Causes and Incidence

The exact cause of testicular cancer is unknown, although it seems to occur more frequently in men with undescended or atrophic testicles. Testicular cancer is rare, however it is the most common solid malignancy in males between the ages of 20 and 35, although it accounts for only about 1% of all cancers in men. Also for unknown reasons, the disease is approximately four times more common in white men than in black men.

Ten to fifteen years ago this disease was greatly feared, as ten times as many patients died then as now. But thanks to advanced technology and improved medication, survival rates are far higher, and testicular cancer is now often completely curable, especially if found and treated early.

Detection and Diagnosis

The majority of testicular tumours are found by patients themselves - either by accident or while performing a self-examination of each testicle. This painless lump is usually pea-sized, however it may also be as big as a marble or even golf ball.
Men can improve their chances of finding a tumour in its early stages by examining their testicles on a monthly basis. This examination should preferably be done after a warm bath or shower when the scrotum is at its most relaxed - making it easier to feel anything unusual.

Self-Examination
Standing in front of a mirror look for any swelling on the skin of the scrotum. Next, examine each testicle with both hands, by placing your index and middle fingers under the testicle and your thumbs on top. Gently roll the testicle between your fingers and thumbs - feeling for any lump or swelling. If you do find a lump, swelling or any other abnormality, regardless whether it is painful or not, consult your doctor immediately.

Doctors use various methods to help diagnose and "stage" testicular cancer, although a physical examination is often first priority. Imaging techniques, blood analyses and tissue sampling, will allow the doctor to correctly "stage" the disease, thus affording the most appropriate treatment for you as an individual.

Stage 1:
Cancer is confined to the testicle.
Stage 2:
Cancer has spread to lymph nodes.
Stage 3:
Cancer has spread beyond the lymph nodes - to remote sites in the body.

Treatment:

Because seminomas and nonseminomas differ in their tendency to spread, patterns of spread, and response to radiation, different treatment strategies are often used.

Seminomas:
Because of the tendency to remain localized and be somewhat slow growing, seminomas are usually diagnosed in stage 1 or 2. In this case, treatment may be a combination of radiation, testicle removal or chemotherapy. Stage 3 seminomas are usually treated with combination-drug chemotherapy.

Nonseminomas:
Although it is unlikely for nonseminomas to be diagnosed in stage 1, there have been a number of cases reported. These men may require no further treatment, other than testicle removal, although it is vital that they undergo follow-up examinations for at least two years, as nearly 10% of stage 1 patients experience recurrences. Stage 2 patients who have had testicle and lymph node removal also often need no further treatment. However, some doctors do prefer a short course of combination-drug chemotherapy, to reduce the risk of recurrence. The majority of stage 3 patients can be cured with the use of drug combinations.

Side-Effects:

Any form of cancer treatment is bound to cause undesirable side-effects, although the severity seems to vary from one patient to another. Some drugs may result in infertility, however studies have proved that most men regain their fertility a couple of years after the cessation of treatment. Chemotherapy has many side effects e.g. nausea, vomiting, hair loss and increased risk of infection, although not everybody will suffer with all if any of these. Radiation therapy may result in the patient feeling extremely listless or experience lowered blood counts. Infertility may also occur, but this is often only temporary.
 

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