Testicular cancer is among the most common cancers in young men...and, for reasons that are not entirely understood, the disease is about four times more common in white men than in black men.  when thinking about testicular cancer there are a few important things consider:  the different kinds or stages of cancer, advice for detecting cancer, and information about treatment.

Let's start with the stages.  There are three stages of testicular cancer:

*Stage 1 -- Cancer confined to the testicle.

*Stage 2 -- Disease spread to retroperitoneal lymph nodes.  These nodes are located in the rear of the body below the diaphragm (a muscular wall separating the chest cavity from the abdomen).

*Stage 3 -- Cancer spread beyond the lymph nodes to other sites in the body.



Now on to to detection....dramatic advances in therapeutic drugs in the last two decades, along with improved diagnostics and better tests to gauge the extent of the disease, have boosted survival rates remarkably. Now, testicular cancer often is completely curable, especially if found and treated early---so early detection is absolutely critical!!

The best way for guys to stay on top of their testicular health is to do regular Testicular Self Examinations or TSE.  This self exam, which shoudl be perfromed regularly, is best performed after a warm bath or shower. Heat relaxes the scrotum, making it easier to spot (or feel) anything abnormal. The National Cancer Institute (who have a significantly more detailed fact sheet about testicular cancer here) recommends following these steps at least once a month:

1.)  Stand in front of a mirror. Check for any swelling on the scrotum skin. Examine each testicle with both hands. Place the index and middle fingers under the testicle with the thumbs placed on top. Roll the testicle gently between the thumbs and fingers. Don't be alarmed if one testicle seems slightly larger than the other. That's normal.
2.)  Find the epididymis, the soft, tubelike structure behind the testicle that collects and carries sperm. If you are familiar with this structure, you won't mistake it for a suspicious lump. Cancerous lumps usually are found on the sides of the testicle but can also show up on the front.
3.) If you find a lump, see a doctor right away. The abnormality may not be cancer, but if it is, the chances are great it can spread if not stopped by treatment. Only a physician can make a positive diagnosis.



Early signs or symptoms, besides lumps, might include an enlarged testicle, a feeling of heaviness or sudden collection of fluid in the scrotum, a dull ache in the lower abdomen or groin, or enlargement or tenderness of the breasts.

If you suspect you might have an issue, a physician can conduct a number of very specific tests to accurately diangose the situation.  There are blood tests that can be done.  Imaging techniques can also help indicate possible tumors. One such method is ultrasound, which creates a picture from echoes of high-frequency sound waves bounced off internal organs. This is a painless, noninvasive way to check for a mass. The only positive way to identify a tumor is for a pathologist to examine a tissue sample under a microscope. Doctors obtain the tissue by removing the entire affected testicle through the groin, a procedure called inguinal orchiectomy. Surgeons do not cut through the scrotum or remove just a part of the testicle, because if cancer is present, a cut through the outer layer of the testicle may cause the disease to spread locally. Besides enabling diagnosis, testicle removal also can prevent further growth of the primary tumor.

Now on to treatment...if the above tests show that cancer is present, a physician will need to determine how extensive the cancer is to make recommendations for treatment.  In treating testicular cancer, there are three primary options:  surgery, radiation therapy, and chemotherapy.  Your physician or oncologist will be able to help you decide which course of treatment is best in your specific situation.