Five Questions on Testicular Cancer, Answered

June is National Men's Health Month, a good time to spread awareness about testicular cancer and the importance of screening for young men ages 20-34, who are at greatest risk for the disease.

According to the American Cancer Society, about 9,910 new cases of testicular cancer will be diagnosed this year and 460 people will die from the disease. Far less common than other cancers, testicular cancer affects about 1 of every 250 men during their lifetime.

Testicular cancer is a disease largely affecting young and middle aged men – the average age at diagnosis is about 33. Only 8% of testicular cancer cases occur in males over the age of 55, and about 6% occur in children and teens.

Because testicular cancer treatments have a high success rate, the lifetime risk of dying from this type of cancer is low – about 1 in 5,000.

Still, the incidence rate of testicular cancer, specifically seminomas – which are germ cell tumors, has been increasing for the last several decades in the U.S. and many other countries.

In an effort to spread awareness about the disease and the importance of testing for young men, radiation oncologist Peter F. Orio, III, DO, MS answers five common questions about testicular cancer prevention, screening and treatment.

When it comes to testicular cancer prevention, how important are routine or annual screenings?

Men should do self-testicular exams to check for any lumps, bumps or masses and report any pain or other abnormalities that would require medical evaluation to their medical professional. 

This is particularly important for men between 20 and 34 years old where the likelihood of diagnosing a testicular cancer is highest. Often an exam is performed at the time of a man’s annual physical, but self-examinations are recommended as abnormalities can be caught sooner.

What kind of screening is available for testicular cancer and at what age should people start being screened? 

Currently there are no standards for routine screening although self-exams are recommended. Most often a man finds abnormalities and reports them to his physician.

Self-examination should start as early as 15 and continue through age 40. For men older than 40, any new lumps, masses or pain should be reported to a physician for further medical evaluation. 

What are some of the risk factors for testicular cancer and are there lifestyle or diet changes that can lower someone’s risk?

Risk factors for testicular cancer include undescended testicles, first born, pre/perinatal estrogen exposure, polyvinyl chloride exposure, advanced maternal age, Down syndrome, Klinefelter's Syndrome (47XXY) and HIV/AIDS.

There are no recommended lifestyle changes outside of limiting exposure to marijuana, as there are reports that frequent and/or long-term marijuana use may significantly increase a man's risk of developing aggressive types of testicular cancer.

What are some of the symptoms of testicular cancer that someone should be concerned about and discuss with their primary care provider or specialist?

New onset pain, swelling, lumps, bumps or masses should be reported to your physician.

What kind of treatment options are available for someone diagnosed with testicular cancer?

Testicular cancer is highly curable. Surgery is the mainstay of therapy. Chemotherapy and radiation have a role in more advanced stages of testicular cancer.

Peter F. Orio, III, DO, MS is the Medical Director of Radiation Oncology at the Dana-Farber Brigham Cancer Center in clinical affiliation with South Shore Health and Associate Professor of Radiation Oncology at Harvard Medical School.