Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


Testicular Cancer

(Cancer of the Testicle; Cancer, Testicular; Seminoma; Germinoma)
Definition

Testicular cancer is a disease in which cancer cells grow in one or both testicles. The testicles are a pair of male sex glands that make and store sperm. The testicles also make male hormones. They are located under the penis in a sac-like pouch called the scrotum.

There are three main types of testicular cancer:

  • Nonseminomas (yolk sac, embryonal cell carcinoma, teratomas, and choriocarcinoma)
  • Seminomas
  • Stromal cell tumors

Treatment will vary depending on the cell type.

Cancer occurs when cells in the body (in this case testicular cells) divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant tumors, which can invade nearby tissues and spread to other parts of the body. A benign tumor does not invade or spread.

Causes

The causes of testicular cancer are unknown. However, research shows that certain risk factors are associated with the disease.

Risk Factors

These factors increase your chance of developing testicular cancer. Tell your doctor if you have any of these risk factors:

  • Abnormal testicular development, such as that seen in Klinefelter syndrome
  • Age: 25-35
  • Personal or family history of testicular cancer
  • Race: White
  • Undescended testicle that did not move down into the scrotum before birth
Symptoms

If you have any of these symptoms do not assume it is due to testicular cancer. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

  • A dull ache in the lower abdomen or groin
  • A painless lump or swelling in either testicle
  • Enlarged breasts
  • Enlargement or swelling of a testicle or change in the way it feels
  • Feeling of heaviness in the scrotum
  • Fluid in the scrotum that appears suddenly
  • Lower back pain (in later stages of the cancer)
  • Pain or discomfort in a testicle or in the scrotum
Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:

  • Excisional biopsy—removal of testicles to test for cancer cells
  • Blood tests
  • Ultrasound—a test that uses sound waves to find or examine tumors

Once testicular cancer is found, tests are done to find out if the cancer has spread and, if so, to what extent. These tests may include:

Treatment
Surgery

Surgery requires removing the cancerous testicle. This is done through an incision in the groin. The surgeon may also remove nearby lymph nodes to check for metastasis.

Radiation Therapy

Radiation therapy is the use of radiation to kill cancer cells and shrink tumors. Radiation therapy for testicular cancer comes from a machine outside the body that directs radiation at the abdomen.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms including: pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells.

Prevention

If you were born with undescended testicles, having surgery to correct this condition may reduce your risk of getting testicular cancer.

The United States Preventive Services Task Force (USPSTF) does not recommend regular screening by a doctor or self-screening in men who do not have any symptoms. However, the American Cancer Society recommends that a testicular exam should be done by your doctor at your routine cancer-related check-ups. No studies have been done that look at the benefit or harm of screening for testicular cancer. Discuss screening with your doctor, especially if you are at high risk for testicular cancer.

Keep in mind that if you notice any symptoms of testicular cancer, such as a lump or swelling in the testicles, it is important that you see your doctor for an evaluation.

Last reviewed: September 2011 by Mohei Abouzied, MD, FACP.

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