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Male marijuana smokers at high risk for testicular cancer

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By Marie Cendejas

A new study has found that young men who use marijuana have a higher risk of testicular cancer, according to ABC News.
The study was published in the journal Cancer and it adds to increasing evidence that smoking pot may have lasting effects on men's fertility and health.

Among 455 men from California, those who smoked pot were twice as likely to be diagnosed with testicular germ cell tumors. It is the most common form of testicular cancer in men aged 35 or younger.

(Editor's note:  Many factors may increase testicular cancer risk.  One thing for sure is that marijuana is not the only thing that causes the disease.   One recent study shows that prenatal exposure to radiation can boost the risk of testicular cancer or testicular germ cell tumors. Gunapala Shetty of The University of Texas MD Anderson Cancer Center, Houston, Texas and colleagues found "the male fetus of women exposed to radiation at about 5–6 weeks of pregnancy might have an increased risk of developing testicular cancer."   Background radiation may be at least partially responsible for the disease, whose incidence is on the rise. Somewhere in Arkansas testicular cancer incidence in teens is particularly higher, compared with other regions in the U.S.  Reports circulated over the Internet say 14 states have been polluted by radioactive particles released from nuclear tests in the 50's.)

Victoria Cortessis, co-author of the study and assistant professor of preventive medicine at the University of Southern California's Keck School of Medicine in Los Angeles, said, "Testicular cancer is on the rise. So we asked, 'What is it that young men are doing more frequently that could account for the increased risk?'"

Cortessie and colleagues used interviews to probe recreational drug use among 163 men diagnosed with testicular cancer and 292 healthy men of the same age, and found those who smoked marijuana had double the risk of testicular tumors, compared with men who passed on grass. 

"Most men who get testicular cancer today survive, and that's wonderful. But as a result of treatment, they may have problems with fertility or sexual function. So we're talking about the risk of developing the cancer in the first place as well as the subsequent effects of the cancer and its treatment." said Cortessis."We now have three studies connecting marijuana use to testicular cancer, and no studies that contradict them. I think we should start taking notice," said Stephen Schwartz an epidemiologist at the Fred Hutchinson Cancer Center in Seattle and co-author of the first study of linking marijuana use to testicular cancer in 2009. 

The National Cancer Institute estimates that in 2012, more than 8,500 men will be diagnosed with testicular cancer and about 360 will die from it. 

The risk of testicular cancer is still unclear on how the marijuana increases the risk. In animal studies, marijuana smoke and the cannabis chemical THC reduce levels of circulating hormones like testosterone.

Cortessis said, "We know testosterone is an important regulator of testes development and function. It may be that marijuana use disrupts this regulation in a way that makes the testes much more vulnerable to cancer."

Cortessis suspects that boys who experiment with marijuana during puberty might be particularly susceptible. In her study, the risk of testicular cancer was higher among men who smoked less than once a week and for fewer than 10 years.

"Guys who tried it and abandoned it may have been very young. We plan to investigate the possibility that men who use marijuana during puberty may be especially vulnerable, which makes sense if marijuana is disrupting the hormone signaling that directs the testes to maturity.” she said.

But other factors could also be at play, as men who use marijuana are more likely to drink and use other drugs. However, Cortessis found men who used cocaine were actually less likely to develop testicular cancer - a result that might reflect the drug's toxic effects.

"My suspicion is that the effect of cocaine is to kill the germ cells so they're not there," she said, describing how cocaine cuts testicular size and function in mice. "It's more analogous to a mastectomy to reduce the risk of breast cancer. And for a young guy, that would be high price to pay."

Cortessis and Schwartz have agreed that more work is needed to find out how marijuana use affects testicular cancer risk.
"I think at this stage of knowledge men deserve to be informed of this. "It's not a huge body of work, but the results are so consistent that it's very unlikely this is due to chance," said Cortessis. 
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