Testicular cancer

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at February 9, 2016
StartDiseasesTesticular cancer

While rare compared to other cancers, testicular cancer is most often diagnosed in American males 15 to 35 years old. When discovered early this cancer is highly treatable and likely curable. Of the 8,400 men diagnosed with testicular cancer every year in the U.S. only around 380 will die from it.

Contents

Definition & Facts

Testicular cancer occurs through an abnormal growth of cells found in the testes. Testes are protected within a sac referred to as the scrotum. The scrotum is a bag of skin that is found under the penis. The testes are a pair of male sex organs that produce and store sperm, along with the male hormone testosterone.

While experts are unsure of what causes testicular cancer, they do know it begins in the cells that make sperm, called germ cells. The most common germ cell cancers are seminomas and nonseminomas. Nonseminomas tend to grow and spread at a much faster rate.

Symptoms & Complaints

Consult with a doctor to rule out other factors that may cause similar symptoms such as hernia, hydrocele (or fluid in the scrotum) or testicular torsion, commonly known as twisting of the testicle. Below are the most common symptoms or complaints of testicular cancer.

  • Lump is present in one or both testes. The testes or scrotum may or may not experience pain. A lump void of any pain is the most common sign and should be checked by a doctor if lasting longer than two weeks.
  • Feeling of pressure or dull ache in the groin area or lower stomach region.
  • Testicles appear swollen, with or without pain.

Advanced testicular cancer may present the following symptoms:

Causes

Doctors don’t know for sure what causes testicular cancer. They do know that when the germ cells develop abnormally and continue to grow in a disorderly fashion, they are more likely to form as a tumor in the testicles. Many men who develop testicular cancer have no risk factors associated with this cancer, but there are some factors that may come into play including:

  • The male is discovered to have an undescended testicle (cryptorchidism). This simply means that before birth, the testicle failed to descend from the abdomen down to the scrotum. The cancer can appear in either the undescended testicle or the normal one.
  • A male who has a father or brother diagnosed with testicular cancer will be at higher risk.
  • This type of cancer is more common in white males than in black males.

Diagnosis & Tests

There are several ways a doctor will determine if testicular cancer is present, and they include:

  • Testicular ultrasound – A doctor uses sound waves to produce an ultrasonic image to determine the nature of the lump and rule out other possible causes. The noninvasive ultrasound will verify if the mass is solid or fluid-filled and whether the lump sits in or outside of the testicle.
  • Blood testsTumor markers are proteins produced by testicular malignancies. They are normally found in the blood, but in cases of cancer the levels may be elevated. Blood tests will determine the levels of tumor markers to help the doctor make a proper diagnosis.
  • Removal of the testicle – If the previous tests suggest cancer the doctor will surgically remove the testicle and send it to the lab to confirm the diagnosis.

If the result is positive, more tests, such as X-ray, CT scans, or MRIs may be required to determine which of the three stages the cancer is at:

  • Stage I – The cancer is isolated only in the testicle
  • Stage II – The cancer is present in the lymph nodes within the stomach region
  • Stage III – The cancer has metastasized or expanded beyond the lymph nodes into other regions of the body, most commonly to the liver or lungs

Treatment & Therapy

Treatment will depend on the aggressive nature of the tumor. If caught in the early stages removal of the testicle may be all that is needed. In other cases the type of cancer, seminomas or nonseminomas, will determine the course of treatment. In either case the doctor will continue to monitor the area with regular check-ups for at least five years.

  • Seminomas – these cancer cells grow and spread at a slower rate and in stage I cancer may only require surgery. In cases of stage II or stage III radiation therapy or chemotherapy may be used individually or combined to eradicate the cancer cells. If any of the mass is still present after therapy, surgery may be needed to remove it.
  • Nonseminomas – can be more aggressive, growing and spreading at a much greater speed. This cancer has proven to not respond well to radiation therapy. Once the testicle is removed a round of chemotherapy or the removal of the lymph nodes may be required individually or together. When completed, any residual tumor will be surgically removed.

Prevention & Prophylaxis

Regular doctor visits and testicular self-exams are the best way to detect and catch it early. Self-exams are best performed soon after a warm shower when the scrotum is relaxed. This will make it easier to detect any abnormalities. Follow these guidelines when performing a self-exam:

  • While standing in front of a mirror, look for any swelling of the scrotum.
  • Use both hands to hold each testicle by placing the index finger and middle finger under it and the thumb on the top
  • Rotate the testicle between finger and thumb. While smooth, they may feel slightly firm. It is normal that one testicle appears larger than the other.

If a lump is detected, see a doctor as soon as possible.