Early Detection Key to Curing Testicular Cancer
The following article was written by PAMF Urologist James Bassett, M.D.
Most young men feel healthy and invincible. Yet this is the population most often stricken with testicular cancer.
Testicular cancer is a relatively common form of cancer. It afflicts approximately 1 in 20,000 men. The American Cancer Society estimates that there will be approximately 8,250 new cases of testicular cancer in the United States in 2006.
While the disease can occur at any age, it most often strikes the young - usually between ages 15 and 35. Fortunately, it's a cancer that can be cured. More than 90 percent of men who receive treatment will ultimately be cured. If caught in the early stages, cure rates are even better.
Although the cause of testicular cancer is unknown, certain factors may increase the risk of developing the disease. Children born with undescended testicles are at 10- to 20-fold increased risk for testicular cancer.
In addition, the cancer is more common in men with a family history of the disease. It's twice as common in whites as in Asians, and five times as common in whites as in African-Americans. Certain occupations may also play a role: testicular cancer is seen more frequently in miners, janitors, and oil and gas workers.
I can't overemphasize that the key to curing testicular cancer is early detection, and the key to early detection is testicular self-examination (TSE). Although testicular cancers occasionally cause pain, most commonly they're detected by finding a painless lump in the testicle or progressive enlargement of the testicle.
It is imperative that adolescent boys be taught how to examine themselves and that they be encouraged to do so regularly. It's best to perform TSE during or after a bath or shower, when the scrotum is most relaxed.
During the TSE, each testicle should be rolled gently between the thumb and fingers using both hands, feeling for any hard lumps or disparity in size of the testicles. Any such changes should be brought promptly to the attention of a physician. Unfortunately, it's all too common for men to delay seeking medical attention. Such delays make curing the disease more difficult.
An experienced physician will often recognize testicular cancer based solely on examination. If there is any question about the diagnosis, an ultrasound may help to confirm the suspicion.
The road to cure begins with surgery to remove the affected testicle. This procedure, called an orchiectomy, can be performed in an outpatient setting using a brief anesthetic. A small incision is made in the groin, and the testicle is removed along with the spermatic cord that leads down to it. Some men choose to have a prosthetic testicle placed inside the scrotum during surgery.
After surgery, CT scanning is done to try to assess whether the tumor has spread. The most common places for the tumor to spread to are the lungs and the lymph nodes within the abdomen.
Depending on the type of tumor, and whether it has spread, further treatment may be recommended, such as radiation therapy, chemotherapy or retroperitoneal lymph node dissection (RPLND) dash; a surgery in which an abdominal incision is made and the affected lymph nodes are removed.
These treatments sound grim, but I encourage my patients to focus on the horizon. The path to cure requires a good deal of work and worry, but the goal is the cure - and in most cases we reach that goal, allowing patients to lead a long and normal life.
One need only call to mind Lance Armstrong, winner of the Tour de France. His cancer was NOT found at an early stage. It had already spread to the lymph nodes of his abdomen and to his brain. But he weathered surgery and chemotherapy, and he survived to win the Tour de France - and to marry and father children. Maybe he is invincible after all.
Dr. James Bassett specializes in urologic surgery at PAMF .
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