Incidence and Mortality
It is projected that 7,600 new cases of
testicular cancer will be diagnosed and 400 men will die of the disease in the
United States in 2003.
Testicular cancer accounts for approximately 1% of all cancers in men. Despite a
slow increase in observed incidence, there has been a dramatic decrease in the
mortality as a result of effective treatments.
Germ cell tumors (GCT) of the testis constitute
94% of testicular tumors and include 5 basic cell types: seminoma, embryonal
carcinoma, yolk sac tumor, teratoma, and choriocarcinoma. Sixty percent of GCT
are seminomas; the remainder are nonseminomatous germ cell tumors (NSGCT).
Almost half of all germ cell tumors contain more than 1 of the 5 cell types.
Unlike most other cancers, this disease is
generally found in young men. In white men, it is the most common cancer between 20 and 34 years of age, the second most common from 35 to 39 years of age, and the third most common from 15 to 19
years of age.
This type of cancer is 4.5 times more common among white men than
black men, with intermediate incidence
rates for Hispanics, American Indians, and Asians.
with cryptorchidism have 3 to 17 times the average risk. There is also an
increased risk in males with gonadal dysgenesis and Klinefelterís syndrome.
Men with a family history of testicular cancer may be at a higher risk of this
A history of testicular cancer
is associated with a higher risk of a contralateral tumor. Although not consistently found to confer a
higher risk, infertility or abnormal semen parameters have been associated with
a higher risk of testis cancer in some studies.
An additional risk factor for the development of
testicular cancer is the presence of carcinoma in situ (CIS). Carcinoma in situ,
if encountered in the contralateral testis, is associated with the development
of contralateral testicular cancer in 50% of patients at 5 years of follow up.
Carcinoma in situ will be found in approximately 5% of contralateral testes
(approximately the same rate as cryptorchid testes).
If diagnosed, CIS is usually treated with low-dose radiation therapy that
usually preserves Leydig cell function and prevents germ cell tumor development.
Approximately 60% of testicular cancers are
localized, 24% regional, and 14% distant stage at diagnosis. Most testicular
cancers are discovered by patients themselves or their partners, either
unintentionally or by self-examination.
Although there has been no appreciable change in
the stage distribution at diagnosis, advances in treatment have been associated
with a 60% decrease in mortality. Testicular cancer is so curable even at
advanced stages, and there are so few cases, that it would be virtually
impossible to document a decrease in mortality associated with screening.
What Are the Symptoms of Testicular Cancer?
The earliest warning signs of testicular cancer
Other symptoms of testicular cancer may include:
- A change in size or shape of a testicle.
- Swelling or thickening of a testicle.
- A firm, smooth, initially painless,
slow-growing lump in a testicle.
- A feeling of testicular heaviness.
Call Your Doctor If:
- Testicular pain.
- Urinary problems.
- A sudden gathering of fluid in the scrotum.
- An abdominal mass or abdominal pain.
- Loss of weight or appetite; fatigue;
lower-back pain; tenderness in the nipples or breast enlargement.
- Very rarely, infertility.
You detect any sort of unusual lump or swelling
in the scrotum. You should have a thorough physical examination as soon as
possible in case the abnormality is cancer. Remember, testicular cancer
discovered early has the highest likelihood of a cure.
Sources: Healthwise and Web MD
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