for both mind and body can take time, and
we urge men struggling to discuss their options with their social worker or doctor.
We have found that there is high numbers of TC survivors that suffer from PTSD. Some men
suffer from depression, feel as if they have lost their “manhood”, and fear re-occurrence. Some
men struggle with infertility as well. At TCF we have bolstered our support system to ensure that
men have resources and support groups to deal with life after cancer.
Special thanks to Tommy John and the Testicular Cancer Foundation for helping to raise awareness on this very important topic. During the month of April, Tommy John will be creating special edition pairs of underwear, and will be donating a percentage of their sales to TCF in order to help further fund research and care.
Photo credit: Testicular Cancer Foundation
Copyright secured by Digiprove © 2018 Linda Girgis, MD, FAAFP
Just keep women out of the equation.
Which equation?