The incidence of testicular cancer is much higher amongst men with HIV than the rest of the male population. One study suggested an incidence fifty times greater amongst HIV-positive men (0.2% vs 0.004%).

A recent study confirmed that testicular seminoma occurs at high rates among men with HIV and that the relative risk increases from pre to post-AIDS. However, the increased risk was not substantial and the authors of this study argued that declining immunity does not have a major impact on seminoma risk. To support this claim, they demonstrated that many cases of testicular seminoma in this study occurred among gay men and white men, suggesting that lifestyle factors may affect rates of this cancer.

Testicular cancer is treatable in around 90% of cases provided that it is detected early enough and treated.

Outward signs of testicular cancer may be detected in several ways. Pain in the testicles should be investigated by a doctor immediately, to rule out an infection. The most frequent cause of testicular pain is an infection for which antibiotic treatment can be given. Changes in the testicles such as lumps or hardening should also be investigated. Regular self-examination of the testicles is advisable, and this is best done during a warm bath or shower.

In some cases ultrasound scans may be used to examine the testes, or blood tests may look at the levels of the tumour proteins alpha feto-protein and beta-human chorionic gonadatrophin. If elevated levels are detected, this suggests that a testicular tumour may be present.

If a suspicious lump is found, the standard treatment is the removal of the affected testicle. Biopies are not performed because they might result in the spread of cancer cells around the body. After removal the tissue is analysed to determine whether the suspected tumour is cancerous. If cancer is detected, patients are generally treated with radiation and/or chemotherapy. Testicular tumours respond well to chemotherapy.

Reference

Goedert JJ et al. Spectrum of AIDS-associated malignant disorders. Lancet 351(9119): 1833-1839, 1998.