Many doctors recommend men between the ages of 15 and 55 perform monthly testicular self-exams, particularly after a warm shower. If you would like to consult with the team at Moffitt Cancer Center about testicular cancer, we can provide prompt and accurate diagnostic services for you.
Full Answer
There are a variety of factors that can raise someone’s risk of testicular cancer, other than his age. These include: A family history of testicular cancer. The race of the individual, as testicular cancer is more common for white men. An HIV diagnosis.
The average age of a testicular cancer patient is 33 years old. While testicular cancer is not a commonly diagnosed disease—one in every 250 men will be diagnosed during their lifetime—it is one of the most prevalent cancers for younger men. It rarely affects boys under the age of 20 (an estimated 6% of cases) or men over the age of 55 ...
Most testicular cancers are first detected by the patient, either unintentionally or by self-examination. Some are discovered by routine physical examination. However, no studies have been done to determine the effectiveness of testicular self-examination or clinical testicular examination in reducing mortality from testicular cancer. An updated systematic review performed on behalf of the U.S. Preventive Services Task Force, published in 2010, found no randomized trials, cohort studies, or case-control studies that examined benefits of testicular cancer screening (whether by physical examination, self-examination, or other screening tests) in an asymptomatic population. [ 2] Likewise, a systematic Cochrane Collaboration review found no randomized or quasi-randomized controlled trials that evaluated the effectiveness of screening by a health professional or patient self-examination. [ 4]
In white men, testicular cancer is the most common cancer from age 20 years to age 34 years and the second most common from age 35 years to age 39 years. [ 6] Approximately 68% of testicular cancers are localized, 18% are regional, and 12% are distant stage at diagnosis. [ 6] . Although there has been no appreciable change in ...
Germ cell tumors (GCTs) of the testis constitute 94% of testicular tumors and include five basic cell types: [ 7]
Testicular cancer is the most common malignancy in men aged 15 to 34 years. [ 2, 3] It accounts for approximately 1% of all cancers in men. Worldwide, testicular cancer has more than doubled in the last 40 years. Incidence varies considerably in different geographical areas, being highest in Scandinavia and Switzerland;
A history of testicular cancer is associated with a higher risk of a contralateral tumor. [ 7, 8] Although not consistently found, infertility, testicular atrophy, twinship, or abnormal semen parameters have been associated with a higher risk of testicular cancer, but the evidence is weak. [ 7, 12 - 14] There is a low cumulative risk of ...
Harms of screening for testicular cancer are poorly quantified. They may include false positive tests [ 22] and resulting anxiety as well as subsequent unwarranted invasive diagnostic procedures. Two systematic reviews found no studies that provided a quantitative assessment of the harms of screening. [ 21, 23]
Testicular cancer is more than four times more common among white men than black men, [ 8, 9] with intermediate incidence rates for Hispanics, American Indians, and Asians. High-risk groups exist. Males with cryptorchidism have 3 to 17 times the average risk. Approximately 7% to 10% of patients with testicular tumors have a history of cryptorchidism. [ 7, 8] Although the association is established, the biological mechanism underlying the association remains uncertain; testicular cancer and cryptorchidism may share environmental and/or genetic risk factors; or, it is the ectopic position per se that is a postnatal risk factor for testicular cancer, or it is a combination of the two. [ 7] Orchiopexy may not prevent cancer in these children but allows clinical surveillance of patients with a previously impalpable gonad.
Overall, testicular cancers are rare, yet they are the most common form of cancer in young men between the ages of 15 and 35 years.
Of the options available, a firm, painless testicular enlargement is commonly identified as the first sign of testicular cancer.
The risk of testicular cancer is 35 to 50 times greater in men with cryptorchidism or in those with a history of cryptorchidism than it is for the general male population. This is not true of the other options.
Bacterial prostatitis can exhibit common manifestations that include a sudden onset of malaise, low back and perineal pain, high fever (up to 40° C [104° F]), and chills, as well as dysuria, inability to empty the bladder, nocturia, and urinary retention. Myalgia and arthralgia also may occur. This selection is the only option that exhibits the symptoms described.
The first sign of puberty in boys is an enlargement of the testes and a thinning of the scrotal skin.
In 95% of cases, delayed puberty is a physiologic delay; that is, hormonal levels are normal and the hypothalamic-pituitary-gonadal (HPG) axis is intact, but maturation is happening slowly. This selection is the only option that accurately describes 95% of those with delayed puberty
Of the options available, a firm, painless testicular enlargement is commonly identified as the first sign of testicular cancer.
The risk of testicular cancer is 35 to 50 times greater in men with cryptorchidism or in those with a history of cryptorchidism than it is for the general male population. This is not true of the other options.
Being over 65 years of age increases the risk for developing prostate cancer. ANS: B, C, D, E. Prostate cancer is the most commonly diagnosed non-skin cancer in American men, and the incidence varies greatly worldwide.
A 24-hour urine test is required to diagnose the disorder. e. Treatment includes appropriate antibiotic therapy. ANS: A, B, C, E. Symptoms of urethritis include urethral tingling and itching or a burning sensation on urination (dysuria), frequency, and urgency.
Bacterial prostatitis can exhibit common manifestations that include a sudden onset of malaise, low back and perineal pain, high fever (up to 40° C [104° F]), and chills, as well as dysuria, inability to empty the bladder, nocturia, and urinary retention. Myalgia and arthralgia also may occur.
Mixed precocious puberty (i.e., virilization of a girl or feminization of a boy) causes the child to develop some secondary sex characteristics of the opposite sex. This selection is the only option that accurately identifies the type of precocious puberty described.
