INTERVIEW HIGHLIGHTS:
Why testicular cancer often strikes younger people
We know that there are some pre-cancer cells that are present at a very early age. In the case of testicular cancer, maybe in the first ten years of life, they get triggered to transform and grow with hormonal changes as well.
In the lifetime of cancer, things do not happen usually overnight. A colon polyp, for example, which is pre-cancer takes about ten years to become colon cancer.
Testicular cancer - if we hit puberty around, let's say 14 or 15, give that additional ten years of transformation and growth to become cancer. That gets you to the usual age range, which is in the mid-twenties.
We understand that extent, but it is certainly still the million-dollar question of why this happens to certain men and why those cancer cells or pre-cancer cells even are present, to begin with.
Are there risk factors for testicular cancer?
The most important risk factor is cryptorchidism or, in layman's term, undescended testicle. There are boys of that age that are born with a testicle buried within their abdomen. It did not make its way down to the scrotum. That's the sac that holds the testicles. Left uncorrected, this certainly increases the risk of testicular cancer.
This is usually something that we can address by early surgical intervention to bring the testicle down to its usual location. And sometimes, if it's a little bit later, the surgeon, the urologist, would elect to remove that testicle. It's not a big deal. We still have this other testicle available if we need to.
But there are certainly other risk factors that we do not necessarily have control over. For instance, men who have brothers or parents with testicular cancer have an increased risk of about six to tenfold higher than the average man.
How dangerous is testicular cancer?
Left untreated, it is certainly a dangerous situation. But fortunately, the landscape for testicular cancer changed forever between the 1970s and early 1990s, when Larry Einhorn at Indiana University started using cisplatin chemotherapy regimens to treat testicular cancer.
It used to be cancer with a 5% survival rate, and he transformed that into a 95% survival rate with the use of that successful chemotherapy combination.
Warning signs
- The simplest one is having a painless or painful lump in the testicle. Any change in the size or the shape of the testicle is a warning sign.
- Some people can have dull aches in the lower part of their abdomen,
- There are some hormonal changes that can happen with testicular cancer. Those cancer cells can produce certain hormones, like suddenly having breast tenderness or growth in those men.
- And then, of course, for men who have more advanced disease, any sign of cancer can cause symptoms like shortness of breath, back pain, and abdominal pain. But those are usually more advanced presentations.
Doctor visits are important, but…
I would say an annual checkup with your primary care doctor, but also to increase awareness. I advise usually young men to do a self-exam of their testicles. Every time you're in a shower, just feel the scrotum. Is it looking normal or not? Because the patients are usually very aware of those subtle changes even before anybody else can pick them up.
RESOURCES:
Interview highlights were lightly edited for clarity.
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