Testicular cancer: Anyone who reacts to the first symptoms has a good chance Knowledge & Environment | DW

The good news: testicular cancer affects only about 1.6 percent of all new cancer cases. But for those who receive such a diagnosis, the news is of course a shock at first. The average age at onset is between 25 and 45 years. But it can also affect boys in puberty from about 14 onwards. The same applies to testicular cancer as to other types of cancer: early detection makes the difference. And every man can do something about it.

About 80 percent of all testicular tumors are discovered by the patients themselves and at an early stage. The German Society for Urology (DGU) advises boys and young men between the ages of 14 and 45 to regularly examine their testicles for possible lumps or hard swellings at least once a month, but even better every week.

If you discover hardening or swelling, you should definitely consult a doctor. A feeling of heaviness in the scrotum can also be a sign of testicular cancer. Some patients initially complain of back pain or neck pain. As a layman, both are unlikely to be associated with testicular cancer at first.

What Are the Causes of Testicular Cancer?

Testicular cancer usually starts in just one testicle. The main risk factor for the development is undescended testicles. One or both testicles are not where they belong, namely in the scrotum. The doctor finds undescended testicles in about three percent of all male babies born on the calculated date. In such a case, the testicles, which are initially formed in the abdomen, have not migrated into the scrotum during the development of the embryo.

Treatment is necessary. This consists of either hormone therapy or surgery. By the baby’s first birthday, both testicles should be in the correct position, otherwise there is an increased risk of developing testicular cancer.

Premature babies are an exception. It is not uncommon for them that the testicles are not yet in the scrotum, because this stage of development occurs relatively late and the position of the testicles can still correct itself.

A genetic predisposition can also be a factor. If testicular cancer runs more frequently in a family, for example if a father or brother already had this disease, then the risk of developing testicular cancer is increased. However, according to researchers, environmental influences have no influence on whether a man develops testicular cancer or not.

How is testicular cancer treated?

In the case of testicular cancer, the surgeon removes the affected testicle completely. If treatment is started at a very early stage, the cure rate is 100 percent. At a later stage, this drops to around 70 percent. Such an operation leads – despite all prophecies of doom – neither to impotence nor is the man incapable of fathering. And in order to preserve the original appearance, a silicone implant can be used in some cases.

After the testicles have been removed, known as an orchiectomy, radiation and chemotherapy follow. In most cases, this has the known side effects such as hair loss, tiredness or an increased susceptibility to infections.

In mid-October, the journal The Lancet published a Swiss study on the treatment of patients with testicular cancer. 116 patients took part in the SAKK 01/10 study. The researchers were able to show that the optimal combination of chemotherapy and targeted radiotherapy reduced the area that had to be irradiated by around 75 percent. In addition, this approach showed fewer side effects.

According to estimates by the Robert Koch Institute, the rate of new cases is around 4,200 a year. In 2019, almost 160 men died from testicular cancer. If the cancer comes back despite treatment, these so-called recurrences usually occur within the first two years after the end of therapy. But even after five years, testicular cancer can develop again.

However, about 96 percent of patients are still cancer-free five years after the initial diagnosis and appropriate therapy. The primary requirement for this is early detection of the cancer. So, palpation is important.