Testicular cancer is the most common type of cancer among men 15 to 35 years old, but it can also affect younger boys and older men. For reasons not yet understood, the incidence of this type of cancer has increased considerably in recent years. Fortunately, if detected early it is one of the most treatable cancers. Discovered in most cases by chance, many survivors admit they didn’t exactly rush to seek help. By learning what the warning signs are, we can look out for the men in our life—big and small—and help them overcome this reluctance.

Men’s aversion to visiting the doctor is nothing to joke about and places them at serious risk when symptoms are ignored and doctor visits are delayed. The results of a survey conducted by the American Academy of Family Physicians (AAFP) show that over 50% of men had not received a physical exam in the previous year, approximately 20% did not get the recommended screening for their age and almost 30% said they “wait as long as possible” to see the doctor when they are ill, in pain or concerned about their health. Waiting, obviously, is not something you should do when cancer is involved.

It is estimated some 7,920 men will be diagnosed with testicular cancer—and 370 will die of this disease—in the United States this year, according to the American Cancer Society (ACS). Being the most common cancer to strike young men, it is by no means a frequent occurrence, with the lifetime chance of having testicular cancer currently at 1 in 270 (compared to breast cancer in women, with lifetime odds of 1 in 8). And since it is one of the most curable cancers, the chances of dying are as low as 1 in 5,000, says ACS. 

There are two main types of testicular cancer, but both start when cells begin to grow out of control in one or both testicles.

  • Over 90% are germ cell tumors starting in the cells that produce sperm, known as germ cells.

  • The rest are tumors that grow in the cells that make hormones and in other tissues; these cases, called stromal tumors, are generally benign, but the small percentage that spreads to other organs, becoming metastatic, is considerably more difficult to treat.

Not only is the outlook different, but also the treatment may differ depending on the specific subtype and stage of the disease. Keep in mind that even if testicular cancer spreads to the lung, liver, bone or brain, it is still testicular cancer and treated as such.

Cases of testicular cancer are increasing sharply worldwide for unexplained reasons; and while most men do not know the cause of their disease, these identified risk factors raise the odds of suffering from testicular cancer, as explained by ACS.

  • Undescended Testicle, a condition known as cryptorchidism. These male organs form in the belly of the fetus and descend before birth, but in approximately 3% of boys this does not happen.

  • Family History increases the likelihood slightly, though several cases of testicular cancer in the same family are rarely seen.

  • HIV Infection seems to raise the odds of developing this cancer and so does having AIDS.

  • Carcinoma In Situ (CIS), a benign tumor in the testicles, can become cancer in some cases, though how often this occurs is not clear.

  • Previous History of testicular cancer in one testicle is known to increase the odds in the other by 3 or 4%.

  • Age is a significant risk factor, considering about half the cases of testicular cancer occur between 20 and 34 years of age.

  • Ethnicity makes a difference for reasons unknown: White American men suffer the highest incidence of testicular cancer, followed by Hispanics, while African American have the lowest rates.

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Not all types of testicular cancer cause symptoms and in many cases no pain is associated with early stages, but there are some signs men should watch out for:

  • A lump or mass, of any size, in either testicle.
  • Enlargement or swelling of a testicle.
  • Discomfort or pain in a testicle or in the scrotum.
  • A feeling of heaviness in the scrotum.
  • A dull ache in the lower abdomen, back or groin.
  • Enlargement or tenderness of the breasts (due to the female hormones some, but not all, testicular tumors release).

A moment of awkwardness could save a life, talk about testicular cancer! This is the urgent message you can read at the Testicular Cancer Society’s webpage. Awkward, uncomfortable, embarrassing… The founder of this non-profit organization, a testicular cancer survivor himself, understands men’s shyness when discussing their “private parts”. He even admits to postponing the visit to the doctor—several months!—after discovering a lump.

Men don’t make health a priority, the AAFP reminds us. Fortunately, 78% of the men with a spouse or significant other, surveyed by this physicians’ association, say the person in their life has some influence over their decision to go to the doctor. And unlike many women, men usually don’t have an ongoing relationship with a physician. So, it is no surprise that many survivors credit their significant other for the early detection of their testicular cancer.

In the case of U.S. Olympic swimmer Eric Shanteau, his girlfriend’s persistence got him to see a doctor. Diagnosed at age 24, barely days before the trials for the Beijing Olympics, the swimmer had surgery to remove an early-stage tumor, but decided to forgo preventative chemotherapy, opting for close surveillance instead. Shanteau returned to the Olympics held in London this past summer and has become a LIVESTRONG envoy to raise awareness among young adults.

LIVESTRONG founder, the cyclist Lance Armstrong was diagnosed with metastatic testicular cancer at 25 years of age, when the disease had already spread to his brain, lungs and abdomen. For months he had attributed the warning aches, pains and swelling to his intensive training sessions. Sadly his notorious doping case has eclipsed the message of hope he stands for: how it is possible to survive testicular cancer even in advanced stages. LIVESTRONG cut all ties with the cyclist in 2012 and continues to offer cancer support services.