The Catch Guide to Testicular Cancer

Description

The testicles are the pair of male organs located at the base of the penis. They are responsible for creating sperm and male hormones, including testosterone. Testicular cancer is primarily found in young and middle-aged men, though it can occur in children and in men over the age of 55. The average age at diagnosis is 33. Around 0.4% of men will be diagnosed with testicular cancer at some point in their life. 

Testicular cancer may not cause any symptoms, but is likely to cause at least some of the following:^[1]

• Lump in the testicle 
• Swelling/enlargement of the testicle
• Testicular pain
• Heaviness or aching in the lower belly/scrotum
• Breast growth or soreness
• Lowered libido 
• Low back pain
• Belly pain

These symptoms may be caused by any number of health conditions. Any new symptoms of this nature should always be evaluated by a medical professional. 

Different forms of testicular cancer are characterized by distinct features and biological behaviors: 

• Seminomas: These tumors start in the testicles’ germ cells, and account for around 45% of testicular cancer diagnoses. Slow to grow and spread, most seminomas occur in men ages 25-45. These tumors may produce human chorionic gonadotropin (HCG), a protein more commonly associated with pregnancy, and which can easily be tested in the blood. 
• Non-seminomas: Non-seminomas also form in the germ cells, and account for about 45% of testicular cancers. Usually found in men between their late teens and early 30s, these tumors tend to grow more quickly and are likelier to spread to other parts of the body than seminomas. There are additional subtypes of non-seminoma tumor; most tumors are a mix of these types (and may include some seminoma cells), and are likely to be treated in the same way. 
• Carcinoma in situ (CIS): This very early form of germ cell cancer has not yet spread beyond the walls of the seminiferous tubules (where sperm is formed). It’s often difficult to find testicular CIS because it generally doesn’t cause symptoms or form a lump that a patient or his doctor can feel. CIS does not always develop into an invasive form of testicular cancer, and some doctors prefer careful monitoring as the best treatment plan. 
• Stromal tumors: Stromal tumors make up less than 5% of adult testicular cancers. Most of these tumors are in fact benign, and can be successfully treated via surgical removal. If they do grow and spread, stromal tumors tend to have a poor outlook, as they don’t respond well to chemotherapy or radiation. 

Survival Rates and Incidence

Testicular cancer survival rates are not available by stage or spread at this time, but the overall 5-year survival rate for testicular cancers is 95%.

Below is the incidence of testicular cancer by age group:^[2] 

Risk Factors

There are several confirmed risk factors that contribute to an individual’s risk for testicular cancer:  

• Cannabis use: Multiple recent studies have shown increased rates of testicular cancer among cannabis users. For heavy or long-time users, the risk may multiply by as much as 2.5 times.^[3]
• Family history of testicular cancer: A family history of testicular cancer, even in the absence of known genetic conditions, increases your risk for likewise developing testicular cancer. 
• Male infertility: Studies have shown that infertility in men correlates with a significant increase in testicular cancer rates. Because this risk may vary widely depending on the specific cause of infertility, any infertility should prompt a thorough examination to determine cause and screen for possible testicular cancers.^[4]
• Undescended testis: In about 3% of boys, one or both testes fails to move from the abdomen into the scrotum by the time they’re born. This condition, called cryptorchidism (or simply undescended testicle), significantly increases the risk of testicular cancer, though early treatment of the condition may reduce that risk. 
• Working as a firefighter: Multiple studies have shown firefighters are at an increased risk for several forms of cancer, including testicular. This is likely due to the known and suspected carcinogens they are exposed to in their work, some of which can be inhaled or absorbed through the skin. 

Protective Factors

There are steps you can take to reduce your risk of testicular cancer:

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• Fruit and vegetables: Fruit and vegetables are rich in various nutrients which have been shown to have protective effects against multiple cancers, including testicular. These foods contain a variety of antioxidants, which help neutralize free radicals in the body and reduce inflammation.
• Low consumption of processed and red meat: Reducing or eliminating red and processed meat from your diet has been shown to decrease the risk of developing testicular cancer. In general, diets low in salt, red meat, and processed meat are protective against several health conditions and cancers. 

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Screening

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Early detection of testicular cancer can help your prognosis and reduce or eliminate the need for lengthy or painful treatment/ 

Depending on your age and risk factors, the optimal testicular cancer screening will vary:

• Physical/self exam: Regular exams with your doctor, as well as regular self-exams, can help find any lumps or changes to your health that might warrant further testing. If your doctor does find anything concerning, they will likely order additional tests to determine whether testicular cancer is present.
• Ultrasound: Ultrasound imaging can determine whether any suspicious lumps are tumors or the result of a benign condition. In asymptomatic individuals, ultrasounds may detect cancers earlier than they would have otherwise been found. 

Blood tests for tumor markers: Certain proteins in the blood, such as HCG or alpha-fetoprotein (AFP), can serve as markers for testicular tumors; high levels of either of these substances might indicate testicular cancer. Levels of these proteins, as well as lactate dehydrogenase (LDH), can also help doctors determine the type of tumor (which may dictate the course of treatment), its spread, and help your medical team track the success of any treatments.