Treatment of Testicular Cancer in Young Men

Although cancer most commonly occurs in older people, certain types are more likely to develop in younger individuals. One of the biggest culprits is testicular cancer, which overwhelmingly occurs in younger men, with the average age of diagnosis just 33. The incidence of testicular cancer begins to rise with the onset of puberty, and many cases develop in adolescent and young adult boys.

Most young men are diagnosed with testicular cancer after seeing their doctor for an enlarged testicle, which may or may not be painful. Physicians usually diagnose the disease with a blood test for tumor markers and an ultrasound.

Christopher Sweeney, MBBS
Christopher Sweeney, MBBS

“The sooner men are seen, the easier the disease is to diagnose, and the higher the likelihood of cure,” explains Christopher Sweeney, MBBS, a medical oncologist in Dana-Farber’s Lank Center for Genitourinary Oncology who treated patients alongside Clair Beard, MD, director of the Testicular Cancer Center. Sweeney notes that Dana-Farber patients with early stage disease are fully cured more than 95 percent of the time.

“Unfortunately, we find that many adolescent boys have enlarged testes for some time before the diagnosis is made, and they require much more aggressive therapy,” adds Lindsay Frazier, MD, medical oncologist at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center and co-director of the Institute’s new Center for Adolescent and Young Adult Oncology. “Urging young men to come forward sooner would help improve chances of cure.”

There is evidence that testicular cancer may be related to genetics, as a man’s risk is doubled if his father or brother has been diagnosed with the disease. But no one gene – such as BRCA for breast cancer – has yet been identified, and other causes are not well defined, Sweeney explains. The disease – which is occurring more frequently, with about 8,850 new cases expected in 2017 – is found less often in African American men and more commonly in men of Scandinavian heritage.

While treatment for early stage testicular cancer is fairly straightforward – generally removal of the testicle, possibly followed by chemotherapy or radiation – having cancer as a young man is anything but. Cancer, especially in the testes, may cause fertility and sexuality concerns, as well as emotional challenges related to isolation, changing relationships, and managing school or work. Finding a care team that is right for you – and includes supportive services such as social work, psychiatry, and sexual health experts – is important in maintaining quality of life during and after treatment.

Having cancer as a teen or young adult can also present challenges regarding where to be treated: in pediatric centers or adult clinics.

“At Dana-Farber, our Center for Adolescent and Young Adult Oncology provides the combined experience of adult and pediatric oncology,” Frazier explains. “We offer treatment in the clinic where the patient will feel most comfortable and will have access to the appropriate support services they need on their cancer journey.”

While there are still many unknowns about testicular cancer, and why it is so prevalent in young men, Dana-Farber researchers are working to identify the genetic signature of testicular cancers to find clues for its cause – and how to prevent it.

Sweeney and his team’s work has also highlighted the need for access to care for un- or under-insured men, who are less likely to be diagnosed at an early stage and have lower cure rates.

Learn more about testicular cancer treatment and research at Dana-Farber Cancer Institute, and view the graphic below for symptoms you should be aware of. testicular cancer, symptoms