The testes are the two male sex organs that produce and store semen as well as the hormone testosterone. They are located in the scrotum. Testicular cancer occurs when abnormal cells grow out of control in the testes. While not very common – the disease affects mostly young men between the ages of 15 and 35, and who are white – testicular cancer is highly treatable if detected early.
There are two subtypes of testicular cancer. Seminoma (germ cell) tumors account for 40% of all testicular cancers. Nonseminoma subtypes, which are more aggressive, account for the rest, and include teratocarcinoma and embryonal cell carcinoma.
The exact causes of testicular cancer are not known, though some issues may increase your chance of getting it. A family history of testicular cancer; the genetic disorder Klinefelter syndrome, which results in two or more X chromosomes; or an undescended testicle all can increase the probability of testicular cancer.
There are many symptoms of testicular cancer, but the most common include:
- Pain in one or both testicles
- Changes in the size or shape of one or both testes
- A heavy feeling in the scrotum
- A dull pressure or pain in the lower back, belly or groin, or in all three places
Many men find testicular cancer themselves during a self-examination, though your physician may also detect it during a routine physical exam. Because other problems can cause symptoms similar to those of testicular cancer, your physician may order tests to find out if you have another problem, or to be sure the cancer has not spread. These tests may include:
- Blood work: Blood may be drawn and examined for high levels of certain proteins that are often secreted by testicular cancer. These proteins include alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG).
- Biopsy: An examination of the tissue for abnormal cell growth. Because of the high risk of contamination and the spread of cancer by doing a scrotal biopsy, the affected testicle is almost always removed and the tissue is examined. The sample will show the type of cancer.
Imaging or X-ray tests:
- CT scan: Performed to screen for and determine extent of disease, including involvement of surrounding tissues or other organs.
- Ultrasound: The physician can produce images of the testes using a wand-like instrument called a transducer, which emits sound waves and picks up the echoes as they bounce off organs.
Our testicular cancer treatment approach depends on each patient's situation. Nearly all men with testicular cancer undergo surgery to remove the affected testicle, a procedure called radical inguinal orchiectomy. This will allow the physician to determine the type of cancer cells present, and to plan other necessary treatments. These post-surgery treatments may include:
- Surveillance: If the cancer was at an early stage, the physician may suggest close surveillance to see what happens following surgery, with regular checkups to make sure that the cancer is gone.
- Chemotherapy: With more advanced cancers, your physician may recommend chemotherapy to destroy cancer cells that remain after surgery.
- Radiation therapy: This high dose of X-rays may be used to destroy cancer cells that remain after surgery, and is mostly used to treat seminoma. Radiation therapy can also be used to treat cancer that has spread beyond the testes.
- Additional surgery to remove lymph nodes: The surgeon may choose to remove potentially cancerous lymph nodes from the lower back and pelvis. This procedure is called retroperitoneal lymph node dissection (RPLND).
For more information on Testicular Cancer visit WebMD's Testicular Cancer page.