The testicles are part of the male reproductive system contained within a sac of skin called the scrotum, which hangs beneath the penis.  The main function of the testicles is to produce reproductive sperm cells and male hormones, the most abundant of which is testosterone.  Testicles are made up of a variety of cell types and when it comes to testicular cancer it is very important to make a distinction between these various cell types since the treatment and prognosis (outlook for survival) depends upon this.

  Although testicular cancer is thirty times less common than prostate cancer, there is some evidence that it is becoming increasingly more common.  The recent article in the August Journal of Urology reported that there has been a 51 percent increase in the incidence of testicular cancer over the past 40 years.  In 1996 there were about five cases per 100 thousand men, according to the National Cancer Institute.  Although this cancer can occur in senior men, it is most commonly diagnosed between ages 30 and 35. 

  More than 90 percent of the cancers of the testicles develop from cells known as germ cells.  These germ cells are not “germs” as in bacteria but rather the cells within the testicles that produce sperm cells.  There are two main types of germ cell tumors, seminomas and non-seminomas.  Seminomas make up about half of all testicle germ cell cancers.  If these tumors are detected before becoming invasive they are curable.  Once cancer becomes invasive its cells penetrate the surrounding tissues and these may enter the blood circulation or lymphatic circulation system, allowing the cancer cells to spread to other parts of the body.  Researchers have estimated that it takes about five years for this form of cancer to become invasive.  Herein lies your opportunity.

  Non-seminoma germ cell cancers tend to develop earlier in life, generally occurring in men in their twenties.  There are many different sub types of these cancers and generally these are more aggressive cancers.  Tumors may also arise from the structural support and hormone producing tissues of the testicles called the stroma.  Stromal tumors normally produce excessive male sex hormones but in some more rare cases they may produce female sex hormones.  Most of these are detected in adults but a small group does occur in children.  Generally these tumors do not spread beyond the testicle and they are often cured by surgical removal.

  The American Cancer Society estimates that about 7,400 cases of testicular cancer will be diagnosed in the United States this year, resulting in about 300 deaths.  This condition is approximately four times higher in white men and the risk for developing this disease is highest among men living in the United States, United Kingdom and Scandinavia.  There is only one risk factor that has been proved to increase the risk of testicular cancer.  Cryptorchidism is the condition of an undescended testicle.  Normally the testicles develop inside the male infant’s body and gradually descend into the scrotum before birth or within the infant’s first year.  Occasionally if a testicle does not reach its normal location, surgery is necessary to help it along.  Cryptorchidism only affects about three percent of the male population.  Other risk factors for this disease include a family history of testicular cancer, HIV infection and prior history of testicular cancer. 

  The symptoms of testicular cancer include pain or discomfort in a testicle or a lump or enlargement of a testicle.  Some patients experience enlargement or tenderness of the breasts and/or nothing more than a dull ache in the region of the groin.  Diagnosis of testicular cancer is done through physical examination and sometimes requires additional tests to rule out infection or other disorders.  Treatment of testicular cancer usually involves surgically removing the entire affected testicle.  The good news is that if this cancer has not become invasive and spread to other parts of the body the removal of the testicle results in a surgical cure.  Detecting these cancers before they become invasive requires monthly self-examination.  Most experts suggest that men begin performing self-examinations monthly starting at age 15.  Consult your family physician or urologist if a painless, firm lump is detected or if a testicle seems enlarged or tender.