Testicular cancer develops when abnormal cells grow out of control in a man’s testes (testicles), which are found inside the scrotum. The testes are male sex organs that produce hormone testosterone and make and store sperm. Compared to other cancers, testicular cancer is quite rare occurring in 1 man per 100,000. Nevertheless, it is the most frequent cancer among American males ages 15 to 35 and is more frequently found in white males than Asian or African men. It is important to note that not all testicular lumps are cancer and a man may have other conditions such as testicular microlithiasis, epididymal cysts and appendix testis, all of which may be painful but are non-cancerous. Testicular cancer is very much treatable and can be treated even after spreading beyond the testicle.
While the exact causes of testicular cancer are not known, the cancer generally occurs when healthy cells of the testicle become altered. Testicular cells usually multiply in a systematic manner to keep the body functioning normally. However, abnormalities in some cells may abruptly cause uncontrollable multiplication, resulting in a surplus of new cells in the testicle. The accumulation of new cells results in a testicular mass or lump. Almost all testicular cancers start in germ cells (testicular cells producing immature sperm).
Risk factors for testicular cancer include:
- Cryptorchidism (undescended testicles): Development of the testicles occurs in the fetal abdomen and the developed testes move down into the scrotum before birth. A man whose testicles never descended in this manner is at greater risk of having testicular cancer than those whose testes descended normally. The risk is still high even if the testes have been surgically relocated into the scrotum.
- Abnormal testicle development: Disorders that hinder normal development of testicles, like Klinefelter syndrome, increase the risk of this cancer.
- Age: Testicular cancer is common in teens and young men (ages 15 to 35). Nevertheless, it may still occur in older men.
- Family history: If your father or brother has had the cancer, you have an increased risk.
- Personal history of testicular cancer: If you have had the cancer treated in one testicle, you may develop it in the other testicle.
- Race: The cancer is more frequent in white males than in black or Asian males.
- Infertility: Men who do not produce sperm when ejaculating have a greater risk.
Signs and symptoms
Knowing the symptoms of testicular cancer can help you to seek treatment when the cancer is still at an early stage. The most common indicators are:
- An enlargement or lump in either testicle.
- Accumulation of fluid in your scrotum.
- A dull pain or ache in the groin or abdomen.
- The scrotum becomes increasingly heavy.
- Discomfort or pain in the testes or on the scrotum.
- Tenderness or enlargement of male breasts.
- Lower back pain.
- In rare cases, testicular cancer can spread and affect other organs resulting in coughing, difficulty swallowing, breathing difficulties and swelling in the chest.
Diagnosis of testicular cancer
A man may detect enlargement or lumps in his testicles through self-examination. A doctor can notice a lump in a testicle during routine physical examination. When an enlargement or a lump is detected, the doctor will suggest a few tests to confirm or rule out testicular cancer. The tests commonly requested are a testicular ultrasound and blood tests for tumor markers. Surgery to remove a testicle for analysis and classification of the cancer also may be performed.
Removal of a testicle is usually done to classify the cancer since it is the type and stage of cancer that determines treatment and prognosis. Testicular cancer is divided into two types, seminoma and nonseminoma. Seminoma cancer can be found in all age groups, but is more frequent in older men. The cancer is less aggressive than nonseminoma. Nonseminoma cancer tends to develop in younger men and teens and is characterized by rapid growth and spread.
Testicular cancer stages
When testicular cancer has been diagnosed, it is then important to determine the stage (extent) of the cancer. For a doctor to assess how far the cancer has spread in or outside a testicle, blood tests and computer tomography (CT) scan are requested. The results of these tests help the doctor to categorize the cancer in stages and to offer appropriate treatment. The stages include:
Stage I: Cancer that is restricted to the testicle.
Stage II: Cancer that has spread out of the testicle into the lymph nodes of the abdomen.
Stage III: Cancer that has spread to various body parts, such as liver, bones, brain and lungs.
Testicular cancer treatment
The appropriate treatment for the cancer depends on many factors, including your general health, stage and type of cancer, and your preferences. For instance the doctor may opt for surgery to remove the affected testicle or nearby lymph nodes. Alternatively, the doctor may use radiation, high-powered beams of energy, like X-rays, to treat the cancer. Another option is chemotherapy, where specific drugs are used to destroy cancer cells. For more information on testicular cancer, visit the site, Advanced Urology Institute.