In the medical world—and especially the genitourinary (GU) world – we’re pretty comfortable having candid conversations about what’s going on below the belt. After all, the “genito” half of our name refers to diseases of the genital organs. April is testicular cancer awareness month and there’s no need for the testes to be a taboo topic. Awareness is key to early detection, so here are 8 things you should know about testicular cancer:
- It can develop in one or both testicles. Our bodies aren’t always exactly symmetrical and the same can be said for cancer development. Just because cancer develops in one side, it doesn’t guarantee that the other testicle will be affected.
- You shouldn’t feel pain. Testicular pain isn’t normal. Visit your primary care physician and inquire about getting an ultrasound to get a better picture of what’s going on. You may also need a referral to a urologist.
- Self-examinations are important. Make an effort to get in a regular habit and aim for once a month. The more you’re familiar with what’s normal for you, the easier it will be to spot something that isn’t right. Not all lumps and bumps mean cancer, but it is important to get them evaluated.
- Certain men are at increased risk. While testicular cancer can affect males of all ages, most new cases occur in men between the ages of 20-34. Other risk factors include men who were born with undescended testes (when the testes don’t move into the scrotum during development), men with Klinefelter’s syndrome (two or more X chromosomes), men with a family history of testicular cancer and certain familial cancer syndromes (inherited cancer genes).
- Testicular cancer has one of the highest cure rates. We have a number of successful ways to treat testicular cancer, including surgery, radiation, and chemotherapy. Seek out a specialist for evaluation if you sense something is wrong as early detection can minimize the amount of treatment needed. A typical initial work up will include an ultrasound and blood tests, and then possibly a CT scan to get a better picture of what’s going on in your body from a variety of different angles. With proper treatment nearly everyone will be cured, including those with cancer that has spread to other parts of the body.
- A diagnosis doesn’t mean you can’t have kids. Most men are able to successfully father children following treatment, but there are occasional situations in which prior history, cancer, or the nature of the treatment can prevent it from happening naturally. Some centers (such as ours) are able to extract sperm, which can be utilized for fertilization. Before starting treatment, ask about your options to preserve fertility, including sperm banking.
- It doesn’t signal an end to your sex life either. Following treatment, sexual function should be normal.
- Some treatments should only be performed at centers of excellence. For example, in today’s treatment era, some men only need removal of the affected testicle. These men can be spared additional surgery, radiation, and/or chemotherapy that might have been administered in the past, but they remain at risk for tumor recurrence that might be missed in less experienced hands. A type of surgery called retroperitoneal lymph node dissection (RPLND) should only be performed by someone with specialized experience in this procedure. Additionally, certain types of chemotherapy regimens are very complicated and require autologous stem cell support (bone marrow transplant) to achieve cure. We happen to offer all of these specialized approaches.
A version of this article was first published on April 30, 2016.
Babak B. Navi, MD, MS
What's New in GU? 