[Testicular cancer. A challenge to the health services taking care of young males].

About 130 Norwegian men (15-45 years old) develop testicular cancer each year. Men with a history of undescended testes, atrophic testes and/or fertility problems probably represent a high risk group. Typical symptoms are tumour, harder consistency and discomfort in the testes, low back pain and gynecomastia. Testicular ultrasonography often helps to establish the correct diagnosis. Seminoma is separated from non-seminoma histologically. Adjuvant radiotherapy to the retroperitoneal lymph nodes is the most frequent treatment in seminoma patients with early disease and is combined with chemotherapy in patients with advanced disease. Chemotherapy and surgery are the main therapeutic modalities in non-seminoma patients. In clinical trials a "wait and see" policy is applicable in selected patients with non-seminoma without metastases, provided that frequent follow-up examinations are feasible. Gastrointestinal side effects, alopecia, peripheral neuropathy and azoospermia are the most frequent acute and reversible side effects of treatment of testicular cancer. Post-treatment paternity can be achieved by at least half of the patients who wish to father a child after treatment. The 5-years' survival rate for young patients with testicular cancer is 95%. Young men should perform testicular self-examination regularly. Medical officers in the Armed Forces and doctors at schools and universities and in occupational health should be aware of testicular cancer in young adults with suspicious clinical findings.