Testicular Cancer Awareness Month: Know the signs, symptoms and risk factors

Testicular cancer might have a 95 percent cure rate and be relatively rare, affecting less than 1 percent of men ages 15 to 44—but this doesn’t mean they shouldn’t take it seriously. During Testicular Cancer Awareness Month, it’s vital to know the signs and symptoms, the importance of regular self-exams and why, if something feels abnormal, delaying medical attention could lead to more serious complications.

Catherine Gu, MD, a urologist at Trinity Health Mid-Atlantic Medical Group’s Comprehensive Urology Langhorne, vividly remembers one patient who came in with severe abdominal pain. The cause? He let a common symptom of testicular cancer go untreated because he was unaware of its implications and hoped it would simply resolve on its own.

“He had a hard, swollen left testicle for three months,” says Dr. Gu. “The reason he had that pain was because the cancer had already metastasized to parts of his abdomen. It can go into the space of the body called the retroperitoneum, which is where the kidneys live. The longest you want to sit on strange testicular findings is a week or two. If it’s not getting better after that, you should come see someone. Testicular cancer can be quite fast moving.”

If caught early, treatment typically involves a radical inguinal orchiectomy, which is the surgical removal of the affected testicle. This outpatient procedure takes an hour at most, with patients going home the same day and having a quick recovery (two to four weeks). However, when the cancer has spread, treatment is more intense, requiring chemotherapy and radiation, in addition to the traditional surgery.

To prevent the latter, it’s important to be aware of any irregularities as soon as possible. According to Dr. Gu, unusual lumps or bumps on the testicles that are either painless or causing discomfort are usually the first indicators of testicular cancer. While a primary care provider can screen for this during an annual wellness visit, Dr. Gu also recommends monthly self-exams beginning at puberty.

“It’s generally easiest to do this after a hot shower or bath,” says Dr. Gu. “You just make sure everything feels about the same consistency—you’re not feeling any bumps or hardness. It is normal for one testicle to be slightly larger than the other, as long as the size difference has been consistent throughout your lifetime. It’s also normal for one side to either hang above or below the other.”

Sometimes, even if something feels concerning, it doesn’t mean a cancer diagnosis. But, stresses Dr. Gu, it’s always better to err on the side of caution.

“I do get men who come in concerned about lumps, but what they’re feeling is a structure called the epididymis that lives on the back of the testicle,” says Dr. Gu. “They’ll feel it and think there’s a lump, especially if they’re doing self-exams for the first time. But that’s a normal structure. That being said, if you have any concerns at all, it’s always better to be safe than sorry and come see a professional.”

In addition to being aware of the signs and symptoms, it’s also important to know the risk factors, which are shaped before a man is even born. Dr. Gu explains that, as testicular tissue—or sperm cells—forms in utero, some don’t reach proper maturity, which can cause problems later in life.

“They have this potency to turn into other things, and that potency stays with you until you hit puberty,” she says. “With all these hormonal changes, those cells are activated and some of them can turn into malignant cells, or cancer.”

Overall, any type of abnormality in testicular formation, such as cryptorchidism—when one testicle fails to drop when it’s supposed to—is a risk factor for testicular cancer. Genetics also increase risk, especially for those with Klinefelter syndrome, which is when a man is born with an extra X chromosome.

Being aware of family history is key, allowing men to know that they’re high-risk, and to take self-exams and annual primary care visits seriously. Additionally, if a high-risk man has a son who is reaching puberty, it’s a good idea to also make them aware of the family history and risk factor.

“It’s important that parents have an encouraging environment of, ‘If there’s anything wrong, please tell me’, especially if you know you have a family history of testicular cancer,” says Dr. Gu. “Teenagers may be more embarrassed to say anything, if there’s lumps, bumps or sudden pain. But it’s important to educate your teens early so that they know to do self-exams and that this is just a health issue. There’s nothing to be embarrassed about.”

If there is a concern, visiting a primary care provider is a great first step. A PCP can order a testicular ultrasound and, if needed, refer to a specialist.

During Testicular Cancer Awareness Month, Dr. Gu shares some words of advice: “A lot of men, especially in these younger ages, do feel more invincible. If they haven’t had any major health events in their life so far, like breaking a bone, a lot of them may not have even touched the medical system at all. But please be proactive about your health – we’re always happy to see you and help you as needed.”

Visit Urology Care for more information on urologic care at Trinity Health Mid-Atlantic and to make an appointment.