The Link between Testicular Cancer and Infertility
About the Study
In a study conducted by Thomas J. Walsh, M.D., M.S. at the University of California, San Francisco, data gathered from more than 22,000 male partners of couples seeking fertility treatment between the years of 1967 and 1998 were analyzed. Of these, more than 4500 men had male factor infertility, as based on the criteria of abnormal semen analysis. The results of the study were alarming, stating that infertile men are nearly three times more likely to develop testicular cancer than their fertile counterparts.
Researchers believe the reason for the increased risk of testicular cancer lies in DNA repair, since severe forms of male infertility are associated with faulty DNA repair - which also is connected to the development of tumors. Genetics and environmental factors are also implicated although it is not clear whether semen quality and environmental factors are connected.
What is Testicular Cancer?
Testicular cancer (TC) occurs when the cells in either or both testes become malignant. The testicles are male sex glands that produce and store sperm and they are the main source of testosterone in men. The development of the reproductive organs along with the development of other male physical characteristics is determined by the hormone testosterone. Testicular cancers are classified according to the characteristics of the tumor - they are either seminomas or nonseminomas. One percent of all cancers in men in the US are testicular cancers, occurring most frequently in men between the ages of 15 and 39.
What are the Risk Factors?
Although the exact causes of testicular cancer are unknown, there are several risk factors that can make a man more prone to developing the disease.
· Undescended testicle or cryptorchidism: It is normal for the testes to descend from the abdomen into the scrotum before birth. If one or both don't move down, then the risk for TC is increased. Even if surgery is performed to move the testicle down, the risk remains high and applies to both testicles.
· Congenital abnormalities: Risk increases for men born with abnormalities of the testicles, penis, or kidneys. Men who have inguinal hernia (hernia in the groin where the thigh meets the abdomen) are also more at risk.
· History of TC: If a man has had TC previously in one testicle, he is at risk for it a second time in the other testicle.
· Family History of TC: A man who has family members (father, brother) with TC is at higher risk for the disease.
How do the Symptoms Present?
Most testicular cancers are discovered by the man by himself or by doctors doing a routine exam. Any kind of abnormality or any unusual appearance should signal the man to see his doctor. He should be on the alert for any of these symptoms:
· A lump or swelling in the testicle that is painless
· Pain or swelling in the scrotum or in a testicle
· Any changes in feeling of the testicle or any enlargement in the scrotum
· A sensation of heaviness in the scrotum
· Dull ache in the lower back, abdomen or groin
· The scrotum suddenly fills with fluid
These symptoms could be cancer or they could be something else. If any of them appear, the doctor should be contacted to determine the cause.
How is TC Diagnosed?
Diagnosis of testicular cancer is made by the doctor. In order to arrive at a diagnosis, a full health history is taken and then some lab and diagnostic tests are done.
· Blood tests are done to determine the levels of tumor markers - substances found in higher-than-normal amounts when there is cancer in the body.
· An ultrasound of the scrotum can indicate the presence of a mass in the testicle. It can also rule out infections or water collection that is unrelated to cancer.
· A biopsy to take some tissue to have analyzed is also done to determine if there is cancer.
If any of the tests reveal cancer to be in the body, then additional tests are done to determine the type and extent of the disease, along with the appropriate treatment for it.
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