What is testicular cancer?
Testicular cancer is a disease in which malignant (cancer) cells form in the tissues of one or both testicles.
The testicles are 2 egg-shaped glands located inside the scrotum (a sac of loose skin that lies directly below the penis). The testicles are held within the scrotum by the
spermatic cord, which also contains the vas deferens and vessels and nerves of the testicles.
The testicles are the male sex glands and produce testosterone and sperm. Germ cells within the testicles produce immature sperm that travel through a network of tubules (tiny tubes) and larger tubes into the epididymis (a long coiled tube next to the testicles) where the sperm mature and are stored.
Almost all testicular cancers start in the germ cells. The two main types of testicular germ cell tumors are seminomas and nonseminomas. These 2 types grow and spread differently and are treated differently. Nonseminomas tend to grow and spread more quickly than seminomas.
Seminomas are more sensitive to radiation. A testicular tumor that contains both seminoma and nonseminoma cells is treated as a nonseminoma.
Testicular cancer is the most common cancer in men 20 to 35 years old.
What are the possible signs and symptoms of testicular cancer?
Testicular cancers are often (90%-95%) curable even if they are metastatic.
The first and early sign of testicular cancer is most commonly a little ("pea-sized") lump on the testis (painless testicular lump). There may be no real pain, at most just a dull ache in the lower abdomen or groin, perhaps a sensation of dragging and heaviness. The signs and symptoms of cancer of the testicle may include...
- a lump in or on a testicle (testicular lump) is the most common sign;
- any enlargement or swelling of a testicle and/or scrotum;
- shrinking of a testicle;
- a feeling of heaviness in the scrotum (scrotal heaviness);
- a dull ache in the lower abdomen (lower abdominal pain) or in the groin (groin ache);
- a collection of fluid in the scrotum;
- discomfort or pain in a testicle or in the scrotum;
- enlargement or tenderness of the breasts;
- lower back pain due to retroperitoneal disease spread; and
- enlarged or swollen lymph nodes or masses due to disease spread.
The best hope for early detection of testicular cancer is a simple three-minute self-examination once a month. The ideal time for this exam is after a warm bath or shower, when the scrotal skin is most relaxed.
Gently roll each testicle between the thumb and fingers of both hands. If any hard lumps or nodules are felt, a man should see a doctor promptly. A lump may not be malignant, but only a doctor can make the diagnosis.
What are the advanced testicular cancer symptoms and signs?
Advanced testicular cancer symptoms may include
- fatigue,
- weight loss,
- early puberty in boys,
- low back pain,
- shortness of breath,
- blood clot (DVT or deep venous thrombosis),
- chest pain,
- stomach or belly pain,
- headaches, and
- confusion
There can be some overlap of symptoms and signs between advanced and early testicular cancer in some individuals. In addition, many symptoms listed above may occur with other diseases. Consequently, individuals should seek medical caregivers (primary care physicians, urologists, oncologists, and pathologists, for example) to get a definitive diagnosis.
Treatment of Testicular Cancer
Surgery to remove the testicle (inguinal orchiectomy) and some of the lymph nodes may be done at diagnosis and staging. Tumors that have spread to other places in the body may be partly or entirely removed by surgery.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:
- External radiation therapy uses a machine outside the body to send radiation toward the cancer.
- Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is used to treat testicular cancer.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Surveillance
Surveillance is closely following a patient's condition without giving any treatment unless there are changes in test results. It is used to find early signs that the cancer has recurred (come back). In surveillance, patients are given certain exams and tests on a regular schedule.
High-dose chemotherapy with stem cell transplant
High-dose chemotherapy with stem cell transplant is a method of giving high doses of chemotherapy and replacing blood -forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.