Why does testicular cancer affect young and middle-aged males of reproductive age?
Testicular cancer is a form of cancer which affects the male testes or sex glands encased within the scrotum, a loose sac of tissue that hangs freely below the penis. Germ cells are specialized cells lining several heavily coiled tubular structures within the testes that are responsible for producing male sex cells called sperms. Other specialized cells - the Leydig cells, produce testosterone which is the sex hormone that propels the male sexual drive.
Testicular Cancer Is Benign to the Point of Being Hundred Percent Curable
Almost 95 percent of testicular cancers affect the germ cells causing the testicles (either one or both) to swell and harden with or without pain. The remaining 5 percent affects the Leydig cells which do not originate from the germ cells.
Testicular Cancer Is the Most Uncommon of Cancers Afflicting the Body
Among all cancers that ravage the human body, testicular cancer is the rarest comprising not more than 1 percent of all detected cancers. In the US, around 8000 cases are detected annually and less than 400 men succumb to the disease. The likelihood of developing this form of cancer is very low; only around 1 in 300 males are at risk. Among those affected by testicular cancer, statistics indicate almost a 100 percent survival rate if cancer is detected early and remains isolated in the testes. Modern treatments are able to cure testicular cancer (up to 98 percent) even when it has spread to other organs like the lungs or liver.
The High-Risk Factors That Make Testicular Cancer an Uncommon Malignancy
1. The Age Factor Which Is Unique to Testicular Cancer
Testicular cancer is more common in the age group between 15 to 35 years which is considered as the major reproductive age - the time when a human male becomes sexually mature with higher levels of the hormone testosterone fueling his sex drive.
Cases of cancer within younger males has virtually doubled from the turn of the century to the present day where it stands at 7.8 per 100,000 males in predominantly western societies and 6.7 per 100,000 males in Northern Europe.
Clinical studies suggest that exposure to higher estrogen levels in the fetal stage may increase the risk of testicular cancer in males. It is also known that cryptorchidism or the phenomenon of undescended testes also increases the risk of testicular cancer, so it could be that we are witnessing a combination of both genetic and externally induced factors triggering this kind of cancer.
2. The Role of Ethnicity in Triggering Testicular Cancer
For some inexplicable reason, cases of testicular cancer is increasingly reported from the white population in developed nations within the western hemisphere and Northern Europe, with Northern Africa showing a much lower rate of 1.6 per 100,000 black males. Though whites have become increasingly susceptible to cancer over the past eighty years, cancer among Africans and Asians have been increasing only since the 1900s. However, though Hispanics and Asians have become susceptible to testicular cancer in higher age brackets, whites tend to develop symptoms at younger stages.
3. The Geographical Variations in Testicular Cancer
As mentioned before, white males have a high risk of developing testicular cancer and the occurrence of this form of cancer is highest in developed economies. Globally, the highest case of testicular cancer is reported from New Zealand and Australia followed closely by the UK, US and European nations such as Spain and Sweden. At the opposite poles are the African and Asian countries with India positioned at the bottom of the list for the lowest occurrence of testicular cancer. This obviously points to genetic or an externally influenced factor that is not yet clearly understood.
4. How Cell Differentiation Affects Testicular Cancer
The most common form of testicular cancer is the one that affects the germ cells which eventually develop into matured sperms. Testicular germ cells are differentiated into two types – the seminomas and non-seminomas. Almost 90 percent of the testicular cancers are those affecting seminoma cells. Fortunately, seminomas are slower in spreading cancers and their activity remains confined to the testes, rarely invading the lymphatic ducts which are the outward conduits for cancer transmission. Cancer in seminoma cells triggers the production of a hormone called Beta-Human Chorionic Gonadotropin (HCG) which appears in blood serum and is measurable. At higher levels, HCG becomes a cancer-specific tumor marker making it easier to confirm cancerous growths in the testes. This is the main reason why seminomas are detected early. Early detection enables faster recovery through prompt surgical interventions.
Seminoma cancers largely affect the younger men within the age group of 15 to 35 years. Periodical self-examination is an easier method of detecting testicular abnormalities brought on by this form of cancer.
Less common testicular cancers are those affecting stromal cells (hormone producers) like the Leydig cells that release testosterone. These cancers can be observed in children as well as in elder males. They are normally benign and surgical solutions are enough to combat their side effects.
5. Testicular Cancer Appearing in Personal or Family History
Testicular cancer is more common among males that share the genes of their grandparents, parents or siblings affected by the same cancer. Studies indicate that inter-generational transmission of deviant genes could account for an increase in the risk of developing testicular cancer 500 folds. The risk of developing cancer within the healthy testicle is far greater if another testicle was surgically removed to battle an earlier episode of cancer.
6. Undescended Testes Increase the Risks of Testicular Cancer
Cryptorchidism is the phenomenon where the male testes remains stationed inside the groin causing infertility among other side effects instead of descending into the scrotal sac after birth. Studies show that testicular cancer appears more commonly in males with undescended testes. Orchiopexy is the corrective surgery which is performed to position the testes in their rightful place outside the body in the scrotal sac. If this surgery is performed after 12 years of age, the chances of developing testicular cancer are far greater. In the majority of cases, cancer appears in slow growing seminoma cells whether it is in the healthy testicle or undescended testicle.
7. Klinefelter Syndrome - the Havoc Played by Truant Genes
Normally, males are born with one set of X and Y chromosomes inherited individually from each parent. In Klinefelter Syndrome, males are born with an extra X chromosome which results in physical and behavioral changes such as a softer voice, broader hips, sparser body hair and larger breasts. Such individuals may not have any problem performing sex but face difficulty fathering children. This singular genetic deviation caused by abnormal cell division makes such individuals more prone to developing testicular cancer.
The Final Diagnosis
What we have discussed so far are the deviations that make testicular cancer more common among certain sections of the male population, especially those exposed to the high-risk factors triggering this form of cancer. Undeniably, this is an affliction that targets the white males more than any other ethnic group and strikes young men at the high point of their reproductive phase.
The good news is that testicular cancer mortality rates are climbing down fueled by earlier detection through self-inspection, lab tests, faster surgery and more sophisticated chemotherapy and radiation treatment options. Complementary and alternative therapies substantially improve the quality of living in cancer patients.