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Testicular Cancer

Testicular cancer is a form of cancer that develops in the testicles, which are located in the scrotum, a loose bag of skin beneath the penis. Testicles produce male sex hormones and sperm for reproduction. Testicular cancer starts when cells begin to grow out of control. Cells located in almost any part of the body can become cancerous and spread to other parts of the body.

In relation to other forms of cancer, testicular cancer is much more rare. With that said, testicular cancer is the most common type of cancer in American males who fall between the ages of 15 and 35. Approximately one in every 250 males will develop testicular cancer at some point in their lifetime. The average age at the time of diagnosis of testicular cancer is about 33 and this disease is more common in young and middle-aged men.

This type of cancer is very easily treated, even when the cancer has spread beyond the testicle. Considering the stage and type of testicular cancer, the patient may receive one of many various treatment options, or a combination of several.

Signs and Symptoms of Testicular Cancer

There are a few tell-tale signs and symptoms of testicular cancer. Some of those may include:

  • Painless lump in the testicle (this is the most common sign of testicular cancer)
  • Pain or a dull ache in the testicle, scrotum, or groin
  • Swelling of the testicle (with or without pain) or a feeling of weight in the scrotum
  • Tenderness or changes in male breast tissue
  • Back pain
  • A sudden collection of fluid in the scrotum

If you locate a lump or a firm part of the testicle, you should seek attention from your doctor to determine if the lump is a tumor. It is common for men with testicular cancer to not feel pain in the testicles at first.

Is is also common for men to wait before informing their health care provider about their signs or symptoms of testicular cancer. In fact, most men wait an average of five months after the development of symptoms to say anything. Since the tumor can spread during that period of time, it is extremely important to speak with a urologist if you notice any of the signs or symptoms mentioned above. This is more important if the symptoms last more than two weeks. A urologist will want to test if the cancer is growing or if the cause is another issue like:

  • Epididymitis: swelling of the epididymis; often treated with antibiotics
  • Inguinal Hernia: when part of the intestine pokes through a weak part of the stomach muscles near the groin; often treated with surgery
  • Testicular Torsion: twisting of the testicles; often treated with surgery
  • Hydrocele: the accumulation of fluid in the scrotum; often goes away without treatment

Causes of Testicular Cancer

Unfortunately, it’s not exactly clear what the actual cause of testicular cancer is, but doctors and urologists have theories as to who may be at higher risk:

  • Men with a father or brother who have a history of testicular cancer
  • Abnormal cells in the testicle called germ cell neoplasia in situ (GCNIS), most often found during an infertility test
  • Men with a history of testes that do not drop before birth (also known as undescended testes or cryptorchidism)

If you find yourself in one of these categories, you should perform a testicular self-examination each month. The self-exam may help you catch problems early, when treatment is much easier.

Screening and Diagnosing Testicular Cancer

As stated above, performing testicular self-exams could lead to finding a cancerous lump early, when treatment is still very easy, but it is important to know how to perform these self-exams. To start:

  • Check each testicle – gently but firmly roll each testicle between the thumb and forefingers. Feel the whole surface. The firmness of the testis should be the same all around. It’s normal for one testis to be slightly larger than the other.
  • Find the epididymis and vas deferens – these are soft, tube-like structures above and behind the testicle. These tubes collect and carry sperm. Just become familiar with how these cords feel.
  • Look for lumps, swelling, or things that do not seem right – lumps or bumps are not normal (even if they feel or cause no pain). Pain in the testicles is not normal.
  • Check yourself at least once per month – Always look for changes in size, shape, or texture.

If you notice a lump or any changes over time, you should seek medical help immediately. It may be nothing to worry about, but if it is testicular cancer, the clock is ticking and it can spread very quickly. When testicular cancer is found early, it is very curable.

To determine whether a lump is testicular cancer or not, your doctor may recommend:

  • Ultrasound – This allows the doctor to get a proper visualization and determine the nature of the lump, such as if they are solid or fluid-filled. Ultrasounds also tell your doctor if the lumps are inside or outside of the testicle.
  • Blood tests – A blood test can help your doctor determine the levels of tumor markers in your blood. Tumor markers are substances that occur normally in your blood, but the levels of these substances may be elevated in certain situations, including testicular cancer. A high level of tumor markers does not necessarily mean you have cancer, although it could help your doctor in correctly determining the diagnosis.
  • Surgery – If the lump is determined to be cancerous, surgery to remove the testicle may be recommended. The removed testicle will be analyzed to determine if the lump is indeed cancerous and, if so, what type of cancer.

Determining the Type of Cancer

The removed testicle will be analyzed to determine the type of testicular cancer present. The type of cancer you have determines your treatment as well as your prognosis. Generally, there are two types of testicular cancer:

  • Seminoma – Seminoma tumors occur in all age groups, but if an older man develops testicular cancer, it is more likely to be seminoma. Seminomas, generally speaking, are not as aggressive as nonseminomas.
  • Nonseminoma – Nonseminoma tumors tend to develop earlier in life and grow and spread rapidly. Several different types of nonseminoma tumors can occur, including choriocarcinoma, embryonal carcinoma, teratoma, and yolk sac tumor.

Treating Testicular Cancer

Treatment options for testicular cancer will depend on several different factors, including the type and stage, your overall health, and your own personal preferences. Some of the treatment options available may include:

  • Surgery – Whether this involves removing the affected testicle or remove the nearby lymph nodes, surgery can be a viable option for treating testicular cancer. Removing the testicle is the primary treatment option for nearly all stages and types of testicular cancer. In cases of early-stage testicular cancer, surgical removal of the testicle may be the only treatment needed. If surgery is your only treatment for testicular cancer, your doctor will recommend a schedule of follow-up appointments. During these appointments, you will undergo blood tests, CT scans, and other procedures to check signs that your cancer has returned.
  • Radiation Therapy – Radiation therapy is a treatment option that is sometimes used in people of have the seminoma type of testicular cancer. Radiation therapy may be recommended after surgery to remove your testicle.
  • Chemotherapy – Chemotherapy treatment uses drugs to kill cancer cells. Chemotherapy drugs travel throughout your body to kill cancer cells that could have migrated from the original tumor.
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