Men's Health

Testicular Cancer

Testicular cancer is the most common cancer in young men between the ages of 15 and 35. It starts as an abnormal growth or tumor that develops in one or both testicles. It is a highly treatable type of cancer with a very good cure rate (about 95%) if found and treated early.
  • 7,920 new cases of testicular cancer are expected to be diagnosed in 2013.
  • Because treatment is so successful, the risk of dying from this cancer is very low: about 1 in 5,000.
  • 370 men will die from testicular cancer in 2013.
  • A man's lifetime chance of having testicular cancer is about 1 in 270.
 
OVERVIEW          TREATMENT          RESOURCES



OVERVIEW

What is testicular cancer?

Cancer begins when cells in a part of the body begin to grow abnormally. As these cancer cells grow and divide, they invade normal tissue and form a tumor. As the tumor grows, it is possible that some cells will get into the bloodstream or lymph vessels, travel to other parts of the body and begin to grow and form new tumors in a process called metastasis.
 
Cancer that develops in one or both testicles is called testicular cancer. The testicles are part of the male reproductive system and are responsible for the production of male hormones (mostly testosterone) and sperm. 
 
Testicular cancer commonly presents as a small hard lump, with swelling or a change in the consistency of the testicle. Some men also experience a dull ache in the testicle or lower abdomen. In the majority of cases, only one testicle is affected. 
 
Men, regardless of age, who find such an abnormality, should go to the doctor immediately.

Are there different types of testicular cancer?
 
Cancers of the testicle are named after the type of cell in which they develop. Testicular cancer can be grouped into three types of tumors:
  1. Germ cell tumors
  2. Stromal tumors
  3. Secondary testicular tumors
More than 90% of testicular cancers develop in germ cells, which are responsible for the production of sperm. There are two main types of germ cell tumors; seminomas and non-seminomas. Testicular cancer can include a mix of seminoma and non-seminoma cells or a combination of the different types of non-seminoma including;

Seminomas: 
  • Classical seminoma (85%)
  • Anaplastic seminoma (10%)
  • Spermatocytic seminoma (5%)
Non-seminomas:
  • Choriocarcinoma
  • Embryonal Carcinoma
  • Teratoma
  • Yolk Sac Tumor
A small number of testicular cancers start in cells that make up the supportive (structural) and hormone producing tissue of the testicles. These are called stromal tumors and have two main types:
  • Leydig cell tumors
  • Sertoli cell tumors
Secondary testicular tumors are caused by cancerous cells that have spread to the testicles from other parts of the body. These cancers are much more rare than the aforementioned forms of testicular cancer.
 
For more information about types of testicular cancer click here.
 
What are the risk factors?

Young men between the age of 18 and 40 years are at the highest risk of developing testicular cancer. The causes of testicular cancer are unknown, however possible factors that may increase a man’s risk include:
  • Undescended testes at birth
  • Family history (father or brother with testicular cancer)
  • Previous incidence of testicular cancer (Around one in 25 men who have had cancer in one testicle are likely to develop cancer in the other testicle at some stage)
  • Down syndrome may also increases a man’s risk.
There is no known link between testicular cancer and injury to the testicles, sporting strains, hot baths or wearing tight clothes.

What are the symptoms?

Men may experience few or no symptoms of testicular cancer. Important symptoms to watch for include:
  • Swelling or a lump in either testicle (usually painless)
  • A feeling of heaviness in the scrotum
  • Change in the size and shape of the testicles
  • Aches or pain in the lower abdomen or groin
  • A sudden build-up of fluid in the scrotum
  • Pain or discomfort in a testicle or in the scrotum
  • Enlargement or tenderness of the breast tissue
What is testicular self-examination (TSE)?

Regular self-examination of the testicles is important for young men, particularly those at risk of testicular cancer. Being familiar with the size, shape and usual level of lumpiness can help you determine if something is not quite right.

A testicular self-examination can help a man find any changes in the testes early, so that if treatment is needed it can start as early as possible. Men are encouraged to perform monthly testicular self-exams, ideally after a bath or shower, when the scrotum is relaxed.

The American Cancer Society recommends having a testicular exam by your doctor as part of your routine checkup. Click here for more information on conducting monthly self-exams.



TREATMENT
Testicular cancer is a highly treatable cancer, and potentially curable, if diagnosed and treated early. Advanced testicular cancer can also be cured with treatment.
 
If diagnosed with testicular cancer, the most important step is to talk at length with your doctor about your treatment choices. In choosing a treatment plan, factors such as your overall health and the type and stage of the cancer should be considered. You may consider getting a second or third doctor’s opinion.
 
In most men with testicular cancer, treatment involves the surgical removal of the affected testicle. This may be followed with surveillance, chemotherapy or radiotherapy.
 
An orchiectomy (surgical removal of the affected testis) is done under general anesthetic. The removed testis is then sent to a pathology laboratory to confirm the stage and type of cancer. 
 
Chemotherapy or radiotherapy is often prescribed after surgery to treat any remaining cancer cells that may have spread to other parts of the body, such as lymph nodes. The level or amount of chemotherapy and radiotherapy will be different for each man and will depend on the stage and type of cancer. 
 
Testicular cancer and the removal of one testicle should not alter sexual function or fertility. The effect on fertility following removal of one of the testicles is minimal as a single testicle produces such large numbers of sperm.
 
For those men who require further treatment, fertility is likely to be affected, at least temporarily. In general, the higher the dose and the longer the treatment, the greater the chance for reproductive problems. For more information on your risk and treatment options for infertility related to cancer, visit Fertile Hope, a LIVESTRONG initiative dedicated to providing reproductive information, support and hope to cancer patients and survivors who are at risk of infertility.



RESOURCES

For help coping with the impact of a testicular cancer diagnosis on your life or the life of a loved one, please contact the following organizations that can provide additional information and support.

LIVESTRONG Foundation provides support to guide people through the cancer experience, to help them live with and beyond cancer. Through LIVESTRONG’s Cancer Navigation Center, those affected by cancer can receive free one-on-one support online or via phone (855) 220-7777.
The American Cancer Society is a nationwide, community-based health organization dedicated to eliminating cancer as a major health problem. The website provides cancer facts, advice and support.















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