Testicular Cancer Awareness: Self-Exams Key for Early Detection, Better Outcomes

April is Testicular Cancer Awareness Month, a good time to shine a light on the disease and the importance of self-exams in detecting cancer early when it is easier to treat.

According to the American Cancer Society, about 9,760 new cases of testicular cancer will be diagnosed this year and 500 people will die from the disease. 

While it is less common than other cancers, testicular cancer still affects 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 (germ cell tumors) has been increasing for the last several decades in the U.S. and many other countries.

Which is why self-exams and routine physical exams with a primary care provider are particularly important for younger men, ages 20-34, who are at greatest risk for the disease. 

Urologist Sergio D. Fefer, MD answers questions about risk factors, symptoms, and treatments for testicular cancer.

Why are testicular self-exams so important and at what age should people start?

The presence of symptoms is usually a later event in testicular cancer and the majority of patients have no symptoms.  Most testicular cancer diagnoses are the result of men noticing some abnormality in a self-examination and bringing it to the attention of their provider. 

Routine self-examinations are key for detecting testicular cancer and should be done monthly starting at the age of 15.

Are there screening tests available for testicular cancer?

There is no screening test for the early diagnosis of testicular cancer, which is why self-exams and routine annual exams with a primary care provider are important.

What are some risk factors for testicular cancer and are there any lifestyle changes that can reduce the risk?

The main risk factors for testicular cancer include undescended testicle (cryptorchidism), a prior personal or family history of testicular cancer, and the presence of abnormal cells in the testicle (usually found during workup for infertility). 

Other risk factors include race – White, American Indian and Alaska Native men are several times more likely to get testicular cancer than Black, Asian American, and Pacific Islander men – and HIV infection.  

There are no lifestyle changes that can reduce the risk of developing testicular cancer, but routine self-exams can lead to early diagnoses and better outcomes for men.

What are some symptoms of testicular cancer you should discuss with your healthcare provider?

The majority of testicular cancer patients have no symptoms other than the presence of a painless lump on the testicle noticed on self-examination or during a routine yearly physical exam by primary care physicians.

Early puberty in boys and breast growth or soreness in some cases can be associated with testicular cancer.

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

The definitive diagnosis and the initial treatment of testicular cancer is surgery.  Removing the whole testicle, radical orchiectomy, through an inguinal approach is most times diagnostic and curative.

Depending on the type and stage of the cancer, further treatment is indicated and usually includes a multidisciplinary approach including chemotherapy, radiation therapy or additional surgery. A combination of all three is extremely successful in the treatment and cure of testicular cancer, even when diagnosed at an advanced stage.

Have advancements in the detection or treatment of testicular cancer improved patient care and outcomes?

Because testicular cancer treatment is very successful and there are multiple options including combinations of surgery, radiation, and chemotherapy, the emphasis during the last 10 to 20 years has been on decreasing the rate of complication in therapy and improving patients' quality of life after treatment.

New protocols of surveillance following orchiectomy have been designed to reduce unnecessary treatment, minimizing side effects while preserving excellent rates of survival.

Sergio D. Fefer, MD is an urologist at South Shore Urology in Weymouth. Learn more about genitourinary care at South Shore Health.