Doug Bank was 26 years old when he first discovered a lump the size of a ball bearing in his left testicle. The graduate student knew the bump wasn’t normal, but it didn’t hurt, so he didn’t worry about it right away. At the same time, Bank’s wife was having trouble getting pregnant. Finally — several months after seeing a doctor who didn’t bother with a full examination — Bank went to a urologist who almost immediately suspected a malignant tumor.
A week after an ultrasound confirmed the urologist’s diagnosis, Bank had surgery to remove the cancerous testicle. Fortunately, Bank’s cancer was caught early and hadn’t spread beyond the left testicle. Nine weeks after the operation, his wife became pregnant.
More than 11 years and three children later, Bank is cancer-free, although he still gets a yearly blood test just to be sure. As a cancer survivor and president of the Testicular Cancer Resource Center Web site, he regularly speaks to high school students about the importance of testicular self-examinations for young men.
“Young men need to realize they’re not bulletproof,” says Bank. “How many guys do you know will feel something different, but it doesn’t hurt, so they figure it’ll go away?”
Early detection is key
Testicular cancer is rare, making up only 1 percent of all cancers. It occurs when the cells within the testis grow and divide abnormally, resulting in a tumor. If detected early, it’s often completely curable.
According to the National Cancer Institute, the problem is that the disease is the most common form of cancer among men ages 15-35 — probably the least likely group to regularly visit a doctor or talk about their testicle troubles. In other words, if a young man is going to get cancer, it’s probably going to be testicular.
The cause of the disease is mostly unknown, making it trickier for a young man to know whether he’s at high risk.
In addition, there’s been a steady, gradual increase in the number of men diagnosed with testicular cancer worldwide in recent decades. In the United States, the rate has risen 25 percent over the last 20 years, according to researchers.
Some theories connect diet to the increase in cases. A recent study published in the International Journal of Cancer linked high dairy consumption, especially cheese, with increased risk of contracting testicular cancer. Other studies link testicular cancer with smoking, HIV and a family history of breast cancer.
Whatever the cause, medical experts and doctors are becoming more vocal about the need for young men to check the family jewels on a regular basis. Men are usually the first to find their tumors, doctors say.
“Self-exam is key because our knowledge of why it occurs is so poor,” says Michael Garner of the MacLaughlin Center for Popular Health Risk Assessment at the University of Ottawa and author of a study examining diet and testicular cancer risks. “Once a month doesn’t take very long.”
Less than 20 years ago, the death rate for testicular cancer was about 10 times higher than it is now. Improved diagnosis, advances in drug therapies and greater public awareness have helped boost the cure rate to over 95 percent when caught early.
No more squemishness
Superstar cyclist Lance Armstrong was 24 in 1996 when he was diagnosed with an advanced case that had spread to his lungs and brain. Given only a 40 percent chance of survival, he went on to become a five-time winner of the Tour de France and symbol of triumph over the disease. Olympic skater Scott Hamilton beat testicular cancer 6 years ago and recently became a first-time father to a baby boy. Comedian Tom Green turned his testicular cancer surgery in 2000 into joke fodder for his TV show.
Armstrong and other celebrities get credit for helping many men get over the squeamishness of confronting the disease.
“Now people find an abnormality and see their doctor pretty quickly, much more than they used to,” says Dr. Stephen Williams, an oncologist and director of the Indiana University School of Medicine’s Cancer Center.
Who's at risk?
In general, doctors say the main risk factors for testicular cancer include having:
- An undescended testicle
- An abnormal development of the testicle
- A previous case of testicular cancer
- A family history of the disease.
Because it is typically a fast-growing cancer, recognizing the symptoms is important. The average time from the first symptom to the disease spreading to the lymph nodes is about 3 months, according to Dr. George Bosl, chairman of the department of medicine at Memorial Sloan-Kettering Cancer Center. From the first symptom, it takes about 4 months for the disease to spread to other parts of the body such as the lungs or brain.
The tumor grows quickly, so the longer the delay, the longer the cancer has to grow,” says Bosl.
Treatment depends on the type and stage of the disease, but almost always involves removing the affected testicle. Because the cancer usually doesn’t spread to the other testicle, most of the time the other one is left untouched. Radiation therapy may follow if the disease has moved into the nearby lymph nodes. When the cancer spreads beyond the lymph nodes, it’s most likely to go into the lungs or liver. If it has reached other parts of the body, combination chemotherapy is used for about 9 weeks.
Like Bank, many men can have children after testicular surgery. Chemotherapy reduces fertility, but most men recover their sperm count after treatment, says Williams.
Even though testicular cancer is highly curable, it’s a potentially serious disease with a small group of patients who don’t recover. That’s why medical experts like Williams stress the importance of early diagnosis.
“If you have concerns you should see your doctor,” he says.