What You Should Know About Testicular Cancer
The overall incidence of testicular cancer accounts for about one percent of all male cancers. Although this is a small number, it is still the most common cancer found in men aged 15 to 35. Testicular cancer is more common in white men than in black men, but any man, no matter what age or race, can develop it.

Fortunately, when testicular cancer is detected early, the possibility of long-term survival is high. This cancer usually occurs only in one testicle, and the other testicle may be used for sexual function or to have children.

Testicular cancer may be broadly classified into two types. Seminomas make up about 30 percent of all testicular cancers. Nonseminomas are a group of cancers that include choriocarcinoma, embyonal carcinoma, teratoma and yolk sac tumors. A testicular cancer may have a combination of both types.

This Web page is designed to give you the information you need to understand and detect testicular cancer. Let’s start by answering some basic questions.

What Are the Testicles?
The testicles, sometimes called testes or gonads, are a pair of male sex glands. These smooth, ovalshaped organs are suspended below the penis in a saclike pouch called the scrotum. Their job is to produce and store sperm. They are also the body’s main source of male hormones. These hormones produce male characteristics, such as facial hair and a lower-pitched voice, and they control the development of the reproductive organs.

What Are the Risks for Developing Testicular Cancer?
All men, especially those under age 40, have some possibility of developing testicular cancer, but some have higher risk factors. Risk factors are things that increase your chance of developing the disease. If you fall into any of the following groups, you should be aware that your risk for developing testicular cancer is increased. However, not everyone at high risk develops testicular cancer. Risk factors include:

 - a testicle that has not descended into the scrotum. This
   is true even if surgery is performed to place the testicle
   in the scrotum. Testicles normally descend into the scrotal
   sack before birth. Parents should have their infant sons
   examined by a doctor to be sure the testicles have properly
   descended.If not, the condition may be corrected with surgery,
   which should be done before age three.
 - abnormal testicular development
 - Klinefelter’s syndrome, a sex chromosome disorder that
   may cause low levels of male hormones, sterility, breast
   enlargement and small testes.
 - a personal history of testicular cancer.

If you have a strong family history of testicular cancer, you may want to learn more about genetic testing and what it means for yourself and your family by contacting the genetic counseling program offered by the SLUCare Division of Hematology and Oncology at Saint Louis University Hospital. This comprehensive, confidential program can help you and your family members identify your testicular cancer risks, take steps that may help reduce the risk and undergo screenings to detect cancer in its early stages. Intensive education and counseling are important parts of the program.

What Are the Symptoms of Testicular Cancer?
The following symptoms may be caused by testicular cancer or by other conditions. If you have any of these symptoms, it is important to see your doctor to determine their cause:

 - a small, hard, painless lump, usually about the size of a
   pea on the front or sides of the testicle
 - any enlargement of a testicle or a change in the way it feels
 - a feeling of heaviness in the scrotum
 - a dull ache in the lower abdomen or groin (the area where
   the thigh meets the abdomen)
 - a sudden collection of fluid in the scrotum
 - pain or discomfort in a testicle or in the scrotum

How Is Testicular Cancer Detected?
Your doctor usually examines your testicles during routine physical exams, so it’s important you have regular checkups. However, many testicular cancers are found by men themselves, since they are most familiar with the normal size and consistency of their testicles. Take three minutes out of every month to perform the following four-step self-examination.

1. First, use a mirror to look for any swelling on the scrotum. Remember that in many men, the left testicle descends somewhat lower than the right testicle.

2. Since a warm environment causes the scrotal sac to descend – making it easier to find a change or a lump – perform the rest of the self-examination while showering or bathing. Examine each testicle gently with both hands. Hold the scrotum in the palm of one hand. Feel each half of the scrotum separately, using the thumb and forefinger of the other hand. Use a gently rolling action to examine the entire testicle. If you notice a small lump, an enlargement of the testicle or a change in the consistency of the testicle, contact your doctor right away.

3. Next, locate the epididymis, a cordlike structure that extends behind the testicles. It stores and transports sperm. It is important to identify the epididymis, so you do not mistake it for a tumor. Normally it is shaped like a comma. If feels soft and is slightly tender when compressed.

4. The last step is to locate the spermatic cord, which also helps transport sperm. It ascends from the epididymis. You should be able to follow the spermatic cord upward along its entire course from the epididymis to the external inguinal ring. Normally, it should feel rather firm, smooth, moveable and similar to a small tube.

Cancer Services at Saint Louis University Hospital
Saint Louis University Hospital’s standing as an academic medical center puts it among those at the forefront in developing and providing some of the latest in cancer screening techniques and tests and medical treatment and procedures for cancer patients. For more information, call our Cancer Information Center at (314)577-8833.