The first sign of puberty in boys is an enlargement of the testes and a thinning of the scrotal skin.
This is called a varicocele. If your testicle seems larger, have a doctor examine you to be sure you have one of these conditions and not a tumor. The doctor may order an ultrasound exam (see Tests for Testicular Cancer ). This is an easy and painless way of finding a tumor.
Hold your testicle between your thumbs and fingers with both hands and roll it gently between your fingers. Look and feel for any hard lumps or nodules (smooth rounded masses) or any change in the size, shape, or consistency of your testicles.
You should also be aware that each normal testicle has a small, coiled tube called the epididymis that can feel like a small bump on the upper or middle outer side of the testis. Normal testicles also contain blood vessels, supporting tissues, and tubes that carry sperm.
Most doctors agree that examining a man’s testicles should be part of a general physical exam during a routine check-up.
Because regular testicular self-exams have not been studied enough to know if they reduce the death rate from this cancer, the ACS does not have a recommendation on regular testicular self-exams for all men.
Testicular imaging with trans-scrotal ultrasound is the primary imaging modality to identify testicular cancer when suspected on physical examination. [39][40][41] Ultrasound imaging, when combined with a physical examination, provides nearly 100% sensitivity in the diagnosis of testicular cancer.[42] Testicular cancer is suspected when an ultrasound reveals a hypoechoic, solid, vascularized intratesticular lesion, and different testicular cancer types show subtle morphologic differences in imaging.[43] Further evaluation should include serum tumor markers (AFP, HCG, and LDH) before any intervention, including orchiectomy. Adequate counseling should be given regarding the possibility of infertility and placement of the testicular prosthesis if desired. Sperm banking should be considered in patients with bilateral testicular pathology. [39][40]
Testicular cancer is the most common malignancy in men aged 15 to 45 years and represents one of the most common curable malignancies when identified promptly and treated with a multimodal approach. It represents 1% of male tumors and 5% of urological malignancies.[1] The incidence of testicular cancer has been increasing over recent years, gaining increased significance due to the long impact both the disease and its treatment can have over the course of a patient's life. Testicular cancer incidence has doubled over the past 40 years.[2]
Genetic risk factors: Multiple genetic changes have been described in the etiology of testicular cancer. The isochromosome of the short arm of chromosome 12 – (i12p) – is pathognomonic of all types of adult germ cell tumors (GCTs), as well as GCNIS. Alterations in p53 have been observed in about 66% of cases of GCNIS. [18][19]Genetic polymorphisms in the PTEN tumor suppressor gene and the risk of testicular cancer (TC) have also been described.[20] Dysregulation in the pluripotent program of fetal germ cells (identified by markers, M2A, C-KIT, and OCT4/NANOG) is thought to be responsible for the development of GCNIS and germ cell neoplasia. Along with this, genome-wide association studies (GWAS) showed evidence of several single nucleotide polymorphisms (SNPs) markers known to have an association with an increased risk of developing testicular cancer, in particular at 15q21.3. [21]
The International Germ Cell Cancer Collaborative Group (IGCCCG)-based clinical staging is used to tailor management strategies in patients with testicular malignancies. All patients are classified as Clinical Stage 0, I, II, or III after imaging and quantification of tumor markers. Stage 0 includes patients with germ cell neoplasia in-situ, stage I includes patients with tumor limited to the testis, stage II patients have lymph node involvement, and stage III patients have distant metastases.
All patients with testicular germ cell tumors should undergo abdominopelvic imaging with computed tomography (CT). Patients with elevated serum tumor markers (AFP, α-fetoprotein; β-hCG, β-subunit of human chorionic gonadotropin; LDH, lactate dehydrogenase) should be evaluated further with computed tomography (CT) of the chest, abdomen, and pelvis for staging.[39] If testicular tumor markers are within the normal range, the rate of metastasis almost outside of the retroperitoneum is very low; therefore, the addition of a chest CT-scan to cross-sectional imaging of the abdomen and pelvis is highly unlikely to alter the treatment plan, and a chest radiograph suffices when combined with abdominopelvic CT imaging. Choriocarcinoma has been shown to spread via hematogenous routes, and patients with high levels of β-hCG should undergo cross-sectional imaging of the brain to identify metastatic lesions due to choriocarcinoma hematogenously spreading to the brain.
With effective management, the prognosis is excellent with >90% cure rate and >95% five-year survival rate. [3][4] Complex environmental and genetic factors are involved in the development of testicular cancer; common risk factors include cryptorchidism, family history of testicular cancer, personal history of testicular cancer in the contralateral testis, age, and ethnicity. Initial evaluation includes history and physical examination, tumor marker assessment, and scrotal ultrasound. Once a solid intratesticular tumor is identified, radical inguinal orchiectomy is performed both for diagnostic and therapeutic purposes. Tumor staging guides further management with options including active surveillance, chemotherapy, retroperitoneal lymph node dissection, and radiation therapy.
Testicular germ cell tumors spread along well-described and predictable lymphatic channels. [45][46] For tumors arising in the right testis, the primary landing zone is the infrarenal inter-aortocaval lymph nodes, followed by paracaval lymph nodes and para-aortic lymph nodes. Tumors arising from the left testis spread primarily to the para-aortic lymph nodes, followed by inter-aortocaval lymph nodes. Retroperitoneal spread from the right side to the left side can be seen in tumors arising from the right testis, but left-to-right spread within the retroperitoneum is rarely seen unless it is associated with bulky lymph node disease.[47] Abdominopelvic cross-sectional imaging is important to identify retroperitoneal lymph node disease arising from primary testis cancer and to inform multimodal treatment.