Testicular cancer, growing as it does in the testicles, probably strikes fear in the heart of most men, especially those who value their fertility. Although testicular cancer is relatively rare as compared to, say, prostate cancer, I'm sorry to report that it is the most common cancer among men aged 15 to 35 (though it occurs in other age groups as well). Most testicular cancer is discovered by the men who have it, either by accident or during a regular testicular exam. The usual symptoms are an irregularity in a testicle, such as a painless lump, a hardening or change in size, or pain in the groin. Of course, such things could be caused by any number of conditions, so should you discover one of them, get thee to a doctor - preferably a urologist - quickly! Testicular cancer is usually curable if caught early.

There are actually a number of different cancers which are lumped under the term testicular cancer. Most grow in the germ cells which produce sperm; the most common of these, seminomas, are slow growing and usually localized, while the less common nonseminoma forms are more aggressive and hence harder to treat. Other forms of testicular cancer, such as sarcomas or lymphomas, are extremely rare.

Like most cancers, testicular cancer may progress through a number of stages, from localized through a spread into the surrounding lymph nodes to full metastatic disease. Surprisingly, considering how difficult the latter is to treat with other cancers, today the vast majority of men whose testicular cancer has metastasized survive after chemotherapy. In the earlier stages, the cancer may be treated by surgery, often using a procedure by the ungainly name of inguinal orchiectomy; this involves removing the entire testicle through the groin. (Taking a biopsy of a testicle still in the body risks having the disease spread locally; it's considered safer to remove the whole testicle.) If necessary, the surrounding lymph nodes are removed. Other treatements include radiation and the dreaded chemotherapy. If caught early, a man may be able to keep one healthy testicle, thus maintaining his sexual function and fertility. Men whose cancer was confined to one testicle and treated with surgery may opt for surveillance as the next step, instead of undergoing debilitating radiation and chemotherapy.

The causes of testicular cancer - which appears to have become much more common in the last several decades - are not known, though the usual lifestyle factors are thought to increase risk (smoking, poor diet, diet high in saturated fats, lack of exercise, stress...you know the drill). Caucasian men have a higher incidence of the disease than men from other racial groups, and men with abnormal testicular development - undescended and the like - are more likely to develop it. Men who have had it in one testicle are more likely to develop it in the other. Monthly testicular exams are considered one of the best preventative measures for testicular cancer.

There are lots of online resources on testicular cancer which have diagrams to show you how to perform a self-exam. Start at
http://www.acor.org/TCRC/
http://www.fda.gov/fdac/features/196_test.html

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