While any boy or man can develop testicular cancer, there are risk factors that make this disease more likely.
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If you’re the dad of a teenaged son, you might be mostly worried about him driving too fast, staying out too late or not studying hard enough at school. What you might not be worried about is the possibility of his getting testicular cancer. And yet one of the risk factors for this disease is being between the ages of 15 and 35: in other words, your son will be at greater risk beginning in high school.
While this is fortunately not a common form of cancer, it is still a health concern — and one that teenage boys need to be aware of.
What is Testicular Cancer?
Testicular cancer refers to an abnormal growth of malignant cells within the testes, which lay inside the scrotum. The testes are incredibly important for male health and future fertility: they produce both male sex hormones (testosterone) and sperm. Most testicular cancers — around 90% — begin in the germ cells, which are responsible for sperm production.
There are two main types of cancers which stem from germ cells:
- Seminoma: this is a less aggressive form of cancer and is more common later in life (men are most likely to contract it between the ages of 25 and 45).
- Non-seminoma: this form of cancer has an earlier onset (boys and men usually contract it between ages 15 and 30) and is a more aggressive, faster-growing form.
Warning Signs
Talking to your son about the warning signs for testicular cancer is also important, so that he is aware of what symptoms should be of concern — and what you will need to report to the doctor. These include:
- A lump or growth in the testicle that might be painful or uncomfortable
- An enlarged testicle
- Swelling or collection of fluid in the scrotum
- Swelling or tenderness in the breasts
More general warning signs include unexplained weight loss, pain, fatigue and changes to the skin.
- If the cancer becomes more advanced, other symptoms can appear as well:
- Back pain (if cancer has spread to pelvic region)
- Shortness of breath (if cancer has spread to lungs)
- Headaches, disorientation (if cancer has spread to the brain).
What Boys are at Greater Risk?
While any boy or man can develop testicular cancer, there are risk factors that make this disease more likely. These factors include:
- Age. For all types of testicular cancer, the average age of diagnosis is between 15 and 35.
- Race. Whites are 4-5 times as likely to develop this as other ethnic groups.
- Family history. If close relatives or family have a history of testicular cancer, this can put a boy or man at higher risk.
- Boys with Klinefelter syndrome, a genetic disorder where they are born with an extra X chromosome, leads to abnormal development of the testes and this can put them at higher risk as well.
- Although evidence is not conclusive, some studies have shown a link between testicular cancer and boys of above average height.
- Some studies have shown that there could also be a link between testicular cancer and HIV/AIDS.
If your son has any of the risk factors mentioned above, it is extra important to talk to him about this important issue.
What to Tell Your Son About Testicular Self-Exams
Some doctors recommend testicular self-exams as a way of detecting the cancer early, before it has the chance to spread. These self-exams involve inspecting and feeling the testicles each month in order to detect any changes in size, shape or other characteristics. However, this might be embarrassing for teenagers—already very self-conscious of their bodies—and awkward for you to talk about as well.
The fact is, though, that few studies have been done on the effectiveness of testicular self-exams and because of this lack of evidence, the American Cancer Society has not made any specific recommendations on this either way. It is something that should be discussed with your son’s doctor/pediatrician to see where he or she stands on the issue.
Diagnosing and Classifying Testicular Cancer
Normally, a lump in the testicles is what prompts a visit to the doctor. At the clinic, the doctor will do a thorough work-up, which usually includes taking down medical and family history (including a history of cancer) and a physical exam (including an exam of the testicles). The doctor will often take a blood sample to look for tumor markers and might order imaging tests such as an ultrasound in order to better visualize the problem.
Diagnosis is usually made on the basis of a CT scan and bloodwork and will then be categorized into one of the following three stages:
- Stage 1: the cancer is entirely in the testicle itself.
- Stage 2: local lymph nodes are also involved
- Stage 3: the cancer has spread to other parts of the body (the most common sites are the lungs and liver)
What Happens Next?
Once a diagnosis has been made and the cancer has been staged, it is possible to talk about treatment options. For some, simply removing the cancerous testical from the scrotum surgically is enough. For other, there will need to be follow-up with radiations or chemotherapy, particularly in cases where the cancer has spread. Generally speaking, though, the prognosis (outlook) for this condition is good.
In short, while testicular cancer is not, fortunately, a common occurrence, it can occur at a young age and it is important for teenage boys to understand what factors put them at risk, what signs and symptoms to talk to you or the doctor about, and what will happen if cancer is diagnosed. Because of the cancer site, it is obviously an embarrassing topic for many teenage boys to talk about, but starting the conversation early and being open and honest about it can help make them feel more comfortable discussing any problems they might have — and it might help to catch this problem early before it becomes more serious.
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