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The Truth About Testicular Cancer

Did you know that almost 9,000 American men will be diagnosed with testicular cancer this year, and 360 of those will die because they didn't take the time to find out more about it?

Don't be a statistic. Find out all you can to keep your family jewels healthy.

What is It?

Cancer of the testicles is the most common cancer among young men between the ages of 15 and 35, but it can affect any age group. It can be discovered by accident or through self-examination.

While there are 14 types of cancers that originate in the testicles, most begin with the germ cells, where new sperm cells are produced. Such types of testicular cancer fall into two categories:

Seminoma cancer: This is primarily made up of young germ cells, grows slowly and stays relatively immobile. Seminomas account for 40% of testicular cancers.

Non- seminoma cancer: Arising from more mature germ cells, non-seminomas tend to be more aggressive than seminomas. They are also combinations of different cancers in the testes.

The causes of testicular cancer remain a mystery to this day. It strikes young men randomly; though some risk factors have been identified, a specific source has yet to be found.

Thankfully, most testicular cancers can be cured if treated early. And early treatment can be guaranteed by performing a monthly self-exam.

What are the Symptoms?

There are three stages of testicular cancer. A series of tests and scans are required to determine which stage a man is in.

In the first, it remains confined to the testes.

If it progresses, it moves to the retroperitoneal lymph nodes — little glands that filter bacteria — and cancer cells form in the lymphatic fluids located between the diaphragm and the kidneys, near the back.

In its final stage, it spreads throughout the body, potentially to the lungs, brain, liver, and bones. If the cancer is aggressive and left untreated, it can lead to death. 95% of testicular cancers are malignant and spread if untreated.

Testicular cancer can produce any of the following symptoms. It should be noted that these symptoms can also be caused by other harmless conditions, so a urologist's opinion is strongly advised:

— A lump in either testicle; it's typically pea-sized, but sometimes bigger

— Any enlargement or significant shrinking of a testicle

— A change in the consistency of a testicle, usually hardness

— A feeling of heaviness in the scrotum

— A dull ache in the lower abdomen or in the groin

— A sudden collection of fluid in the scrotum

— Pain or discomfort in a testicle or in the scrotum

— Enlargement or tenderness of the breasts

Who is at Risk?

Young men between the ages of 15 and 35 are at the highest risk of developing testicular cancer, though it can strike any man at any time. Still, this kind of cancer is rare, striking four in 100,000 men.

Though the causes are unknown, statistical evidence shows that Caucasian men are at higher risk than Latinos, Blacks and Asians.

Men who were born with undescended testicles (when the testicles develop in the lower abdomen and not the scrotum) have a higher likelihood of getting it. This remains unchanged even if the condition itself is corrected.

Men with other kinds of testicular problems are also at a greater risk of developing this type of cancer. There is even talk of pollutants contributing to the problem, as the incidence of this cancer doubled in the last 30 years. But all these hypotheses remain exactly that: hypothetical.

Perform a Self-Exam

The best way to detect testicular cancer early on is through monthly self-exams, which every man should perform from the age of 15 on. It's simple, fast and painless. The more you do it, the more familiar you'll be with the normal size and texture of your testicles, and thus be better able to detect any abnormalities. Here's what you should do:

1- Take a hot shower or bath. The heat relaxes the scrotum, making it easier to feel through it.

2- Stand in front of a mirror and check for any swelling.

3- Examine each testicle with both hands. Hold them with your index and middle fingers underneath, and gently roll them between your thumbs and fingers.

4- Locate your epididymis, the soft tube behind the testicles that transports sperm. Do not mistake this for a lump, as lumps occur mostly on the front and sides of the testicles.

5- If you find a lump, see a urologist right away. Most lumps are not cancerous, but only an expert can know for certain.

What Can You Do?

There is little a man can do to prevent the onset of testicular cancer, but detecting it early is the best way to cure it. And the good news is that it is almost always curable.

There are four main treatments: surgery, chemotherapy, radiation therapy, and surveillance.

Surgery is the most common, wherein the affected testicle is removed through the groin, a procedure called inguinal orchiectomy. Sometimes it's necessary to remove the lymph nodes in the abdomen if the cancer has reached the second stage, and other tissues if in the third.

Radiation therapy involves the localized application of high-energy rays to destroy cancer cells. Seminomas are highly sensitive to radiation and die promptly. Non-seminomas are much more resistant, so radiation therapy is rarely used on them.

Chemotherapy is the chemical treatment of cancer. This procedure is used more often when the cancer has spread to the body. Drugs are injected periodically and the patient's progress monitored. Cisplatin is widely seen as the perfect testicular cancer drug, curing about 92% of cases.

The Side Effects

Removing one testicle does not interfere with a man's ability to have an erection, experience orgasms, or bear children — one testicle can do the job of both. Implants exist to replace a removed one, which have the same weight and feel as the original.

Removing the lymph nodes has no effect on erections and orgasms, but can cause infertility because the operation interferes with the nerve mechanics of ejaculation. Men undergoing this type of surgery should ask their doctors about any alternatives that can spare these nerves.

Normal cells are also affected by radiation therapy, but can recover. Radiation therapy doesn't affect sexual performance, but it can damage sperm production temporarily, usually for a few months. Physical side effects include fatigue, diarrhea and nausea. Some skin irritation is possible, and doctors should approve any lotions or balms.

Chemotherapy causes the most serious side effects. These include hair loss, loss of appetite, suppressed immunity to disease, nausea, vomiting, and mouth sores. Chemo also affects sperm production. Some men recover in a few years; for others, infertility is permanent.

Every man who is treated for testicular cancer is monitored over several years to ensure the disease is completely gone.

How to Cope

Finding out you have cancer is hard. Mixed, often volatile emotions swell up, like confusion, fear, numbness, denial, and anger. Some men isolate themselves, bringing further damage to themselves and those close to them.

It's important to talk about your concerns with family, doctors and friends. It assuages fears and lets you know that others are there for you. But the victim needs to initiate the dialogue. Forcing a man to open up can be counterproductive.

Support groups and social service clinics are a trusted source of information and comfort, and should be liberally consulted.

But mostly, a man should have the courage to seek help when he discovers he has cancer and calm the worries of those nearest to him.

An Ounce of Prevention

Although testicular cancer is rare, it selects its victims semi-randomly. A man should do his monthly self-checks religiously, especially if he falls in the risk groups. And since the disease is highly curable, there's no reason not to get it checked right away. Lance Armstrong is living proof that testicular cancer can be treated.

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