The Young Man’s Concern: Testicular Cancer

My previous post in this series about why I participated this year in No-Shave November was to encourage men to get tested for Prostate Cancer as we get older. In this post, I provide information about another cancer specific to men: Testicular Cancer, which is especially for younger guys.

First, I have to admit, I shaved my beard now that November is over. After many years without any facial hair, it really started to bug me. It also didn’t help that my wife nicknamed last month, “No Kiss November”!

But it doesn’t mean I’m no longer interested in helping educate guys about our serious health issues. While I’m not a physician, I do want to help us become better men so please keep reading!

What Men Can Do to Live Longer

As I wrote in previous posts, the latest CDC figures show the average American man lives 5 years less than the average American woman. But there is evidence that our biology —and not just our risky behavior, may also abbreviate our lifespan.  

A post from earlier this year explained that I believe God designed men to be wild at heart so we naturally need some risk in our lives to feed our souls. But we can improve our success at living longer by doing just one thing differently:

See a doctor early and often! 

This is especially true for beating cancer since early detection is crucial.

Be Aware, Young Guys!

While cancer of the testicles is very rare, the National Cancer Institute (NCI) estimates that about 9,600 men a year are diagnosed with testicular cancer. The Movember website says testicular cancer is the most common cancer in American young men.

Yes, you read that right!

Testicular cancer is more prevalent in younger men, whereas prostate cancer is an older man’s concern, along with heart disease. 

Approximately 80% of testicular cancers occur in adult men under the age of 44, and more than half occur in men between 20 and 34 years old.

Screen Shot 2015-07-13 at 14.32.06
Figure 1. Mortality of testicular cancer, England & Wales, 2013.
Data from ONS (2014), Deaths registered in England and Wales (Series DR), 2013.

As you will read below, one treatment is removing the cancerous testicle, which can impact your sex life and ability to have children.

So take this cancer seriously and do not avoid the doctor!

Does Testosterone Shorten a Life? 

The Time magazine article titled, Why Do Women Live Longer Than Men? references a 2012 study by doctors who examined the historical health records of 81 Korean eunuchs.

Sadly, eunuchs were men castrated as children and, therefore stopped producing much testosterone.

Historically, they were employed as guards and servants in harems across the Middle East and Asia. The Imperial court of the Korean Chosun Dynasty (1392–1910) also had eunuchs, but the Chinese empire officially banned the practice in 1925. 

The study National Research Foundation of Korea found these eunuchs tended to live about 14 to 19 years longer than uncastrated men who shared their same socio-economic status.

Now, you probably do not want to visit those doctors.

Nor, does this mean a man’s testosterone is solely to blame for a shorter life span or any ungodly behaviors!

But this does show that the relationship between male hormones and our health is complex and important. 

About Testicular Cancer 

The Cancer Treatment Centers of America explains that testicular cancer, like prostate cancer, is a disease of the male reproductive system.

The Male Reproductive System

This image from the Mayo Clinic shows the testicles, located inside the scrotum, which the loose bag of skin underneath the penis. This system of organs produces male sex hormones that help regulate our sex drive, muscular development, and physical maturity.

The testes also produce sperm for reproduction. Sperm develops through a process of cellular division called meiosis. When the cells begin to divide uncontrollably, they stop producing functional sperm and create copies of themselves that become cancerous.

Causes of Testicular Cancer

Although the exact causes of testicular cancer are unknown, certain factors that can increase your risks include age, ethnicity, genetics, and other factors. 

Testicular cancer cases are most common in the early 20s and early 40s since men actively produce testosterone and sperm when they are younger, thus raising the risk.

Unlike prostate cancer, caucasian men have a five times greater risk of developing testicular cancer than black men and three times greater risk compared to Asian-American or American Indian men. Hispanic/Latino men have a lower risk than Caucasians but a higher risk than Asian-Americans. Testicular cancer also occurs more frequently in the United States and Europe, and less often in Asia or Africa.

