What Do You Know About Reproductive Cancers?

Testicular cancer is rare. It affects 1 out of 250 men. But it's the most common cancer in young men ages 20 to 35.

Most testicular cancers are found by men on their own. Talk with your healthcare provider about whether you should do a testicular self-exam and how often you should do it. Some providers advise that all men do monthly testicular self-exams after puberty. If you do one, the best time is during or right after a shower or bath. This is when the skin of the scrotum is relaxed. Men should see a healthcare provider if they notice any of the following symptoms:

• A painless lump or swelling in either testicle
• Any enlargement of a testicle or change in the way it feels
• A feeling of heaviness in the scrotum
• A dull ache in the lower belly (abdomen) or where the thigh meets the belly (called the groin)
• A sudden build-up of fluid in the scrotum
• Pain or discomfort in a testicle or in the scrotum

These symptoms can be caused by cancer or by other conditions. It's important to see a healthcare provider to find out the cause of any symptoms.

Men born with 1 or both testicles in the abdomen that did not move down into the scrotum (undescended testicle) are at a higher risk for testicular cancer. Surgery done on younger children may reduce the risk of testicular cancer. Experts aren't sure if this helps when the child is older. Other factors that increase a man's chance of testicular cancer include abnormal testicular development; a family or personal history of testicular cancer; being younger than 35; and being white (white men are 4 to 5 times more likely to develop testicular cancer than Asian-American or African-American men).

Other than skin cancer, prostate cancer is the most common cancer in American men. It's usually slow growing but still a potentially deadly disease found most often in older men. This cancer has been found in men of all ages, but nearly two-thirds of all prostate cancers are found in men older than 65. Besides age, other factors that can increase prostate cancer risk include a family history of the disease and race (Black men and Caribbean men of African descent are at highest risk).

Prostate cancer seldom causes symptoms when it's small. This is why it's important for men to talk with a healthcare provider about their risk and decide if screening is right for them. Screening tests can help find cancer before it starts causing symptoms. The most important screening test for prostate cancer is a simple blood test called prostate-specific antigen (PSA). Some providers add a digital rectal exam (DRE) to feel for nodules or an enlarged prostate. Symptoms of later-stage prostate cancer include:

• A need to pee (urinate) often, especially at night
• Trouble starting urine flow
• Problems holding back urine
• Weak or stop-and-go flow of urine
• Pain or burning feeling when peeing
• Trouble getting an erection
• Pain with ejaculation
• Blood in urine or semen
• Pain or stiffness in the lower back, hips or upper thighs

Many of these symptoms can be caused by other, less serious health problems, such as prostate swelling or an infection. But someone who has symptoms like these should see a healthcare provider to be sure they are not caused by prostate cancer.

Factors that put a woman at risk of developing ovarian cancer are:

• Family history. Having a mother, daughter, or sister with the disease puts you at increased risk. If you have a close relative who has had ovarian cancer, genetic testing for BRCA1 and BRCA 2 is important. These are genetic mutations closely linked to breast and ovarian cancer.
• Age. Most ovarian cancers start after menopause, and about half of them are in women 63 or older.
• Childbearing. People who have never carried a pregnancy to full term are more likely to develop this cancer.
• Personal history. Women who have had breast, uterine, rectum, or colon cancer may have a greater chance of developing ovarian cancer.

Hormone therapy (HT) may also raise risk. Some studies suggest that people who use HT after menopause may have a slightly increased risk. Having 1 or more of the risk factors mentioned here does not mean that a person is sure to develop ovarian cancer. But the chance may be higher than average.

Other symptoms include:

• General abdominal discomfort, pain, or both. Discomfort may include gas, indigestion, pressure, swelling, bloating, or cramps.
• Feeling tired all the time
• Needing to pee often
• Pain during sex
• Irregular vaginal bleeding

These symptoms are common and more often related to less serious health problems. If they happen often or are getting worse, a woman should see a healthcare provider so the problem can be found and, if needed, treated.

The Pap test is a simple, painless tests to find cancer early. A Pap test is used to find changed (abnormal) cells in and around the cervix. This test should not be done when someone is menstruating. The best time for it is at least 5 days after the menstrual period stops. For about 2 days before a Pap test, you should not douche; use spermicidal foams, creams, or jellies; or have vaginal sex. The provider uses a small scraper (spatula), a small brush, or both to collect a sample of cells from the cervix and upper vagina. The cells are sent to a lab to be checked for abnormal changes. People over age 21 should talk with their healthcare provider about how often they should have PAP tests to screen for cervical cancer.

About 90% of women with endometrial cancer have abnormal vaginal bleeding. Endometrial cancer is more likely to develop after menopause. But it can happen at younger ages, too. It's important to see a healthcare provider about any abnormal vaginal bleeding, spotting, or discharge. Other symptoms of endometrial cancer include pain in the pelvic area and losing weight without trying. These symptoms can also be caused by many other less serious conditions. Most often they're not cancer. But only a healthcare provider can tell for sure.

Endometrial cancer is most common in women older than 50. Other risk factors for this cancer are:

• Endometrial hyperplasia
• Hormone therapy. People who use estrogen to treat menopause symptoms are at higher risk.
• Overweight and obesity. Estrogen can be made in fatty tissue, so overweight women have higher estrogen levels. This puts them at increased risk for this cancer.
• Diabetes. Endometrial cancer is about 2 times more likely in women with type 2 diabetes compared with those without it.
• Family history. Women who have certain cancer syndromes linked to gene changes that are passed in families are at increased risk. This includes hereditary nonpolyposis colon cancer (HNPCC) or Lynch syndrome.

Other risk factors are related to how long a woman's body is exposed to estrogen. Those who have no children, start their periods (menstruation) at a very young age, or enter menopause late in life are exposed to estrogen longer and have a higher risk.