percent of cancer in those aged 15 to 34. There is another, though lesser, peak risk period among men in their seventies. Caucasians with the disease outnumber African Americans four to one. Testicular cancer typically appears as a firm, painless lump or swelling in the front part of a testicle. Some men have also described a dull aching or heavy sensation located in the lower abdomen, groin, or scrotum, and swollen lymph nodes in the groin. About 95 percent of testicular cancers arise in the sperm making germ cells. The cause is unknown, but men who have an undescended testicle have about a fivefold increase in risk for developing the disease. There has been a marked increase in both undescended testes, or cryptorchidism, and testicular cancer in the last 40 years, especially among white males. Some researchers attribute this rise to mothers using hormones just before or during pregnancy. Studies have found a twofold increase in undescended testes among males born to women who took oral contraceptives in the month before conception. Risk was also increased by the use of DES, an artificial estrogen given to women until the late 1960s to prevent a threatened miscarriage. Possible risk factors for testicular cancer include exposure to cadmium and other industrial chemicals or metals.
Diagnostic Studies And Procedures
Any lump, swelling, or change in the way a testicle feels calls for prompt medical investigation. An ultrasound examination of the scrotum can locate the lesion and differentiate it from other conditions, such as epididymitis, an inflammation of a cordlike structure on the back of the testicle. A biopsy confirms the presence of cancer. If cancer is diagnosed, X-rays, CT scans, and other imaging studies of the abdomen and chest will be ordered to determine whether it has spread. Additional tests may include a urine flow study, or program, to detect any obstruction of the urinary tract; blood tests for various tumor or genetic markers; lymphography, X-ray depiction of the lymph system; and possible scans of the liver, brain, and bones.
Medical Treatments
Treatment usually begins with surgical removal of the entire testicle through inguinal orchiectomy, an incision in the groin. However, in some cases, radiation or chemotherapy alone is sufficient. Depending upon the cancer type and extent of any spread, surgery may be followed by radiation, chemotherapy, or a combination of the two. Even after treatment is complete, frequent checkups are important to spot any recurrence as early as possible. Testicular cancer is highly curable when detected and treated early.
Alternative Therapies
There is no substitute for medical treatment in dealing with testicular cancer, although such alternative therapies as meditation, self hypnosis, and visualization can help control pain and foster a sense of well being.
Nutrition Therapy
Some naturopaths recommend zinc supplements for men who have testicular tumors, based on laboratory findings that zinc injections sometimes shrink these cancers in animals. However, this treatment has not been studied scientifically in humans; indeed, there is some evidence that excessive exposure to zinc may actually promote testicular tumors.
Self Treatment
Early detection is the key to curing testicular cancer, and monthly self examination is the best means of early detection Men who find an abnormality often delay seeing a doctor, perhaps because they believe that removal of one or both testicles will prevent normal sexual intercourse. This fear is unfounded; a man can still achieve a normal erection following removal of one or both testicles. However, the cancer treatment may result in infertility; thus, he may want to have some of his sperm frozen for future use. Another important preventive step involves early treatment of an undescended testicle. Even after treatment, anyone born with an undescended testicle should be particularly conscientious about regular self examination.
Other Causes of Testicular Abnormalities
An injury to the scrotal area, a hernia, and epididymitis are among the benign conditions that can cause testicular swelling or lumps.