Check and Catch Testicular Cancer Early
J.Conaway
“Women are expected to regularly examine themselves for indications of
breast cancer,” said my physician during the course of giving me a physical
examination. “But when it comes to men examining their testicles for abnormalities,
forget it.”
Testicular
cancer is far less common than breast cancer but it is still a concern for doctors, if not
for the majority of their male patients. Although rare, it is the most common form of
cancer among men aged 20 to 35. This year, about 7,400 Americans will develop testicular
cancer, according to the National Cancer Institute.
Men's general reluctance to focus on possible medical
problems is graphically illustrated by their touchiness in this vital — and highly
symbolic — area. Real men don't spend a lot of time examining their privates, or so
the argument goes. That's a shame, because in about 40 percent of the victims of
testicular cancer, the malignancy has spread to other parts of the body by the time it is
diagnosed.
All of us
between the ages of 15 and 40 should check our testicles for abnormalities about once a
month, and older men should continue to occasionally do so. The shower or bathtub is a
good place for this because warm water relaxes both the scrotum and the man. To test, roll
each testicle between the thumb and first two fingers of each hand and look for a lump, or
nodule, that feels firm but is painless when pressed. A visual exam in front of a mirror
is another way to look for abnormalities, and allows a man to more easily locate all of
the various components that should be checked.
Some men
mistakenly discount the possibility that a problem exists because their testicles
don’t hurt. Tenderness, too, can
indicate a problem, and so can swelling of a testicle. Neither of these symptoms should
cause initial alarm, however, because there are many possible causes other than cancer.
For instance, an inguinal hernia can produce swelling
in the scrotum that has nothing to do with the testicle, and infection (epididymitis) of
the tube that transmits sperm can cause tenderness. The hernia can be repaired surgically
if it is severe enough or causes too much discomfort, and epididymitis can be successfully
treated with antibiotics.
Other
complications related to the testicles arise now and then and should be reported to a
doctor. So should any variation in the glands, which should be
smooth-surfaced and
slightly spongy, and any persistent sense that things are not right down there. Some
victims of testicular cancer do experience outright pain, particularly if a tumor has
formed and there's bleeding. Less-common indications of the disease are back pain, weight
loss, and enlarged lymph nodes and breasts.
Most testicular cancers develop in the sperm-producing
cells and are classified as seminomas. One common — and alarming — trait is the
seminoma's rapid development. The worst tumors can double in size in as little as three
weeks, and for this reason early detection is important.
The progress
in treating testicular cancer has been dramatic. In the 1960s, 90 percent of the men with
the disease died of it, whereas today 90 percent of them survive. But the incidence of
this potential killer is trending upward, for reasons that have yet to be scientifically
determined.
If a malignant testicle is suspected, a testicular
ultrasound is conducted. Next comes a blood test for certain proteins produced by cancer
cells. If these tests strongly suggest cancer, a biopsy follows. This involves surgical
removal of the testicle, a process known as a radical inguinal orchiectomy, and it can be
a traumatic experience for a young man worried about his love life and his potency.
Fortunately,
sexual performance is not related to this problem, at least not physiologically, and the
remaining testicle isn't affected by the cancer, either, since it is an independent gland.
And one testicle is more than capable of producing the requisite number of sperm to pass
along the family genes.
Cancerous
cells in a testicle spread quickly, first to the lymph nodes of the abdomen and chest and
then throughout the body. But most men
whose cancer has progressed this far can still be cured — including the 40 percent
who did not detect the cancer in its early stage — by a combination of surgery,
radiation and chemotherapy.
Men with early seminomas receive, after the
orchiectomy, X-ray therapy in the pelvic and abdominal areas. The healthy testicle is
shielded from radiation, thus preserving its reproductive viability. Lymph nodes are
removed from the rear of the abdomen of some testicular cancer patients. If the malignant
cells have reached the lymph nodes of the chest and other organs, chemotherapy is used.
This does pose a great danger to fertility, and most men are advised to make a deposit in
a sperm bank before undergoing treatment.
Studies
suggest that there is a hereditary factor in testicular cancer, and a racial one as well,
which has yet to be identified. Caucasian men are seven times more susceptible to this
cancer than are African-American men. Although no substances have been clinically
associated with the incidence of testicular cancer, scientists believe that environmental
conditions are also a factor. The general decline of the earth's environment is probably a
factor in the rising incidence of this type of cancer worldwide.
