Kenneth L Abbott, MD, FACP  |  4/10/2023

April Is Testicular Cancer Awareness Month

Many of us think of cancer as predominantly a disease of older people. Televised advertisements for children’s cancer research institutions remind us cancer is no respecter of youth, however. In the vigor and vitality of young adulthood, it is easy to overlook cancer threats, and psychologically a young man seems especially prone to pay little heed to his risks for this disease. This does not mean he can afford to ignore it, particularly when it threatens parts of his body tightly connected to his maleness.

Testicular cancer and related malignancies are the most common to afflict men between ages 15 and 35 years, men in the very prime of exuberant health. Numerically, the threat is not large (around 9000 cases in the United States each year) and the prognosis is among the best in all cancer medicine because of the exquisite sensitivity of the disease to modern treatments. But, as in all things cancer, early recognition and intervention are critical to optimal results. Young men must be aware of their risks and act accordingly.

The disease is most common in white populations for poorly understood reasons, which is not to say men of other ethnicities or heritages need have no concerns. A positive family history or prior personal history of testicular cancer should prompt greater vigilance. Persons infected with the human immunodeficiency virus (HIV) are more prone to developing certain subtypes of testicular cancer.

A specific individual risk for testicular cancer—correctable when intervention occurs early—happens in boys who are born with an undescended testicle. Prior to birth, these organs form within the back of abdomen, then naturally migrate into the scrotal pouch. But not always. We should expect the testicles of an infant boy to find their way “home” before his first birthday. Failure for one (almost always the condition is one-sided) to do so, called cryptorchidism (“hidden testicle”), raises the risk for subsequent cancer development. Ideally, a surgeon should move the undescended testicle into the scrotum before puberty, the earlier the better. Parents of boys, and preadolescent boys themselves, should be aware of this potential problem.

Because of cryptorchidism, and the common presentation of testicular cancer as a feelable lump within the scrotum or uneven enlargement of a testicle, regular self-examination presents a simple, readily available, and inexpensive means of screening. While men of any age do well to conduct such an examination regularly, those aged 15 to 35 years should make a special effort. Educational videos are easy to find online. And your personal health care provider can certainly help. If all else fails, find a willing friend—who knows what might develop? It could be the start of a beautiful, healthy, and long-lived relationship.
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