Testicular cancer is fairly rare, with just under 8,000 new cases a year in the United States. But this is among the most common cancers in young men, typically striking between the ages of 15 and 34. Caucasian men are five times as likely to develop testicular cancer as African American men. The rate of testicular cancer in the United States has risen 51% since World War II for unknown reasons, according to a study by Columbia University Department of Urology at NewYork-Presbyterian Hospital surgeon Dr. James M. McKiernan. Testicular cancer is a highly treatable and usually curable form of cancer. Studies show that it has a cure rate in all stages combined that exceeds 95%.
The testicles produce sperm and the male hormone testosterone, and contain several types of cells in which cancer can develop. More than 90% of testicular cancers originate in germ cells, the cells that make sperm. These tumors can be further classified as seminomas or non-seminomas. Seminomas are composed of one type of cell, while nonseminomas contain a mixture of cell types. Nonseminomas tend to grow faster, develop at earlier age, and have a lower 5-year survival rate. While seminomas are more sensitive to radiation and to chemotherapy, new treatments are improving the prognosis for nonseminomas.
Testicular cancer sometimes develops in the hormone-producing cells and the supportive tissues (stroma) of the testicles. These tumors are called stromal tumors, and are often benign.
Testicular cancer is a highly complex disease to treat because there are a number of possible treatment avenues including observation, surgery, radiation, chemotherapy, or in some cases a combination of all four. Successfully integrating all of these treatment choices is a complicated process that is best done by doctors with extensive experience treating testicular cancer. The Columbia Urology team has substantial experience with this multidisciplinary undertaking.
Testicular cancer and treatment for it can affect a man’s chances of fertility. Because many men who develop testicular cancer are in their mid-20s, they are concerned about their ability to have children in the future. Columbia Urology has an active male fertility team that can work with these patients to address their concerns.