Family history also plays a role. Approximately 3% of cases of testicular cancer occur in families where a brother or father had testicular cancer. This factor alone slightly increases your risk of developing the disease.

Other conditions such as Cryptorchidism (an undescended testicle), HIV infection, and Carcinoma (a type of cancer that starts in cells that make up the skin or the tissue lining organs, such as the liver or kidneys).

Also, a previous history of testicular cancer shows approximately 3-4% of men who had cancer in one testicle, will later develop it in the other.

Get Examined!

Most doctors agree that examining a man’s testicles is part of your routine physical exam each year. But they also recommend that we also examine our own after reaching puberty.

Each of us has to decide whether or not to self-exam. However, it’s important if you have certain risk factors such as an undescended testicle, previous tumors in a testicle, or a family history of this type of cancer.

The American Cancer Society provides instructions on the self-exam but also some guidance on what’s normal and what’s not. 

The ACS suggests that it’s normal if one testicle is slightly larger than the other. One may even hang lower than the other. A normal testicle has a small, coiled tube called the epididymis that can feel like a small bump on the upper or middle outer side of the testis. Testicles also contain blood vessels, supporting tissues, and tubes that carry sperm, which some guys may confuse as abnormal lumps. 

Symptoms of Testicular Cancer

Knowing the symptoms of testicular cancer also increases the likelihood of finding the disease in its early stages.

The John Wayne Cancer Institute at Saint John’s Health Center in Santa Monica, CA, provides these 8 warning signs and symptoms of testicular cancer:

  1. A painless lump or swelling on either testicle. If found early, a testicular tumor may be about the size of a pea or a marble, but it can grow much larger.
  2. Pain, discomfort, or numbness in a testicle or the scrotum, with or without swelling.
  3. Change in the way a testicle feels or a feeling of heaviness in the scrotum.
  4. Dull ache in the lower abdomen or groin.
  5. Sudden buildup of fluid in the scrotum.
  6. Breast tenderness or growth. Although rare, some testicular tumors make hormones that cause breast tenderness or growth of breast tissue.
  7. Lower back pain, shortness of breath, chest pain, and bloody sputum or phlegm can be symptoms of later-stage testicular cancer.
  8. Swelling of one or both legs or shortness of breath from a blood clot are symptoms in some young or middle-aged men.

Of course, you should always report abnormal symptoms to your doctor.  

Screening and Diagnosis

Your doctor may then want to run further tests to identify the cause of the lump or other symptoms. He or she can then determine the correct treatment, if necessary.

Some of the tests to diagnose testicular cancer include:

  • Biopsies (usually performed only after removing the affected testicle because of the danger of cancer spreading into lymph nodes). Once the testicle is removed, a pathologist will perform tests for a more specific diagnosis.
  • Lab tests help identify proteins most frequently associated with testicular germ cell cancers.
  • Imaging tests help determine whether testicular cancer has spread to other parts of the body or to monitor treatment progress. Common imaging tests include CT scans, Lymphangiogram, MRIs, PET scans, Ultrasound, and X-rays. 

Testicular cancer is often treated with surgery, followed by radiation therapy and chemotherapy to kill any cancer cells that spread to other parts of the body. 

Educate, Self-Examine, See a Doctor

The good news is that the 5-year survival rate for men with testicular cancer is 95%.

But as with all health concerns, don’t be afraid to consult your doctor. Most importantly, do not ignore any of the warning signs.

So even though men’s health month is over, it’s important for you to remain educated about all the health issues that affect men.  Join me next week for another major concern for men: addictive behaviors. 


2 Responses

    1. Good question Gordon. I could not find a specific chart for rates of Testicular Cancer by age for U.S. men but an article in Annals of Oncology (linked below) states the survival rate in the age groups 15–29 and 30–49 years was between 90% and 95%, with little change over time and very little difference between Europe and the USA. The good news is that Testicular cancer is one of the most curable cancers nowadays!

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