Testicular Cancer: Signs, Risk Factors, and Insights for Young Men

Testicular Cancer is amongst the most common cancers affecting young men (15-40 years). More importantly, testicular cancer is one of the most treatable cancers of the human body and the key to successful treatment lies in timely detection. Hence, it is time to take the matter into your hands and learn about Testicular Self-Examination (TSE).

When and how should Testicular Self-Examination (TSE) be done?

The best time to perform a Testicular Self Examination is after a warm bath or shower as the scrotum is relaxed, making it easier to detect any abnormalities.

• Correct position for Self-Examination: Standing, sitting, or lying down. It can be done in any position which makes you feel relaxed and comfortable.
• Support the scrotum: Use one hand to support the scrotum (testicular sacs) and gently lift each testicle, one at a time, with the other hand.
• Examine each testicle: Gently roll each testicle between your thumbs and fingers– feel for any lumps, swelling, hardness, or any change in texture. Also note any tenderness, discomfort, or any visible changes in size, shape, or consistency of the testicles.

Remember, one of the testicles may be slightly larger or slightly lower than the other, which is normal.

How often should one do TSE?

It is generally recommended to do TSE once a month. Initially, one could do it more frequently to gradually get used to it and understand normal variations.

What are some risk factors for testicular cancer?

The following are the key factors that increase the risk of having testicular cancer:
1. Age: Testicular cancer can affect any age but most commonly affects males between age 15-44 years.
2. Undescended testes: If one or both testicles are not felt in the testicular sac, it is referred to as undescended testes (or cryptorchidism). This condition increases the chances of having testicular cancer
3. Family History: Having a close relative, such as a father or brother, with a history of testicular cancer increases the risk.
4. Personal history: Men who have previously been diagnosed with testicular cancer in one testicle have a higher chance of developing cancer in the other testicle.
5. HIV infection: Individuals with Human Immunodeficiency Virus (HIV) have a higher risk of developing testicular cancer.

Apart from this, genetic syndromes such as Klinefelter’s syndrome or exposure to environmental chemicals or pesticides can increase the risk of testicular cancer. It's important to know having one or more risk factors does not necessarily mean they will develop testicular cancer. 

Conversely, some individuals diagnosed with testicular cancer may not have any identifiable risk factors. Nonetheless, being aware of the risk factors can help individuals understand their susceptibility and take proactive steps, such as regular self-examination and seeking medical advice if they notice any concerning symptoms.

Is testicular cancer completely curable and how?

If detected timely, the testicular cancer is completely treatable. The key is early detection. When a person has a suspicion of testicular cancer, they will undergo some investigations such as tumor markers in a blood sample and imaging like ultrasonography of the scrotum and CT scan. The treatment of testicular cancer primarily involves surgical removal of the testis followed by either surveillance, chemotherapy, or radiation therapy depending upon the stage of the disease. Sometimes, another surgery for removing any lymph nodal lump in the belly (lymph nodes) is also needed depending upon the disease stage and response to therapy. With the help of robotic surgery in the current era, these surgeries can be done with minimal incision and extreme precision, causing the least morbidity.

Can one bear a child once they have been detected with testicular cancer?

Yes, because only the testis which is affected by testicular cancer is removed and the other testicle is mostly enough to help produce sperm and hormones for bearing children. However, chemotherapy and radiation therapy might have detrimental effects on an individual's fertility, and hence, sperm banking and cryopreservation are always offered before going in for such therapies.

Warning Signs and Symptoms for Testicular Cancer:

• A painless lump 
• Swelling, with or without pain
• A feeling of weight in the testicles
• Pain or dull ache in the testicle, scrotum, or groin