One thing that is consistent for all teenage boys is that no one is talking about what going on "down there!" As young men approach adolescence, the thought of a conversation regarding their testicles is almost ludicrous. Certainly they will not talk to their parents, and the doctor also is likely to get the silent treatment when questioning if they have any concerns regarding their "private parts." One study, however, showed that testicular cancer is on the rise, particularly in the industrialized nations (J. Urol. 2003;170:5-11).
Testicular cancer is rare, accounting for only 1% of all male cancers, but it is the most common cancer for males aged 15-35 years (CA Cancer J. Clin. 2013;63:11-30). Every year there are about 8,300 men diagnosed with testicular cancer, approximately 350 of whom will die (CA Cancer J. Clin. 2011;61:212-36).
Dr. Francine Pearce
Risk factors for testicular cancer are history of undescended testes, family history, and history of contralateral testicular cancer. A screening test has not been found to be beneficial, given the low incidence and high cure rate.
Testicular cancer is very treatable when caught early, with nearly a 90% cure rate with radical orchiectomy and continued surveillance with radiation and or single-agent chemotherapy. When it is not caught early and metastasis has occurred that number decreases to 70% (Eur. J. Cancer 2006;42:820-6).
Testicular cancer is painless, presenting as a lump on the testicle. The testicle may enlarge, feel heavy, or become hard, so it’s not hard to imagine how this can easily be overlooked without regular self-exams.
With this cancer being on the rise, it is imperative that pediatricians educate young men about their risk and teach them how to do self-examinations. Also, using sports physicals and annual wellness exams to do an inspection will aid in early diagnosis, so that even subtle changes can be identified.
We have become very comfortable in educating women that monthly breast exams are important. Testicular exams also are important, and education is the first step in preventing advanced testicular disease.