Newsletter of the PREVENTION It’s all in your hands! Summer 2011 T here are two major principles of preventive medicine: taking healthy people with no complaints and intervening to lower their risk of disease, or catching a disease early enough in its course to prevent serious illness or death. To make preventive strategies worthwhile, a disease must be common enough, and serious enough, to impact upon the individual, and the population as a whole. increases one’s risk for the disease. A history of an undescended So how about prevention of testicle (cryptorchidism) is Testicular Cancer? present in about 10% of men The incidence of testicular cancer with testicular cancer, but even has been increasing over the last in those cases up to a quarter of 40 years, but nobody really knows the cancers detected are in the why. It is the most common normally developed testicle. Rare cancer in men between the ages of disorders associated with infertility 15-35, and we see a second bump or abnormal development of the in incidence in men aged 45 -55. testicles (gonadal dysgenesis, The good news is that testicular androgen insensitivity, Kleinfelter’s cancer is far less common than syndrome) are also risk factors. other types, accounting for only 1% By far, the greatest risk factor for of all cancers in men. Moreover, testicular cancer is the presence of it is easily detected and most intratubular germ cell neoplasia often found at an early stage. In (ITGCNU) or abnormal cells found fact, the cure rate for all testicular in the testicle on biopsy. ITGCNU cancers is over 90%. As we do is found in less than 1% of the not know what causes testicular general population, but is present cancer, preventing the disease from in almost all cases of testicular developing in the first place using cancer, as well as in the testicles a vaccine or medication is not an of men with the gonadal disorders effective strategy. mentioned above. What about early detection or screening? So what is the best screening tool? There are some risk factors known for testicular cancer. A family or personal history of testicular cancer Regular self-examination is the best method of early detection. Testicular cancer most often presents as a painless lump in one testicle. However, redness, swelling, and pain in the testicle can also be symptoms. Men of all ages, but especially those in the age groups mentioned above, should be familiar with how their testicles and scrotum feel. Given the young age of onset, it is never too early to teach children to be familiar with their own bodies, and to seek help when something feels wrong. Undescended testicles should be surgically repaired as soon as feasible to preserve fertility and allow for easier screening with physical exam, and ultrasound. In the setting of known ITGCNU or conditions associated with high risk of this abnormality, North American guidelines favor close surveillance with ultrasound. Testicular cancer is a story of success. It is easily detectable at a very early stage, and highly curable, but it’s all in your hands! Dr. Kylea Potvin, London Health Sciences Centre.