Signs You Have Testicular Cancer, According to Oncologist
Nobody wants to hear a testicular cancer diagnosis, but the good news is it's very treatable. According to John Hopkins Medicine, "The cure rate is excellent (greater than 95 percent for all men with testis cancer). Only about 400 men will die from testis cancer each year (the chance of death from testis cancer is better than one in 5,000). Because of the excellent cure rate, about 20,000 are surviving with cancer and 200,000 have been cured at any given time in the United States." That said, staying on top of symptoms and early detection is essential to beating testicular cancer. Eat This, Not That! Health spoke with Dr. Murugesan Manoharan, Chief of Urologic Oncology Surgery at Miami Cancer Institute, part of Baptist Health South Florida who shared signs to watch out for and what to know about the cancer. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.
Dr. Manoharan states, "The primary symptom of testicular cancer is a lump or mass in either testicle. Seeing or feeling a mass that comes off the testicle, and it's usually a lot harder in consistency than the normal feeling of a testicle. If men feel a lump or mass, they should go see their doctor, whether it's their primary care physician or a urologist if they have access to one."
Feeling of Heaviness in the Scrotum
Dr. Manoharan says, "It's worth saying that testicular cancer is generally painless. If people complain of pain, it's not really pain — it's more of a discomfort or heaviness if the mass gets bigger. And, the mass can grow big really fast over weeks and months. So, the heaviness from the size of the mass is what creates discomfort."
Shortness of Breath or Coughing Up Blood
According to Dr. Manoharan, "Testicular cancer is highly metastatic and spreads very quickly. Usually, we can catch it early by detecting a small mass. However, when men ignore the masses since they are not painful, then the cancer can spread and this is when rare symptoms can happen. Some patients may have a lung mass as their lungs have been affected by testicular cancer. These patients may get shortness of breath because the normal lung tissues are significantly reduced. Sometimes these patients can even cough up blood. These symptoms are the most worrisome as the cancer has metastasized."
"In instances where the cancer has spread, some patients may develop very large lymph nodes in the retroperitoneum (the area in the back of the abdomen behind the tissue that lines the abdominal wall and covers most of the organs in the abdomen)," Dr. Manoharan says. "As a result, these patients may come in to see us due to back pain. The cause for this pain may turn out to be that the testicular cancer has spread."
Absence of One or Both Testes in the Scrotum
Dr. Manoharan explains, "Patients with absence of one or both testes, usually from birth, might indicate undescended testes. These patients are at a higher risk of developing testicular cancer in the undescended side and opposite side normal feeling testes. Also, the cancer of the undescended testes may be difficult to diagnose as they are mostly inside the abdomen or groin and difficult to palpate."
What Causes Testicular Cancer?
Dr. Manoharan shares, "We find that the incidence of testicular cancer is increasing compared to the incidence rate 10 or 20 years ago. Every five years, the incidence increases about 10 percent. What is the cause of this increase? It's unknown. It's most likely environmental changes that cause genetic mutations that could be resulting in higher rates of testicular cancer. Still, at the end of the day, testicular cancer is rare. It's just that the incidence is increasing over time."
Who is at Risk and Why?
Dr. Manoharan reveals, "White men tend to have more testicular cancer (than men of color), and most develop the disease between the ages of 20 and 34. The other risk factor, in addition to a family history of testicular cancer, is being born with undescended testicles. When a boy is born with undescended testicles, we wait up to a year for the testicles to descend on their own. After one year, if it doesn't descend, we perform a surgical procedure known as orchiopexy to move the testicle down into the scrotum. So, males born with an undescended testicle are at a higher risk of having testicular cancer in the future, even if the orchiopexy was successful. Additionally, men infected with HIV are at risk for testicular cancer."
How Treatable is Testicular Cancer?
"There is no standard practice for testicular cancer screening, " says Dr. Manoharan. Testicular cancer can go undetected in early stages because a painless lump or mass may go unnoticed. Our philosophy at Miami Cancer Institute is to find the plan that not only treats the cancer, but also fits the patient. Our team will consider the patient's specific diagnosis and type of tumor, stage of disease, size and location of tumor and whether it has spread to other parts of the body. Surgery is often the first step to treating testicular cancer. During this procedure, surgeons will remove the tumor and the testicle where it is located (radical orchiectomy). In some cases, this may be the only treatment needed for tumors that have not spread beyond the testicle. It's important to note that surgery to remove the testicle generally will not affect the patient's fertility or ability to maintain an erection. If the cancer has spread, we may recommend surgery to remove the lymph nodes in the retroperitoneum, which is the space behind the lining of the abdomen (peritoneum). This surgery is called retroperitoneal lymph node dissection, or RPLND. During RPLND, the surgeon may also stop blood supply to the cancerous testicle."
Early Detection is Key
According to Dr. Manoharan, " There are preventive measures in terms of early detection, but not in terms of not getting testicular cancer. Men who are going to develop testicular cancer will develop it no matter what. What they can do is to detect it very early before it metastasizes so it can be treated early. Prevention can take the form of self-examination once a month in the shower. We recommend that men between the ages of 15 and 40 perform self-exams. This is the peak time for testicular cancer. Once a month, every man should examine their testicles. The self-exam is done with one hand over each testicle, usually with the thumb and the middle and index finger against the skin. Stretch the skin over the testicle. With the other hand, feel the testicle to see if there is a lump or mass or different consistency. Perform the same self-exam over the other testicle."