By Ms. Patricia Deal (Army Medicine)June 15, 2011
FORT HOOD, Texas"Testicular cancer, although a rare form of cancer, occurs most often in men between the ages of 20 and 39, which means the majority of male Soldiers at Fort Hood are potentially at risk, warn the medical professionals at Carl R. Darnall Army Medical Center.
“Soldiers need to be aware of the risk. While the survival rate is more than 90 percent, testicular cancer can still be lethal if it is too advanced once it is discovered,” said Maj. (Dr.) Eric Whitman, urologist at CRDAMC’s Department of Surgery.
As part of National Men’s Health month in June, Whitman is promoting education and awareness of the disease. He encourages Soldiers to take an active role in managing their testicular health by performing regular, monthly self-exams.
“Soldiers should always be on the offensive, not just for one month out of the year or at their annual physical exam. Ignoring a testis mass for a month, or several months, can be fatal,” he added. “Testicular cancer is now one of the most curable cancers, but the more advanced it is, the less options a man has for treatment and he will also be more likely to require more treatment modalities.”
Whitman described testicular cancer as the fastest growing solid tumor known to man.
“Tumors can double in size in less than one week. No other cancer that I know of behaves like that. Most other cancers take decades to develop,” he said. “Since it grows so fast, we don’t delay when dealing with testis mass--we remove it the same day that we discover it.”
Most men with testicular cancer can be cured with surgery, radiation therapy, and/or chemotherapy. Whitman said that while the cure rate is high, the treatments are pretty aggressive. Side effects vary, depending on the type of treatment and may be different for each person. Chemotherapy can leave some men infertile.
The testicular cancer rate has more than doubled among white men in the past 40 years, but has only recently begun to increase among black men, according to the National Cancer Institute. There is no known cause, but some men may be more at risk for developing testicular cancer if they have had an undescended testicle or if a brother or father had the disease.
More cases of testis cancer are identified in the Army population in part due to service members’ improved access to care, as well as required annual exams and early screening efforts. Whitman said he sees more testis cancer and testicular torsion cases than his civilian counterparts because of the primary age group of Soldiers that he serves.
“While neither condition is common, I see a lot of both conditions--typically three to five cases of each a year, which is a lot for a hospital our size,” he added.
Testicular torsion is the twisting of the spermatic cord, which cuts off the blood supply to the testicle (only the testis and epididymis). It can be associated with trauma to the scrotum, particularly if significant swelling occurs. It may also occur after strenuous exercise or may not have an obvious cause.
“It’s important to note that testicular torsion can happen without trauma,” Whitman stated. “When they notice their scrotum begins to swell and they have discomfort, most young men attribute it to some vigorous activity that they recently did. If they wake up with severe testicular pain, they assume it’s because they got hit there playing basketball the night before, when in actuality, the trauma may not necessarily be the cause.
“Any acute pain, with swelling, lasting for over an hour, needs emergency evaluation for torsion,” he cautioned. “If we get to it within four to six hours, we will probably be able to save the testis. After 12 hours, there is almost no hope.”
Whitman said he can’t emphasize enough the importance of being aware of testicular health and performing monthly self exams.
“Being shy about one’s anatomy is the most likely reason why men present so late with tumors or torsion,” he said, “but most men will be less shy if they know that they could lose a testicle (in the case of torsion) or should lose it (in the case of tumors) before it spreads.
“From all the publicity, everyone knows that Lance Armstrong recovered from testicular cancer, and that he has helped promote awareness of the disease,” Whitman said. “But I haven’t seen the push to perform self exams in the media, and more importantly, to seek care immediately for any changes discovered in that exam. That’s the most important message. Perform those exams regularly. Teach your pubescent sons how to do an exam, too.”
After a self-exam, men should see their primary care provider if they notice any symptoms such as a painless lump or swelling in a testicle, any enlargement of a testicle or change in the way it feels. Seek immediate medical attention for any pain and swelling lasting more than hour.
A testicular self-exam chart is available at the U.S. Army Public Health Command website