The L.A.N.C.E. of Testicular Cancer – Part 1

To celebrate the last day of Movember, we’re re-running a two-part post about a men’s health issue that is especially important to male college and graduate/professional students.

The dramatic story of cyclist Lance Armstrong’s cancer survival has raised public awareness of testicular cancer and has made it easier to discuss.  Seizing this opportunity, I want to highlight 5 facts about testicular cancer that everyone must know – the L.A.N.C.E. of testicular cancer.

Lethal.  Most testicular tumors are malignant, meaning that they have a tendency to metastasize (spread) to other parts of the body, like the lymph nodes, lung, and brain.  It is invasion of these other organs, rather than damage to the testicle itself, that leads to serious illness or death.

All men.  Testicular cancer occurs most commonly in Caucasians, but all men are at risk.  The cause of testicular cancer is not known, but there are well-established risk factors:

  • History of an undescended testicle. Even with corrective surgery, an undescended testicle is 3-5 times more likely to become cancerous than a properly descended testicle.
  • A testicle that has not developed properly because of previous trauma, torsion, or mumps infection
  • Family history of a brother who has had testicular cancer.

Numbers.  Testicular cancer is the single most common type of malignant tumor occurring in men ages 15-35.  The incidence of testicular cancer has been increasing in many countries, including the United States.  The American Cancer Society estimates that approximately 8,400 new cases of testicular cancer are diagnosed in the United States each year. 

Curable.  Among all forms of malignancy, testicular cancer is one of the most curable.  If it is diagnosed in an early stage (e.g., while the tumor is still localized to the testicle) the cure rate is nearly 100%.  Even when it is widely metastatic prior to detection, the cure rate with aggressive treatment is greater than 80%.  At a minimum, treatment of testicular cancer requires surgical removal of the cancerous testicle.  Abhorrent as this might seem, it does not typically have any long-term effect on fertility or sexual function, as long as the remaining testicle is normal.  When metastases are present, treatment requires chemotherapy and sometimes radiation therapy or additional surgery.

Early self-detection is critical.  Most testicular tumors are discovered by the man himself, through intentional or inadvertent testicular self-exam, and sometimes even by an intimate partner.  The reality is that testicular cancer discovered during a routine medical examination, or after symptoms have developed, is likely to be much further advanced than one discovered by the man himself.  

If you are worried that you may have an undescended testicle, of if you notice any change in the size or shape of your testicle,  be sure to seek medical consultation as soon as possible.  Next week, we will discuss testicular self-examination.

James R. Jacobs, M.D., Ph.D., FACEP

Director, The Ohio State University Student Health Services