​The recommended screenings for many diseases don’t apply until you reach a certain age, meaning a lot of teens and young adults don’t give them much thought until later in life. However, testicular cancer is actually more common in younger men, with the average age of diagnosis being 33 years old, according to the American Cancer Society (ACS). That’s why doctors recommend regular self-examination as early as your teenage years.

The good news is, testicular cancer is rare, with the ACS estimating about 9,760 new cases diagnosed in the U.S. in a year. The better news is, it’s one of the more treatable types of cancer with a high survival rate. In fact, there are only an estimated 500 deaths attributed to the disease each year. Even when testicular cancer commonly spreads, it remains one of easiest cancers to successfully treat.

But a low risk is still a risk, which is why experts such as Brian Mannion MD, an oncologist with The Christ Hospital Physicians – Hematology & Oncology​, say it’s important for young men to be aware of the disease, and be proactive about watching for the signs.

“I’m generalizing, but in young men, there’s often a sense of immortality, like nothing can hurt them,” Dr. Mannion says. “But this is one instance where that particular population is at a higher risk, and as with other types of cancer, it’s always better the earlier it’s found.”

Symptoms and diagnosis of testicular cancer

The most obvious signs of testicular cancer are testicular lumps or swelling. These can occur painlessly, which is why many doctors recommend a monthly self-examination by gently rolling each testicle between your fingers to check for lumps. Some recommend this during a shower as the warm water helps to relax the scrotum to make the exam easier.

“Unlike other forms of cancer, it’s not something that’s hidden inside our body,” Dr. Mannion says. “It can be easily felt if you look for it.”

When first beginning self-examinations, you may notice one testicle is larger than the other. This is not unusual, however, it’s important to note changes in size over time.

In some cases, symptoms may be painful, even beyond the scrotum. For example, cases where the cancer has spread to the lymph nodes in the abdomen may cause pain in the lower back. Whether you experience pain, or discover lumps or swelling without the pain, Dr. Mannion says it’s important not to wait to talk to your doctor.

“Even with the high odds of successful treatment, it’s always better to discover any cancer as early as possible,” he says. “Not to mention, catching and treating the cancer before it spreads decreases the need for more extensive treatments such as radiation or chemotherapy that can have other negative side effects.”

Testicular cancer is usually diagnosed with a testicular ultrasound. However, if there is suspicion that it has spread, your doctor may order additional blood tests or even an MRI if there are signs that the cancer may have reached other parts of the body.

Treatment of testicular cancer

The primary treatment for most cases of testicular cancer is surgical removal of the affected testicle.

“In 60 to 65 percent of cases, that’s all that’s required,” Dr. Mannion says. “However, depending on the size of the tumor or whether or not it has spread, treatment may also involve radiation, chemotherapy or some combination.”

It’s common for patients, especially young men, to have concerns about the impact of surgical removal of a testicle. However, Dr. Mannion points out that there is actually very little impact.

“Even with one testicle, you have a high enough sperm count that it doesn’t affect reproduction,” he says. “There is also enough testosterone produced that it doesn’t affect natural male development or the quality of the rest of your life.”

Also encouraging, Dr. Mannion points out, is that once the cancer is successfully removed via surgery, statistics show that it only returns in the remaining testicle about one percent of the time. “That’s higher than the general population, but is still a very low number,” he says

Patients are encouraged to follow a successful treatment with continued self-examinations and with regular monitoring through their provider to watch for a return, or signs that the cancer had unknowingly spread.

Prevention myths and risk factors for testicular cancer

The impact of treatment for testicular cancer on sexual performance, reproduction and general male development are only a few of the myths that doctors hear from patients. Other common myths involve prevention or risk factors. Some of these myths include:

• An increase of risk due to previous testicular injury

• An increased risk following a vasectomy

• The impact of the frequency of ejaculation on the risk of developing cancer

• The use of nutrition to lower the risk

Dr. Mannion points out that these myths are just that. “There’s nothing proven to decrease risk,” he says. “That includes diet, injuries, etc. It’s a common question, but the reality is there’s nothing men can do to decrease the risk. But that’s a good opportunity to remind them the importance of being proactive to increase the chance of early detection.”

One risk factor that is not a myth, however, is men who had an undescended testicle. This means a testicle did not move down into the scrotum from the abdomen at birth. In some cases, they eventually descend late, while others require surgical assistance. Either case increases the chance of developing testicular cancer later in life, so it’s important for those men to be aware.

Dr. Mannion reiterates that the best thing any man can do is to be aware and not wait or ignore the signs. “Your gut reaction may be to tough out any pain or to not address lumps because they aren’t hurting you,” he says. “But you really need to look into it. If it’s nothing, it’s nothing.”