The medical procedure that increases testicular cancer risk

If you’re a man, particularly a young man, it’s important to check regularly for any signs of testicular cancer. Testicular cancer is the most common form of cancer in men between the ages of 15 and 45. An estimated 9,610 cases will have been diagnosed in the U.S. in 2020, and 440 men will have died from the disease.

The exact cause of testicular cancer is not known. But there are some factors that can raise your risk of contracting it. For instance, if you have cryptorchidism, a condition in which one or both testicles fail to descend from the abdomen to the scrotum before birth, you are many times more likely to get testicular cancer. Also, men infected with HIV, especially those with AIDS, have an increased risk.

If your father or brother had testicular cancer, you’re at a higher risk of getting it too. If you’re white, your testicular cancer risk is 4 to 5 times greater than that of Black and Asian American men. And if you’re between the ages of 20 and 34, your risk is increased.

Now, a new study may add another possible risk factor for testicular cancer to that list…

Diagnostic imaging and testicular cancer

Results from a recent Penn Medicine study suggest early and repeated exposures to diagnostic imaging via X-rays and CT scans may increase the risk of testicular cancer.

Radiation can damage DNA, which is why it’s a known risk factor for cancer. When cells are unable to sufficiently repair damaged DNA, cancer-causing genetic mutations can happen.

Senior study author Dr. Katherine L. Nathanson, deputy director of Penn’s Abramson Cancer Center, notes that a steady rise in testicular germ cell tumor (TGCT) cases over the past several decades suggests an environmental exposure risk that has not yet been identified.

“Our data suggests that the increased use of diagnostic radiation below the waist in men over that same time may contribute to the increase in incidence,” Dr. Nathanson says.

There have been limited studies on the role diagnostic radiation, particularly from CT scans, could play in TGCT. Past reports have focused on occupational exposure in people such as military and nuclear workers, rather than patients receiving radiation from diagnostic imaging.

In the most recent study, researchers observed 1,246 men between the ages of 18 and 55 with and without testicular cancer at Penn Medicine. The participants filled out a questionnaire, giving information on known and presumptive risk factors for testicular cancer. They were also asked about when they had undergone diagnostic imaging during their lifetime, including the location and number of exposures, before their cancer diagnosis. Tumor samples were also collected from the testicular cancer patients.

When adjusting for known risk factors of testicular cancer, the researchers found a 59 percent increased risk of TGCT among individuals reporting at least three exposures to diagnostic radiation below the waist, compared to men with no exposure. The risk was also somewhat higher for those exposed to diagnostic radiation in their first decade of life compared to those first exposed at age 18 or later, though it wasn’t a statistically significant increase.

Best practices for lowering your risk

It can be hard to avoid diagnostic imaging when conditions call for it. Still, the researchers are recommending health care professionals take steps to reduce “medically unnecessary and avoidable” testicular exposure to diagnostic radiation. They suggest reducing radiation dose and optimizing shielding practices where appropriate.

When caught early, testicular cancer can usually be treated successfully, which is why it’s so important to check regularly for any changes in your testes. And these checks should continue no matter what your age — about 8% of testicular cancer cases are diagnosed in men over 55 years of age.

Related: The antioxidant that counters radiation ‘cancer boost’ from CT, PET and X-ray

About once a month, check your testes while showering. Look for any abnormalities such as lumps, swelling or heaviness. If you notice any of these, or are experiencing pain in your testes, see a doctor right away.

Beyond early detection, there is no known way to prevent testicular cancer from occurring, since many of the risk factors cannot be changed. It’s possible to correct cryptorchidism in boys, but it’s unclear if that has any impact on their testicular cancer risk.

That said, following a healthy lifestyle can help lower your overall cancer risk. Make sure your diet consists of whole, unprocessed foods, don’t smoke and don’t drink alcohol excessively. And try to stay active; the American Cancer Society recommends getting between 150 and 300 minutes of moderately intense physical activity every week.

Sources:

Diagnostic Imaging May Increase Risk of Testicular Cancer — Penn Medicine

Lower abdominal and pelvic radiation and testicular germ cell tumor risk — PLOS ONE

Key Statistics for Testicular Cancer — American Cancer Society

Risk Factors for Testicular Cancer — American Cancer Society

10 Cancer Symptoms Men Often Ignore — Easy Health Options

Can Testicular Cancer Be Prevented? — American Cancer Society

American Cancer Society Guideline for Diet and Physical Activity — American Cancer Society