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By Dr. Steven Rockoff, MS, MD, FACS
Urologist, UPMC Susquehanna
One in 250 men will develop testicular cancer in his lifetime. It has increased in recent decades and affects younger men, typically between the ages 14 and 44. Fortunately, when detected early, it is highly curable.
Part of the male reproductive system, the testes are located within the scrotum just below the penis. In adult males, each testicle is normally a little smaller than a golf ball. The best opportunity to detect testicular cancer early is through regular self-exam. Routine self-examination ensures early discovery of any changes that should be brought to a doctor’s attention.
Early symptoms to watch for in self-exams:
More advanced stages of the disease can spread to other parts of the body-the lymph nodes, lungs, liver, and brain-making it more challenging to treat successfully. Advanced testis cancer can cause weight loss, fatigue, back pain, stomach pain, shortness of breath, coughing, headaches, and confusion.
To diagnose testicular cancer, doctors often perform an ultrasound to examine any abnormalities found on or within the testis and a blood test to check for elevated levels of tumor markers. To rule out the possibility that the cancer has spread, doctors may order a scan of the chest, abdomen, and pelvis.
Once diagnosed, the first step in treatment is surgical removal through a small
incision in the groin. This procedure should not impact fertility as typically the other testicle remains viable, but men can often bank their sperm before this procedure as a precaution.
A pathology exam of the removed testicle determines the type of testicular cancer and dictates the course of additional treatment: radiation, chemotherapy or lymph node removal. The cure rate for stage one testicular cancer (confined to the testis) is 99 percent. Stage two (spread to the lymph nodes) is 96 percent, and stage three (advanced) drops to 73 percent.
The causes of testicular cancer are not yet known, making it difficult to recommend concrete preventive steps for the disease. For now, a habit of monthly self-examination beginning at puberty, is the best way to detect testicular cancer early when it is most curable.
Dr. Steven Rockoff is a board-certified urologist with UPMC Susquehanna.
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