Testicular cancer develops in the testes, the male reproductive organs located in the scrotum. The testes produce sperm and testosterone. Testicular cancer typically affects men age 15 to 35. When detected early it can be treated successfully in more than 95% of cases. Any lumps or changes in your testicles should be reported to your doctor immediately.
While the cause of testicular cancer is unknown, the following factors may increase your risk:
- Age – young men aged 15 to 35
- An undescended testicle
- Klinefelter’s Syndrome – an extra X chromosome causes testicular failure
- Family history of testicular cancer
- Race – Caucasian men are at higher risk
Types of Testicular Cancer
Most testicular cancer originates in undeveloped cells, called germ cells that produce sperm. A small percentage of testicular cancer develops in the stroma, the hormone producing tissue of the testicle. There are two main types of germ cell testicular cancer:
- Seminomas – tend to be less aggressive and are responsive to radiation therapy
- Nonseminomas – tend to grow and spread rapidly but are responsive to chemotherapy
Men with testicular cancer usually have no symptoms except for finding a lump in the testicle when performing a self-exam or during a doctor’s visit.
Symptoms may include:
- Testicular swelling, hardness or pain
- Heavy or aching feeling in the scrotum or lower abdomen
Pain is not always a sign of cancer, but should be investigated
Your doctor will obtain a thorough history and thorough physical exam.
Testing may include:
- Ultrasound of the scrotum
- CT scan
- Chest x-ray
- Blood tests – AFP (alpha-fetoprotein) and HCG (human chorionic gonadotropin) are tumor markers. High levels indicate testicular cancer
- Biopsy – when other tests are inconclusive, a biopsy is performed.
Once diagnosed with testicular cancer, your doctor will determine the stage of the cancer.
- Stage I – cancer is confined to the testicle
- Stage II – cancer has spread to the abdominal lymph nodes
- Stage III – cancer has spread to lymph nodes or organs in other parts of the body
- Surgery is the primary method of treatment and diagnosis and is usually performed immediately after finding a suspicious lump in the testis. Delay is not advisable. While surgery to remove one testis should not affect fertility, you may wish to store sperm in a sperm bank as a precaution. Both radiation and chemotherapy may cause temporary or permanent infertility.
- Radical Inguinal Orchiectomy – the most common treatment to remove the cancerous testicle and attached spermatic cord.
- Retroperitoneal Lymph Node Dissection – if the cancer has spread to the lymph nodes or the diagnosis of the tumor is high grade or unfavorable, your doctor may perform this procedure to remove the affected lymph nodes. In many cases this can be done laparoscopically, or through an abdominal incision.
- Radiation therapy – the most common treatment for patients diagnosed with seminoma cancer. High energy x-rays are precisely targeted at any cancerous cells that have spread to lymph nodes.
- Chemotherapy – drugs are given intravenously, by mouth, or by injection into a muscle to destroy cancer cells that remain after surgery. This treatment is done under the direction of an oncologist, a cancer specialist.