Catching Testicular Cancer Early the Best Way to Save Your Fertility
Up to 95% of men with testicular cancer are cured. The earlier it is treated, the greater the chance of success.
Just as a painless lump in the breast can herald breast cancer, a painless lump in the scrotum can be a sign of testicular cancer. This disease usually strikes men between the ages of 15 and 35, when a serious medical problem is the last thing on their mind.
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The good news is that most men survive this cancer.
“Up to 95 percent of men with testicular cancer are cured. The earlier it is treated, the greater the chance of success,” says urologic oncologist Andrew Stephenson, MD.
Although a painless mass — often discovered by accident — is the most common symptom of testicular cancer, the mass may become painful if it is injured, grows rapidly or bleeds.
Sometimes, a man will notice a change in the size, shape or firmness of a testicle, or even finds it unusually tender. This is also cause for concern.
If the cancer has spread, back pain, abdominal pain, coughing or shortness of breath may occur. Swelling of the breast or tender nipples may occur when the tumor causes excessive hormone production.
“If you experience any of these symptoms, bring them to the attention of your personal physician or urologist right away,” Dr. Stephenson says. “Early treatment may save your life and your fertility.”
There is a close connection between testicular cancer and male infertility. The cancer is sometimes discovered when a man’s partner is unable to become pregnant, and the couple undergoes an infertility assessment.
Men born with undescended testes are at increased risk as well, but who else can gets testicular cancer is hard to predict.
It’s more common in non-Hispanic Caucasian men than in men of other races or ethnicities, but only 1 percent to 2 percent of patients have a family history of the disease.
The diagnosis of testicular cancer is confirmed by an ultrasound and blood test. When a solid mass is present, the testicle is removed through a small incision in the groin that leaves the scrotum intact. If desired, the testicle can be replaced with a prosthesis.
The need for further treatment after surgery depends on the type of testicular cancer, and whether it has spread. Some patients are closely observed. Others may need chemotherapy or radiation or have surgery to remove enlarged lymph nodes that remain after chemotherapy.
“New surgical techniques preserve nerve function, leaving ejaculation unaffected in 95 percent of men,” says Dr. Stephenson.
Testicular cancer is rare enough that it’s easy for patients to ignore and physicians to misdiagnose. Dr. Stephenson offers this advice:
“Don’t delay contacting a doctor in hopes the lump will go away. It probably won’t,” he says.
If your physician diagnoses you with epididymitis and prescribes a four-week course of antibiotics, request an ultrasound of your testis.
“If you have cancer, a mass will be visible, and you won’t waste valuable time taking antibiotics you don’t need,” he says.