Early Diagnosis Is Key to Treatment.

• Position: Testicular cancer - Brief Article

American cyclist Lance Armstrong has proven that testicular cancer survivors are champions. With his 1999 and 2000 victories in the Tour de France, Armstrong's story brought public attention and helped spread the word about a disease that is the most common type of cancer affecting males between the ages of 15 and 40.

While the facts about testicular cancer indicate how rare it is and how successful doctors have been in treating it, the disease is often misperceived and misunderstood. Between 5,500 and 6,000 cases of testicular cancer are reported annually, giving males a 0.2% chance of developing it, notes Richard D. Williams, head of the Department of Urology, University of Iowa, Iowa City.

The cause of testicular cancer is not known for certain. One possible source is linked to the hormone diethylstilbestrol (DES), which many women took during pregnancy to prevent miscarriages. Males whose mothers used DES have increased susceptibility to testicular cancer. Similarly, men who are born with one or both of the testicles undescended (not in the scrotum) have a 20 to 40 times increased chance of developing the disease. However, there is little evidence to conclude that genetics plays a role in the occurrence of testicular cancer.

There are five types of testicular cancer and three phases of its development. Men with early stage seminoma, the most common type of testicular cancer, are easiest to treat because the cancer cells are localized for long periods of time. For patients in phase I, the cancer is confined to the testicle; in phase II, the cancer can spread to the retroperitoneal lymph nodes just behind the abdomen; and in phase III, it spreads to remote parts of the body such as the lungs or brain.

In many ways, treatment of testicular cancer begins with the patient since early detection is crucial to ensuring a positive outcome. Williams, who is also a urologic oncologist at the University's Cancer Center, stresses the importance of regular self-exams so that warning signs of testicular cancer are not overlooked.

Testicular cancer symptoms include enlargement in the breasts, a feeling of heaviness in the...