By Christopher M. Prior, DO, FAAFP, CAQSM– physician at Sheridan Memorial Hospital’s Primary Care practice
April is Testicular Cancer awareness month. Testicular cancer is the most common solid tumor among males age 15-34 years old. The American Cancer Society estimates almost 10,000 new cases will be diagnosed this year and about 460 deaths. The incidence of testicular cancer is about one per 250 young men, with a peak incidence between ages 30-34 years old. Testicular cancer has an overall five-year survival rate of 97%.
Risk factors include undescended testis, personal or family history of testicular cancer, age, ethnicity, HIV infection, and infertility. Whites, Hispanics, and American Indian/Alaska Natives have the highest rates of testicular cancer. The incidence of testicular cancer has increased over the past several decades for unclear reasons.
Symptoms of testicular cancer include:
- Acute pain in the scrotum or testicles
- Dull ache in the scrotum or abdomen
- Firmness of the testicle
- Painless solid testicular mass
- Scrotal heaviness
- Swelling
Epididymitis is another ailment that can present with similar symptoms to testicular cancer in the same age group. While a clinical exam can help differentiate the epididymitis from testicular cancer, an ultrasound of the scrotum is the imaging test of choice to diagnose these conditions.
The US Preventative Services Task Force recommends against routine screening in asymptomatic men by clinician and patient self-exams. The British Journal of Cancer reports that muscle-building supplements containing creatine, protein, and testosterone enhancing androstenedione increase the risk of testicular cancer by 65%.
Congress passed the PACT Act in August 2022. It included “reproductive cancers of any kind” on the list of presumed conditions for qualifying Gulf War and post-9/11 veterans exposed to toxins from burn pits. In this case, if you were exposed to burn pit toxins and now have testicular cancer, you do not need to prove the exposure caused the cancer because the VA has already established this connection. A claim may be initiated on your own, with the aid of the American Legion, DAV, VFW, or your local Veteran Service Officer Lisa Griffith 307.620.0884 or lisa.griffith@wyo.gov.
Young men must see their medical provider if they have symptoms related to testicular cancer. Survival rates have improved significantly as a result of increased surveillance and improved patient-specific or targeted therapies. Survivors need continued surveillance for possible re-occurrence, cardiovascular disease, infertility, as well complications of therapy.