Testicular cancer originates in the testicles, which are part of the male reproductive system. While not among the most common cancers, it is a significant health concern, particularly for young men. Despite its potential seriousness, testicular cancer is highly treatable, especially when identified and addressed early.
Age of Onset
Testicular cancer can occur at any age, but it is most frequently diagnosed in young and middle-aged men. The average age at diagnosis is around 33 years, and it is the most common cancer among males aged 15 to 40. While rare, cases can also be found in younger individuals, including infants and children. Approximately 6% of diagnoses occur in children and teenagers, with about 8% affecting men over the age of 55.
In the pediatric population, testicular tumors are uncommon, accounting for about 1% to 2% of all tumors in boys. They are particularly rare before puberty. However, two peak ages are observed for these tumors in children: early boyhood and the teenage years. Benign tumors are more prevalent in very young boys and infants, whereas malignant tumors are more often seen in boys who have entered puberty.
Recognizing Symptoms and Early Action
Recognizing the symptoms of testicular cancer is important for early detection. The most common sign is the presence of a painless lump in one of the testicles. Other indications can include a feeling of heaviness in the scrotum, swelling or a sudden collection of fluid, or a dull ache in the groin or lower abdomen. Some individuals might also experience pain or discomfort in the testicle or scrotum, or notice a shrinking of the testicle.
Self-examination is a proactive measure that can help individuals become familiar with the normal feel of their testicles, making it easier to identify any changes. Many healthcare professionals suggest performing a monthly self-examination, ideally after a warm shower when the scrotum is relaxed. If any unusual symptoms, such as a lump, swelling, or persistent pain, are noticed and last for more than two weeks, prompt consultation with a healthcare provider is recommended.
Factors That Increase Risk
Several factors can increase an individual’s predisposition to testicular cancer. One is cryptorchidism, also known as an undescended testicle, where one or both testicles fail to move into the scrotum before birth. This condition is a notable risk factor, and the risk remains elevated even if surgery is performed to correct the testicle’s position.
A family history of testicular cancer also plays a role, with an increased risk if a father or brother has been diagnosed with the disease. While most cases do not have a familial link, it is a recognized consideration. Individuals who have previously had testicular cancer in one testicle face a higher likelihood of developing it in the other, affecting about 3% to 4% of those cured. Additionally, certain genetic conditions, such as Klinefelter syndrome, have been linked to an increased risk.
Next Steps for Diagnosis and Treatment
When testicular cancer is suspected, the diagnostic process typically begins with a physical examination and a review of the individual’s medical history. An ultrasound is commonly performed next, which uses sound waves to create images of the testicles. This helps determine if a mass is present, whether it appears solid or fluid-filled, and can differentiate between benign conditions and those that might indicate cancer.
Blood tests are also conducted to measure levels of certain proteins called tumor markers, such as alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and lactate dehydrogenase (LDH). These markers can assist in diagnosis, staging, and monitoring the disease. The definitive diagnosis often involves the surgical removal of the affected testicle, known as an orchiectomy, which is also the initial treatment step. Biopsies are generally avoided due to the risk of spreading cancer cells. The success rate for testicular cancer treatment is high, often exceeding 95%, especially when detected early.