Testicular Cancer: The Good News
Testicular cancer is rare, but it's the most common cancer in young men between ages 15 and 35. The excellent news is that testicular cancer has one of the highest cure rates of any cancer, especially when caught early. At Riverstone Urology, Dr. Libby helps men understand their risk, perform effective self-exams, and provides expert diagnosis and treatment when needed.
Self-Exam: Your First Line of Defense
Monthly testicular self-exams are the best way to detect testicular cancer early. The ideal time to perform an exam is after a warm bath or shower when the skin is relaxed. Gently feel each testicle by rolling it between your fingers and thumb, checking for lumps, swelling, changes in texture, or areas of hardness. It's normal for one testicle to be slightly larger or hang lower than the other. You're looking for new changes compared to your baseline. If you notice anything unusual, contact Dr. Libby right away.
Warning Signs
See a doctor if you notice: a lump or swelling in either testicle, pain or aching in the testicles or groin, a feeling of heaviness in the scrotum, or chest tenderness (in rare cases). Many of these symptoms can be caused by benign conditions, but it's important to have them evaluated promptly.
Diagnosis
If you feel a lump or have symptoms, Dr. Libby will perform a physical exam and order an ultrasound, which is the best imaging tool for evaluating testicular masses. If cancer is suspected, blood tests measure tumor markers (AFP, beta-hCG, and LDH) that help confirm the diagnosis and guide treatment. A biopsy is rarely needed before surgery.
Staging and Prognosis
Testicular cancer staging involves determining how far the cancer has spread. This may require imaging of the abdomen, chest, and pelvis. The stage, tumor type, and tumor marker levels all influence treatment decisions and prognosis. Even advanced testicular cancer has excellent cure rates, often exceeding 95 percent with appropriate treatment.
Treatment: Orchiectomy
The primary treatment for testicular cancer is surgical removal of the affected testicle, called an orchiectomy or radical inguinal orchiectomy. This surgery is performed through a small incision in the groin and has minimal morbidity. Removing the testicle does not affect sexual function or fertility if the other testicle is healthy, and hormone replacement is typically not necessary. Many men return to normal activities within one to two weeks.
Additional Treatment Options
Surveillance
For early-stage disease, active surveillance with regular imaging, blood tests, and follow-up visits may be appropriate, avoiding unnecessary chemotherapy.
Chemotherapy
For more advanced cancers or certain high-risk features, chemotherapy provides excellent cure rates. Dr. Libby works with medical oncologists to coordinate your care.
Retroperitoneal Lymph Node Dissection
In select cases, surgery to remove lymph nodes in the abdomen may be recommended.
Fertility and Sexuality
Testicular cancer and its treatment can affect fertility and sexual function. Sperm banking before surgery or chemotherapy may be an option if you're concerned about future fertility. Dr. Libby discusses these important considerations with you before treatment begins.
Follow-Up Care
After treatment, regular follow-up appointments and imaging are essential to monitor for recurrence. The frequency decreases over time as your cancer-free survival extends. Most recurrences occur within the first two years, so diligent follow-up early on is crucial.
Young Men's Health Matters
If you're a young man with concerns about your testicles or have been diagnosed with testicular cancer, Dr. Libby is here to provide expert, compassionate care. With early detection and modern treatment, testicular cancer is highly curable.