Testicular Cancer

Testicular cancer is when cancer cells grow in the testicles, also called the testes. The testicles are the two male sex glands. They are located in the scrotum, the loose sac that hangs down beneath the penis. The testicles have two important functions: making sperm and making testosterone, a male hormone.

Testicular cancer is the most common type of cancer for men older than 15 years and younger than 35 years. Testicular cancer is very rare in children. About half of all testicular cancers are in men older than 20 years and younger than 35 years, but men of any age can develop it.

Most testicular cancers start in the germ cells of the testicles. These are the cells in the testicles that make sperm. There are two main types of testicular germ cells tumors: seminomas and non-seminomas. Seminomas grow and spread more slowly than non-seminomas. Testicular cancer can be in one or both of the testicles, but usually starts in just one. It is possible for testicular cancer to recur (come back) and affect the other testicle later.

Although there is no screening test for testicular cancer, men often have symptoms in the early stages and discover it early. Prognosis (outlook) depends on what type of tumor it is and how much it has spread, but many testicular cancers can be cured with the right treatment.

These are the symptoms of testicular cancer:

• A lump in the testicle.
• Swelling in the testicle. The testicle can become swollen for reasons besides cancer. It could be a hydrocele (hy-dro-seel), which is fluid in the testes. Swelling can also be due to a varicocele (var-i-koh-seel). This is like getting a varicose vein in the testes.
• Pain or heaviness in the scrotum.
• Ache in the groin.

See a doctor if you notice a lump or swelling in your testicles, or if you have any other symptoms of testicular cancer.

Although researchers don’t know what causes testicular cancer, there are a few risk factors:

• Having an undescended testicle. Before birth, the testicles develop in a boy’s abdomen and then descend (go down) into the scrotum. In many cases, the testicle descends on its own before the first birthday, but sometimes it doesn’t. Researchers don’t think that the undescended testicle causes cancer. Instead, it seems that something else might be causing both the cancer and the undescended testicle.
• Abnormal development of the testicles.
• Having testicular cancer in the past.
• Family history of testicular cancer.
• Being white. White men have a greater chance of getting testicular cancer than African American or Asian American men.

These risk factors increase a person’s chances of getting testicular cancer. But many men who get testicular cancer don’t have risk factors, and men with risk factors won’t necessarily develop testicular cancer.

The doctor will talk to you to find out more about your symptoms and what you are feeling and noticing. The doctor will also ask about your family’s health history. The doctor will examine the testicles for lumps or swelling.

If the doctor suspects that testicular cancer is possible, you may have one or more these tests to diagnose it:

• Ultrasound exam. This test uses sound waves that bounce off the testicles and make echoes, which can be used to make a picture of what is there. It can be used to find a tumor.
• Blood test to check for a tumor. This test checks for levels of certain substances that are released by tumors, called tumor markers. These tumor markers are for testicular cancer:
• Alpha-fetoprotein (AFP)
• Beta-human chorionic gonadotropin (β-hCG)
• Inguinal orchiectomy surgery. After the doctor finds the tumor marker levels, the doctor may do an inguinal orchiectomy—removal of the testicle that has cancer cells. The doctor can do a biopsy to find out what type of cancer it is and what stage it is. See Treatments for more information about this surgery.

Treatment for testicular cancer depends on the type and stage of the cancer. Treatment options include:

• Inguinal orchiectomy surgery. All testicular cancer is treated with a surgery called inguinal orchiectomy. In this surgery, the surgeon removes the whole testicle that has cancer cells by making a cut in the groin. The surgeon removes it carefully, and doesn’t cut through the scrotum, so the surgery doesn’t cause the cancer to spread. It’s good to have a surgeon who is experienced with this type of surgery.
• Surgery to remove lymph nodes. Depending on the stage of the cancer, the surgeon may remove lymph nodes in the back of the abdomen.
• Radiation. This therapy uses high energy X-rays (radiation) aimed at cancer cells from outside the body to kill cancer cells or keep them from growing. Radiation is used mostly for seminoma testicular cancer or the lymph nodes in the back of the abdomen.
• Chemotherapy. This therapy uses drugs that keep the cancer cells from growing. For testicular cancer, chemotherapy (chemo) is used when the cancer has spread beyond the testicle. It is injected through a vein and goes throughout the whole body.
• High-dose chemotherapy and stem cell transplant. If the cancer comes back or doesn’t respond to regular chemotherapy, the doctor may use a high-dose chemotherapy. This type of chemo can also damage the bone marrow where new blood cells are made, so it is done along with stem cell transplant to replace stem cells that make blood cells. To do this, blood is taken from the patient before chemotherapy. A special machine removes the stem cells from the blood, and then the blood is returned to the patient. The stem cells are frozen until after chemotherapy, and then the patient gets the stem cells back.

There is no known way to prevent testicular cancer at this time.

• National Cancer Institute
• American Cancer Society