Man-To-Man—Let’s Talk Testicular Cancer
So you’ve been self-checking and found a lump—what now? If this has happened to you, you’re not alone. Researchers estimate that 8,000 men receive a testicular cancer diagnosis every year.
But while there’s power in numbers, knowing that this new-found lump might make you a statistic is less than comforting. You’re bound to have some questions, and that’s normal.
However, just because you found a lump on your testicles doesn’t mean you have testicular cancer. A lump could be a number of things, most of which aren’t linked to testicular cancer. It may be something as simple as a cyst, or something more serious like a testicular torsion that needs immediate medical attention.
Either way, a lump should never be ignored, and you should see your urologist as soon as possible. There are a number of tests that will need to be done to determine if the lump is cancerous or not. If it is, more testing will determine what stage of cancer is present.
We want to discuss this process with you, so you know exactly what to expect if you find a lump on your testicles. By remaining transparent, we hope to shed light on and bring awareness to testicular cancer this Testicular Cancer Awareness Month.
The First Step After Discovering A Lump: Visit Your Urologist
When you discover a lump, it’s crucial that you visit your urologist as soon as possible. When you visit your urologist, they will be able to examine the lump through a series of tests to determine if it is cancerous. Here are some of the tests you may likely experience:
Ultrasound
This is typically the first test conducted and allows your urologist to get a better look at the lump. An ultrasound sends sound waves into the testicles and scrotum to get a picture of what’s going on. Additionally, a urologist can see if the lump is filled with fluid or not, or if it’s inside or outside of the testicles.
Blood test
By conducting a blood test, your urologist can examine the tumor marker levels in your blood. Everyone naturally has tumor markers in their blood, but if cancer is present these levels may be elevated.
While high tumor marker levels don’t necessarily mean you have cancer, these levels will help your urologist come to a more correct diagnosis. When a urologist looks at the tumor marker levels in the blood, especially when testicular cancer is suspected, they keep an eye out for elevated levels of these markers:
- Alpha-fetoprotein. Also known as AFP, this protein is normally only noticeable in pregnant women because it is needed to produce a fetus. In grown men, and women who are not pregnant, this protein should be undetectable. High levels of this protein may suggest to a urologist that cancer or a tumor is present.
- Beta Human Chorionic Gonadotropin. Beta-hCG is also a hormone only found in pregnant women. When high levels are detected in the urine or blood of men (or women who aren’t pregnant), urologists may determine cancer is present.
- Lactate Dehydrogenase. While LDH doesn’t normally aid in the diagnosis of testicular cancer, elevated levels may suggest widespread damage or cancer. If these levels are high, your urologist may suggest further testing.
Orchiectomy
Also known as a testicle removal, an orchiectomy may be a necessary result if tumor marker testing confirms the presence of cancer in a testicle. While this outcome is not ideal, losing one testicle should not make a man infertile or reduce their sex drive.
Once your urologist determines the makeup of the lump, they can recommend next steps. If cancer is detected, further tests will need to be done to determine the staging of the cancer.
What To Do If Testicular Cancer Is Detected
If your urologist feels confident that you may have testicular cancer, you will need to visit with a certified pathologist. Pathology, in its most simplistic definition, is the study and diagnosis of disease. A pathologist will be able to look at the state of the tumor and determine the stage of cancer it is in.
Staging is the process of determining how far the cancer has spread. This step is crucial in figuring out treatment options for testicular cancer.
Below, we are going to discuss the tests that will need to be completed in order to determine the stage of cancer present, and then talk about what each stage means in terms of next steps.
Tests To Determine Testicular Cancer Staging
Computed Tomography Scan. A CT scan uses x-ray beams to take detailed pictures of the scrotum, testicles and body. These pictures will then be uploaded to a computer, which will transform the pictures into a detailed cross-sectional image.
A dye may also be injected into the veins, which will be highlighted on the scans to give more clarity. This dye is especially helpful when determining if the cancer has spread, and if so, where. This process is also known as lymphangiography.
Magnetic Resonance Imaging. During an MRI, radio waves and magnetic fields take photos of the scrotum, testicles and body—instead of an x-ray. An MRI isn’t a common staging method for testicular cancer though. A CT scan can produce the same results for a lower price.
