Testicular Cancer (Cancer of the Testicle)

Definition

Testicular cancer is a disease in which cancer cells grow in one or both testicles. The testicles are a pair of male sex glands that produce and store sperm and produce male hormones. They are located under the penis in a sac-like pouch called the scrotum.

There are three main types of testicular cancer: seminomas, nonseminomas (yolk sac, embryonal cell carcinoma, teratomas, and choriocarcinoma) and stromal cell tumors. Treatment will vary depending on the cell type.

Cancer occurs when cells in the body (in this case testicular cells) divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant tumors, which can invade nearby tissues and can spread to other parts of the body. A benign tumor does not invade or spread.

Causes

The causes of testicular cancer are unknown. However, research shows that certain risk factors are associated with the disease.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

Risk factors include:

• Personal or family history of testicular cancer
• Race: White
• Age: 25 to 35
• Abnormal testicular development, such as that seen in Klinefelter syndrome (a sex chromosome disorder involving low levels of male hormones, sterility, breast enlargement, and small testes)
• Undescended testicle that did not move down into the scrotum before birth

Symptoms

Symptoms include:

• A painless lump or swelling in either testicle. For this reason, young men, who are at greatest risk for developing testicular cancer, should make a practice of regularly examining their testicles, much in the same way that women examine their breast. The earlier a lump is discovered, the better the prognosis.
• Enlargement or swelling of a testicle or change in the way it feels
• Feeling of heaviness in the scrotum
• A dull ache in the lower abdomen or groin
• Fluid in the scrotum that appears suddenly
• Pain or discomfort in a testicle or in the scrotum
• Lower back pain (in later stages of the cancer)
• Enlarged breasts

Note: These symptoms may also be caused by other, less serious health conditions. A man experiencing these symptoms should see a doctor.

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:

• Blood tests—to measure the levels of tumor markers in the blood. Tumor markers are substances that appear at higher levels in the blood if cancer is present in the body.
• Ultrasonography—a test that uses sound waves to find tumors.
• Excisional biopsy —removal of an entire testicle and microscopic examination for cancer cells. Most testicles with suspicious lesions on ultrasound are entirely removed.

Treatment

Once testicular cancer is found, tests are performed to find out if the cancer has spread and, if so, to what extent.

Treatments include:

Prevention

There are no guidelines for preventing testicular cancer. However, having your testicles examined by your doctor during regular physical exams can detect cancer in its early stages when it may be more treatable. Contact your doctor immediately if you notice any lumps, hardness, or changes in your testicles. All men should perform self-testicular exams on a monthly basis, regardless of the presence of risk factors.