What is testicular cancer?
The testicles (testes) are oval organs located in the scrotum, the bag of skin hanging beneath the penis. The testes produce sex hormones and sperm. Testicular cancer is a form of cancer usually found in only one testicle. Though it is rare in comparison to other types of cancer, testicular cancer is the most common form of cancer in American males between 15 and 35 years of age.
While its cause is unknown, nearly all types of this cancer begin developing in the germ cells. These are cells within the testes that produce immature sperm. The two most common types of testicular cancer are:
- Seminoma – Though it can occur in all age groups, seminoma is usually the form of testicular cancer found in older adult males. It is typically not as aggressive as nonseminoma.
- Nonseminoma – This tumor has a tendency to develop earlier in life and grows and spreads (metastasizes) rapidly. There are several different types of nonseminomas, including yolk sac tumor, embryonal carcinoma, and choriocarcinoma.
Factors that may increase the risk of developing testicular cancer include:
- Abnormal testicular development
- An undescended testicle (cryptorchidism)
- A family history of testicular cancer
- Ethnicity (more common in white males than black males)
What are the symptoms of testicular cancer?
Symptoms of testicular cancer include:
- A lump or swelling in either testicle
- Back pain
- Dull aching in the groin or lower abdomen
- Enlarged or tender breasts
- Heavy feeling in the scrotum
- Pain or discomfort in a testicle or the scrotum
How is testicular cancer diagnosed?
Following the discovery of a lump during a self-exam or physical exam, a physician may recommend any of the following tests:
- Blood tests to determine if there are elevated levels of tumor markers in the bloodstream
- Radical inguinal orchiectomy, when the testicle under the suspicion of cancer is surgically removed for analysis
- Ultrasound, in which sound waves are used to create an image of the scrotum and testes
Once a diagnosis is confirmed, a physician will determine what stage the cancer is in.
Stages of testicular cancer are:
- Stage I: Cancer is within the testicle
- Stage II: Cancer has spread to the lymph nodes in the abdomen
- Stage III: Cancer has spread to other parts of the body (most commonly to the lungs and liver)
How is testicular cancer treated?
Treatment options are dependent on several factors, including the individual’s overall health, stage/type of cancer and preferences. Options include:
Surgery to completely remove the testicle is the primary form of treatment for all types and stages of testicular cancer. In some cases, surgery to remove the surrounding lymph nodes (known as a retroperitoneal lymph node dissection) may be necessary to keep the cancer from spreading.
If surgery is the only treatment for the cancer, follow-up appointments every few months will be recommended to ensure the cancer has not returned.
Radiation therapy utilizes high-energy beams targeted in the affected area to kill cancer cells. It is done using a machine that moves around the body to direct the beams in exact locations. Radiation therapy is typically used following surgery to destroy any remaining cancer cells.
Radiation is occasionally used for individuals with seminoma and may be recommended after the testicle is removed surgically.
Chemotherapy may be utilized to kill any cancer cells remaining after surgery or shrink a tumor as much as possible before surgery. This form of treatment may be the only treatment utilized or may be recommended following lymph node removal.