If the cancer looks like it has spread and is traveling to distant lymph nodes, more testing like bone scans and chest x-rays may be performed.
Once these tests are complete, a pathologist can determine the staging of the tumor.
The Stages of Testicular Cancer
Stage 0
In Stage 0, abnormal cells have been identified but no cancer is present. These cells may develop into cancer over time, so it’s important to keep an eye on the affected area going forward.
Urologists can only determine Stages I through III after performing an orchiectomy.
Stage I
If a tumor marks as Stage I, that means cancer is present. Stage I breaks down into three parts: IA, IB and IS.
- In IA, the cancer resides in the testicle and epididymis (the tube connected to the testicle that stores sperm) and tumor markers are normal. Cancer may have also moved to the membrane surrounding the testicle.
- During IB, the cancer is in the testicle and epididymis and has either spread to the blood or lymph vessels, the membrane surrounding the testicle, or the testicular cord (which contains nerves, lymph vessels and the vas deferens). Tumor markers are also normal.
- In IS, cancer resides anywhere in the testicle, testicular cord or scrotum. During this stage, tumor marker levels are slightly above normal or high.
Stage II
Similar to Stage I, Stage II divides into three parts: IIA, IIB and IIC.
- In IIA, cancer is in the testicle, testicular cord or scrotum and has spread to no more than five lymph nodes in the abdomen. In this stage, the lymph nodes are no larger than two centimeters and tumor marker levels are slightly above normal or normal.
- During IIB, cancer is in the testicle, testicular cord or scrotum and has either spread to more than five lymph nodes (less than two centimeters), or less than five lymph nodes that are larger than two centimeters but smaller than five in the abdomen. Tumor markers are also normal or slightly above normal.
- In IIC, tumor markers are normal or slightly above normal. Cancer has spread to the testicle, testicular cord or scrotum as well as a lymph node in the abdomen that is larger than five centimeters.
Stage III
Stage III divides into IIIA, IIIB and IIIC.
- In IIIA, cancer is in the testicle, testicular cord or scrotum and has spread to more than one lymph node in the abdomen, and to distant lymph nodes or to the lungs. Here, tumor marker levels may be normal or slightly above normal.
- During IIIB, cancer is in the testicle, testicular cord or scrotum and may have spread to more than one lymph node in the abdomen, or a distant lymph node, or to the lungs. Again, tumor markers are normal or slightly above.
- In IIIC, the spread of cancer is the same as stage IIIB, but tumor marker levels are high. Stage IIIC can also mean that cancer is in the testicle, testicular cord or scrotum, is in one or more lymph nodes in the abdomen and has not spread to distant lymph nodes or the lungs, but rather to other parts of the body. Tumor marker levels will also be high.
How To Cope With A Testicular Cancer Diagnosis
Receiving the news that you have testicular cancer is never easy to hear, but there is hope after diagnosis. Testicular cancer is one of the most treatable and curable cancers—the five-year survival rate for men is 95 percent!
Treatments vary from man to man, and depend greatly on what stage of cancer is present. The key to making it through any treatment, no matter how difficult, is to remain hopeful.
Spreading Hope Through Diagnosis and Beyond
While April is Testicular Cancer Awareness Month, is it also the National Month of Hope. Here at the Urology Specialists of the Carolinas, we want to spread awareness about testicular cancer as well as give hope to those fighting and those who have yet to be diagnosed.
Our team of urologists cares, and we want to be with you through check-ups, treatments, diagnoses and more if you find yourself battling a testicular cancer diagnosis. You shouldn’t have to walk this journey alone—let us help.
Testicular cancer is most common in men between the ages of 15 and 35. It is so important to self-check frequently, and make regular appointments with your urologist. If at any point you find a lump, you should be able to catch and treat it in time with the support of our urologists.
As a man, it’s up to you to make sure the men in your life realize the importance of self-checking regularly. That way, we can all work together to fight testicular cancer and spread awareness to men everywhere.
For more information on male health, download our Man-To-Man Guide On Healthy Aging below.