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Testicular cancer is a rare form of cancer which mostly affects young men between the ages of 15 and 40.
It is classified into two types based on the nature of the cancerous cells in the tumor- seminomas and non- seminomas.  It is commonly found in men who have a positive family history of testicular tumors. Men born with congenital anomalies of the testes, penis or kidneys are at an increased risk of developing testicular cancers. Similarly there are more chances of its development in men born with inguinal hernia. Gonadal dysgenesis, cryptorchidism and Klinefelter's syndrome also increase the risk for the development of testicular cancer. There are 8 to 10 times more chances of developing tumor on the contra-lateral side if one testicle has been involved earlier.

According to the National Cancer Institute, a doctor's opinion should be sought in case any of the following are noticed by the patient:
  • Any painless growth in either testis
  • Any change in the size or texture of the testis
  • Dragging sensation in the scrotum
  • Pain in the testis or scrotum
  • Heaviness in the groin region
  • Rapid fluid collection in the scrotal sac
  • Testicular cancer can be diagnosed with the help of following tests: estimating the levels of various tumor markers like alpha- fetoprotein, Beta- human Chorionic gonadotropin and lactate dehydrogenase in the blood.
Ultrasound of the scrotum which also helps in differentiating the cancer from any swelling due to infection and non cancerous fluid collection. There are many myths around testicular cancer, some of which are very silly and can be dispelled by applying a little common sense. Some of these rumors are:

1. Testicular cancer is the most common cancer affecting men.

The fact is that it is one of the rarest forms of cancer accounting for just around 1 % of all cancers in men in the Unites States. Around 8000 men are diagnosed with it annually, of which about 390 men succumb to the disease.

2. Testicular cancer is usually fatal.

This is a totally wrong idea. In fact, testicular cancer is one of the most treatable forms of cancer. Nine out of ten patients undergoing treatment for this disease survive. The five year survival rate for all men with testicular cancer is 95%.

3. Testicular cancer can be easily diagnosed by doing a biopsy.

Unlike other organs, a biopsy of testicular tumor to ascertain malignancy is seldom done because of increased likelihood of spreading the disease due to the procedure. In case of suspicion of a testicular malignancy because of altered levels of tumor marker in the blood or as seen by ultrasound, the entire testis is removed through an incision in the groin, a procedure named as radical inguinal orchiectomy. Only in very rare circumstances, like when the man has only one testicle, an inguinal biopsy is done, where the tissue from the tumor is taken through an incision in the groin. If the biopsy shows the presence of cancer cells, then the surgeon proceeds with orcheictomy. It is important to note that the biopsy is not taken by a cut through the scrotum as it may cause the malignancy to spread.

4. Pain is seldom a feature of testicular cancer.

People often believe that testicular cancers are painless and there is no need to suspect malignancy in case of a painful swelling. This is a myth. Almost 18 to 46 % of patients suffering from germ cell tumor of the testicle approach a doctor with pain as the predominant complaint. So to rule out malignancy, just because the tumor is painful, is plain foolishness.

5. Testicular cancer does not produce any symptom.

As discussed earlier, pain is a common symptom in many testicular tumors. Besides pain, patients may develop enlargement of breasts (gynaecomastia) in 10% cases of choriocarcinoma, backache or pain in the groin region in 10% cases of testicular cancer which is metastatic and loss of fertility in less than 5% of all testicular cancers.

6. Testicular cancer is a disease of old people.

As generally, the incidence of all types of cancers increases with age, so most people tend to believe that the same holds true for testicular cancer as well. But, on the contrary, it is a disease of young men. It is the most common cancer affecting men between the ages of 20 to 34, second most common between the ages of 35 to 39 and the third commonest cancer between the ages of 15 to 19.

7. Testicular cancer spreads on undergoing surgery.

This myth may have originated many years ago when the disease used to be diagnosed at an advanced stage. On opening, the doctors used to find that the disease had already spread but the patients blamed the spread on the surgery. The fact is that surgery is done to limit the spread of the disease. For testicular cancer, the entire affected testicle is removed in a procedure called as orchiectomy.

8. Once you are diagnosed with testicular cancer, it is the end of your sexual life.

As in most of the cases, only the affected testicle is removed leaving behind the other testicle intact, there is no noticeable change in either the sexual drive or in the ability to produce children. These problems arise only in case of bilateral orchiectomy. Hormonal injections given subsequent to the operation restore the sexual drive in such cases though the same cannot be said about the fertility.

9. Cryptorchidism leads to testicular cancer.

Cryptorchidism is the condition when the testes fail to descend into the scrotal sac and remain trapped in the abdomen. It is a known risk factor for testicular cancer. However testicular cancer is in itself a very rare disease and moreover it is found in only 2% of the patients having undescended testicles.

10. Undergoing vasectomy can lead to the development of testicular cancer.

Recent studies undertaken establish either no connection or a very weak association between undergoing vasectomy and developing testicular cancer. According to the National Institute of Cancer, keeping in mind the negligible relation between the two, it will be better if men planning to undergo a vasectomy are not swayed by its association with the testicular cancer.

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