Testicular cancer is a cancer that originates in one or both testicles (testes). The testes are the male reproductive glands located inside the scrotum (the pouch of skin located underneath the penis). They are responsible for producing sperm and the testosterone hormone.
Testicular cancer often begins with changes in the germ cells, or the cells in the testicles that produce sperm. Testicular cancer is sometimes referred to as a germ cell tumor.
There are two main types of testicular cancer: seminomas and nonseminomas. Seminomas are slow-growing testicular cancers. They are usually confined to the testes, but the lymph nodes may also be involved. Nonseminomas are more common form of testicular cancer. This type is faster growing and may spread to other parts of the body.
Testicular cancer is the most commonly diagnosed cancer in men ages 15 to 35, but it can occur at any age. It is also one of the most treatable cancers, even if it has spread to other areas. According to the National Center for Biotechnology Information (NCBI), in those with early-stage seminomas, for example, the survival rate is 95 percent or higher. The rate is slightly lower for those with more advanced stages of testicular cancer (NCBI, 2012).
Risk factors are characteristics that increase your risk for developing a disease. Risk factors for testicular cancer include:
- having a family history of the disease
- abnormal testicular development
- being of Caucasian descent
- having an undescended testicle
Some men are asymptomatic when diagnosed with testicular cancer. When symptoms do appear, they can include:
- testicular pain or discomfort
- swelling of a testicle
- lower abdominal or back pain
- development of breast tissue
Make an appointment with your doctor if you have any symptoms of testicular cancer.
Your doctor may use a number of tests to diagnose testicular cancer. These may include:
- a physical exam, which can reveal any abnormalities of the testicles, such as lumps or swelling
- an ultrasound to examine the internal structure of the testicles
- blood tests called tumor marker tests, which may show elevated levels of substances related to testicular cancer, like alpha-fetoprotein or beta-human chorionic gonadotropin
If cancer is suspected, the entire testicle may need to be removed to obtain a sample of testicular tissue. This cannot be done when the testicle is still in the scrotum, because doing so can cause cancer to spread through the scrotum.
Once the diagnosis has been made, tests — such as pelvic and abdominal computed tomography (CT) scans — will be performed to see if the cancer has spread anywhere else. This is called staging. Stages of testicular cancer range from Stage I to Stage III:
- Stage I indicates that the cancer is limited to 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. This type of cancer commonly spreads to the lungs, liver, brains, and bone.
The cancer is also categorized based on the expected response to treatment: good, intermediate, and poor prognosis.
There are five standard treatments used for testicular cancer. Depending on the stage of your cancer, you may be treated with one or more options.
Surgery is used to remove one or both testicles and some surrounding lymph nodes to both stage and treat the cancer.
Radiation therapy uses high-energy rays to kill cancer cells. It may be administered externally or internally. External radiation uses a machine that aims the radiation at the cancerous area. Internal radiation involves the use of radioactive seeds or wires placed into the affected area. This form is often successful in treating seminomas.
Chemotherapy uses drugs to kill cancer cells. It is a systemic treatment, which means it can kill cancer cells that have traveled to other parts of the body. When taken orally or intravenously, the drugs can travel through the bloodstream to kill cancer cells.
Observation, or "watchful waiting," may be an option if the cancer is in an early stage and there are no symptoms.
In very advanced cases of testicular cancer, high-dose chemotherapy may be administered, followed by a stem cell transplant. Once the chemotherapy has destroyed the cancer cells, the stem cells are administered to the patient, and these cells develop into healthy blood cells.
Though testicular cancer is a highly treatable cancer, it can still spread to other parts of the body. If one or both testicles are removed, your fertility may also be affected. Before treatment begins, ask your doctor about your options for preserving your fertility.