Get to Know the Most Common Type of Cancer for Young Men

The month of April may be most commonly known for its spring rains and Easter egg hunts, but it is also increasingly becoming recognized as Testicular Cancer Awareness Month. Sounding the alarm on testicular cancer is imperative, as it is the most common cancer in males between the ages of 15 and 35, with 50 percent of cases affecting men 20 to 34 years old.

According to the American Cancer Society’s estimates for 2018, 9,310 new cases of testicular cancer will be diagnosed this year (including 790 in Texas) and it will cause approximately 400 deaths. Testicular cancer is relatively rare, affecting one in 250 men in their lifetimes, and is more likely to occur in males with abnormal testicle development, an undescended testicle or a family history of testicular cancer.

Pat Fulgham, M.D., urologist on the medical staff and medical director of surgical oncology services at Texas Health Dallas, says that testicular cancer affects young men most often, but they are less likely to see a physician as soon as they notice symptoms.

“Testicular cancer is most common in men ages 13 to 20 and 35 to 40-years old and the most common presenting symptom is a painless lump or mass in the testicle,” he explains. “Any change in the scrotum should be evaluated as soon as it is noticed, and men should see their primary care physician, who may refer them to a urologist. The biggest misunderstanding about testicular cancer is that there are no symptoms until it has progressed to an advanced stage. There is no pain associated with it.”

The good news is that the five-year survival rate is as high as 99 percent when the cancer is still local to the testicles. Those rates drop to 73 percent if the cancer has spread to other organs or lymph nodes away from the original tumor, underscoring the importance of early detection.

While some men may not experience any physical symptoms until the cancer is advanced, the most common signs and symptoms of testicular cancer include the following:

  • Swelling or a painless lump in one or both testicles
  • Pain or discomfort in the testicles or scrotum
  • Changes in how the testicles feel
  • A dull ache in the groin area or lower abdomen
  • A sudden build-up of fluid in the scrotum

In rare cases, testicular cancer can also produce breast growth or soreness, as well as the onset of early puberty in boys. If cancer has spread from the testicles to other parts of the body, it can cause lower back pain (lymph nodes), belly pain (lymph nodes or liver), headache or confusion (brain) or a shortness of breath, chest pain or cough (lungs).

If any of these symptoms are present, men should schedule an appointment with their doctors for a physical exam and any necessary diagnostic testing, including ultrasound, blood test for tumor markers, or surgery. While biopsies are common for other types of cancer, testicular biopsy carries a high risk that it could allow the cancer to spread to nearby parts of the body. As a result, if testicular cancer is strongly indicated, a surgeon will remove the tumor, testicle and spermatic cord. Testing will then confirm the type and extent of the cancer, which will assist in creating a treatment plan.

Due to the fact that testicular cancer affects so many young men, one of the most common concerns is the possibility that the cancer and/or the treatment can affect hormone levels and leave a man unable to father children. Patients should discuss the possibility of infertility and the potential necessity to bank sperm before starting treatment.

Once a patient’s team of physicians determines the best course of action based on the type and stage of his cancer, one or more of the following types of treatment will be selected:

  • Surgery
  • Radiation therapy
  • Chemotherapy
  • High-dose chemotherapy with stem cell transplant
  • Surveillance (includes frequent exams, blood tests and scans)

Patients should also talk to their doctors about any available clinical trials.

Once your treatment is complete, it is important to continue seeing your doctor regularly for follow-up appointments. Your physician will want to watch for any troublesome side effects or a recurrence of the cancer, which usually happens in the first two years, if it does come back. It is important to make healthy choices going forward, including proper nutrition, regular exercise, reducing stress, and eliminating or decreasing your use of alcohol and/or tobacco, as well as finding an emotional support system.

For more information about cancer services at Texas Health facilities, visit:

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