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Testicular Cancer

Testicular cancer is a disease in which cells become malignant (cancerous) in one or both testicles. The testicles are a pair of male sex glands. They produce and store sperm and are the main source of testosterone (male hormones) in men.

Based on the characteristics of the cells in the tumor, testicular cancers are classified as seminomas or nonseminomas. Testicular tumors may contain both seminoma and nonseminoma cells.

Seminomas may be one of three types:

  • Classic
  • Anaplastic
  • Spermatocytic

Types of nonseminomas include:

  • Choriocarcinoma
  • Embryonal carcinoma
  • Teratoma (tumors composed of multiple cell types)
  • Yolk sac tumors

Testicular cancer accounts for only 1 percent of all cancers in men in the United States. About 8,000 men are diagnosed with testicular cancer, and about 390 men die of this disease each year. Testicular cancer occurs most often in men between the ages of 20 and 39. It is the most common form of cancer in men between the ages of 15 and 34.

Testicular cancer is most common in Caucasian men, especially those of Scandinavian descent. The testicular cancer rate has more than doubled among white men in the past 40 years, but has only recently begun to increase among black men. The reason for the racial differences in incidence is not known.

Risk Factors

The exact causes of testicular cancer are not known. However, studies have shown that several factors increase a man's chance of developing this disease.

  • Undescended testicle (cryptorchidism) Normally, the testicles descend from inside the abdomen into the scrotum before birth. The risk of testicular cancer is increased in males with a testicle that does not move down into the scrotum. This risk does not change even after surgery to move the testicle into the scrotum. The increased risk applies to both testicles.
  • Congenital abnormalities - Men born with abnormalities of the testicles, penis, or kidneys, as well as those with inguinal hernia (hernia in the groin area, where the thigh meets the abdomen), may be at increased risk.
  • History of testicular cancer - Men who have had testicular cancer are at increased risk of developing cancer in the other testicle.
  • Family history of testicular cancer - The risk for testicular cancer is greater in men whose brother or father has had the disease.

Symptoms

Most testicular cancers are found by men themselves. Also, doctors generally examine the testicles during routine physical exams. Between regular checkups, if a man notices anything unusual about his testicles, he should talk with his doctor.

Men should see a doctor if they notice any of the following symptoms:

  • Painless lump or swelling in a testicle
  • Pain or discomfort in a testicle or in the scrotum
  • Enlargement of a testicle or change in the way it feels
  • Feeling of heaviness in the scrotum
  • Dull ache in the lower abdomen, back, or groin
  • Sudden collection of fluid in the scrotum

If you have these symptoms, it is important to be seen by the Miami Valley Hospital’s cancer team who has expertise in treating this specific disease.

Causes

The cause of testicular cancer is unknown. Men who have an undescended testicle are at greater risk for the disease. The male children of women who took hormones while pregnant may also be at greater risk.

Diagnosis

If you have symptoms that suggest testicular cancer, your doctor may recommend one or more of the following tests and procedures:

Treatment

Treatment for testicular cancer begins with a radical inguinal orchiectomy, which is surgery to remove the affected testicle(s).

Depending on which type of cancer cells are present and whether your cancer has spread to other areas of your body (stage), this procedure may be followed by one or more of the following treatments:

  • Watchful waiting - A period of time during which you are being monitored by your doctor but are not receiving treatment. It is also called observation or surveillance.
  • Radiation therapy - The use of high-dose X-rays to destroy cancer cells and shrink tumors. This type of treatment is commonly used to treat seminomas, as these cells are highly sensitive to radiation. Radiation therapy is not effective in treating nonseminoma cancers.
  • Chemotherapy - The use of very powerful medicines to destroy cancer cells. The most common chemotherapy used to treat testicular cancer is called cisplatin combination therapy. It involves the use of several different medicines. This treatment varies in intensity and is often used for men whose cancer has spread beyond the testes to lymph nodes or other organs.
  • High Dose Chemotherapy with Stem Cell Transplant – a method of giving high doses of chemotherapy and replacing blood-forming cells destroyed by the cancer treatment.
  • Surgery – surgery to remove the testicle and some of the lymph nodes may be done at diagnosis and staging. Tumors that have spread to other placed in the body may be partly or entirely removed.

Additional surgery may be required to remove cancer cells that have spread to lymph nodes or other areas of your body. One type of surgery, called a retroperitoneal lymph node dissection (RPLND), is a common treatment for nonseminomas involving the removal of lymph nodes in the abdomen and lower back.

Patient Education

Learn more about testicular cancer so you can better understand your condition and your treatment options.

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