What is Testicular Cancer?
Testicular cancers are either seminomas or nonseminomas, depending on where the cancer started. Other types of cancer that arise in the testicles are rare.
Seminomas may be one of three types: classic, anaplastic, or spermatocytic.
Types of nonseminomas include choriocarcinoma, embryonal carcinoma, teratoma and yolk sac tumors.
Testicular tumors may contain both seminoma and nonseminoma cells.
Research is increasing regarding what we know about Testicular Cancer. Scientists are learning more about its causes. Following are common risk factors for the disease:
- Congenital Abnormalities - Men born with abnormalities of the testicles, penis, or kidneys, as well as those with Inguinal Hernia (hernia in the groin area) may be at increased risk.
- Family History - Testicular Cancer is greater in men whose brother or father has had the disease.
- Previous Testicular Cancer - Men who have had testicular cancer are at increased risk of developing cancer in the other testicle.
- Undescended Testicle (Cryptorchidism) - A Testicular Cancer risk is increased in males with a testicle that does not move down into the scrotum. (Note: This risk does not change even after surgery to move the testicle into the scrotum.)
Signs & Symptoms
Most testicular cancers are found by men themselves. Between regular checkups, men should pay attention to notice if he has any of the following symptoms:
- Dull ache in the lower abdomen, back, or groin
- Enlargement of a testicle or change in the way it feels
- Feeling of heaviness in the scrotum
- Pain or discomfort in a testicle or in the scrotum
- Painless lump or swelling in a testicle
- Sudden collection of fluid in the scrotum
Diagnosis and Staging
Most men find testicular cancers themselves. Doctors examine the testicles during physical exams. If a man experiences pain, heaviness, discomfort, enlargement or any other changes in the testicles or scrotum, he should see a doctor.
To determine the cause of these symptoms, the doctor will evaluate a man’s overall health and may order one or more of the following tests:
Blood Test - The blood may be tested to measure the levels of tumor markers, or substances found in above average amounts when cancer is present. AFP (alpha-fetoprotein), BHCG (beta-human chorionic gonadotropin) and LDH (lactate dehydrogenase) are all tumor markers that might suggest a testicular tumor. Blood tests can detect tumor markers even if the tumor is too small to be seen by imaging tests or physical exams.
Ultrasound - Sound waves and a computer are used to create a picture of the scrotum that can show the size and shape of a mass in the testicle. This test is good for ruling out other conditions not related to cancer.
Biopsy - A pathologist looks at a sample of tissue from the testicle under a microscope to check for cancer cells. In almost all cases of suspected cancer, the doctor removes the affected testicle through an incision in the groin. In rare cases, the doctor removes a sample of tissue through an incision in the groin, and only removes the entire testicle is cancer cells are found.
If testicular cancer is found, more tests are needed to find out if the cancer has spread from the testicle to other parts of the body. The stage of the cancer helps the doctor determine the right treatment.
Treatment and Side Effects Management
Treatment options for testicular cancer patients depend on the cancer stage, the patient’s age, and the patient’s overall health. Patients have time for second opinions and to talk through all of their options with their doctors and develop a treatment plan that best fits their needs.
Seminomas and nonseminomas are treated differently. Seminomas are more sensitive to radiation. If a tumor contains both types of cells, it is treated as a nonseminoma.
There are three types of standard treatment:
Orchiectomy is the procedure for removing the testicle through an incision in the groin. A man with one healthy testicle can still have sexual intercourse and this operation seldom affects a man’s ability to produce children.
Some men choose to have a fake testicle placed in the scrotum during or after surgery for cosmetic purposes.
A large machine directs radiation at the body and uses high-energy rays to kill cancer cells. Radiation aimed at the lymph nodes in the abdomen is used to treat seminomas, usually after surgery. Men with nonseminomas usually do not undergo radiation therapy, since those tumors are less likely to respond to radiation.
This treatment uses drugs to kill cancer cells. In patients with testicular cancer, chemotherapy is usually given after surgery, but it may be the initial treatment in advanced cases. Most often, drugs are injected into the veins.
Recovery after testicular cancer depends on treatment type, spread of disease, and other factors. Follow-up care after treatment for testicular cancer is important. Even when the cancer seems to be gone, it can return if cancer cells remain in the body after treatment. Regular doctor visits are suggested. Doctors check patients with regular blood tests, x-rays, and CT scans. Men who have had testicular cancer have an increased change of developing the disease in the other testicle.