Second Testicular Cancers Are Rare

NEW YORK (Reuters Health) - Men with testicular cancer have a higher-than-average chance of developing cancer in the other testicle at a later time, but the overall risk is low and survival remains high, study results show.

These findings, the authors suggest, "provide support for continuing the usual clinical practice of not subjecting the (other) testis to routine biopsy."

Dr. Sophie D. Fossa, from the Norwegian Radium Hospital in Oslo, and her colleagues analyzed data from the National Cancer Institute's SEER database, and report their findings in the Journal of the National Cancer Institute.

The data covered 28,045 men with testicular cancer diagnosed between 1973 and 2001. Subsequently, another tumor in the other testicle was diagnosed in 287 of the men.

The cumulative risk of developing a second testicular cancer over a 15-year period was only 1.9 percent, the investigators calculate. Although low, this rate is still 12 times higher than in the general population. The risk is higher for men first diagnosed at younger than 30 years of age.

The team found that risk declines with time. For example, the risk up to 4 years after first diagnosis is nearly 14-fold higher than the general population, while the risk at 15 years or more is just 3 times higher.

The 10-year survival rate following diagnosis of a cancer in the other testicle is 93 percent, Fossa's group notes, which is not significantly different from the survival rate of men who don't develop another testicular cancer.

The researchers say doctors should encourage all men who have been treated for cancer in one testicle "to perform regular self-examination and, possibly, undergo regular testicular ultrasonography." If a second tumor is diagnosed early enough to perform testis-sparing surgery, the problems associated with male hormone replacement after surgery could be avoided.

However, they say, testicular biopsy followed by counseling and treatment "may be justified for high-risk patients," such as those with a history of undescended testes, infertility, or a family history of testicular cancer."

SOURCE: Journal of the National Cancer Institute, July 20, 2005.