What Is Testicular Cancer? – Dr. David Samadi Explains
Testicular cancer, as its name suggests, occurs when malignant or cancerous cells form in the tissues of one or both of a man’s testicles. According to the American Cancer Society (ACS), more than 90% of testicular cancers form in germ cells, which are the cells that produce sperm. Almost all testicular cancers start in the germ cells. The two main types of testicular germ cell tumors are seminomas and nonseminomas. These two types grow and spread differently and are treated differently. Nonseminomas tend to grow and spread more quickly than seminomas. Seminomas are more sensitive to radiation.
A testicular tumor that contains both seminoma and nonseminoma cells is treated as a nonseminoma. In some cases, testicular cancer may be “secondary,” meaning that the cancer started in another organ and spread to the testicles. Testicular cancer is the most commonly diagnosed cancer in men ages 15 to 35, but it can occur at any age. It’s also one of the most treatable cancers, even if it has spread (metastasized) into other areas of the body.
Although there is no known cause, several factors are known to raise a man’s risk. These risk factors include:
- An undescended testicle (cryptorchidism)
- Congenital abnormalities
- Family history
- A personal history of testicular cancer
- risk of developing the disease in the other testicle.
The most common symptom is a lump or a swelling in a testicle. Lumps can be as small as a pea. Swellings can feel like irregular thickening on a testicle. Symptoms are often painless. Some may cause discomfort. Other symptoms may include:
- ache or pain in the back, groin, lower abdomen, or scrotum
- a change in the usual size or feel of the testicle
- a sensation of heaviness in the scrotum or bloating in the lower abdomen
Diagnosing testicular cancer usually begins with a visit to your doctor. Your doctor will ask you about any symptoms you have and perform a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for testicular cancer or other health problems. The following tests are commonly used to rule out or diagnose testicular cancer:
- Blood tests
- Surgery to remove a testicle (radical inguinal orchiectomy)
Staging The Cancer
If your doctor diagnoses testicular cancer, it’s important to determine how advanced it is. In order to find out whether the cancer has left its site of origin (whether it has spread), the doctor may order an MRI (medical resonance imaging) scan, CT (computerized tomography) scan, and X-rays. Blood tests will help determine whether cancer is still in the patient’s body after the testicle was surgically removed. After carrying out all the relevant tests, your doctor will then be able to stage the cancer. This helps determine what treatment to use.
- Stage I – the cancer is only in the testis (testicle). It has not spread outside.
- Stage II – the cancer has reached the lymph nodes in the abdomen.
- Stage III – the cancer has spread further, to other parts of the body. This could include the lungs, liver, brain and bones.
The treatment options for testicular cancer depend on the type and stage of the cancer. You may be treated with one or more of the following options:
- Surgery (Orchiectomy) is used to remove one or both testicles and some surrounding lymph nodes to both stage and treat the cancer
- Radiation therapy uses high-energy rays to kill cancer cells. It may be administered externally or internally
- Chemotherapy uses drugs to kill cancer cells
- Retroperitoneal lymph node dissection is a surgery to remove lymph nodes at the back of the abdomen
In very advanced cases of testicular cancer, high-dose chemotherapy may be administered, followed by a stem cell transplant. Once the chemotherapy has destroyed the cancer cells, the stem cells are administered and these cells develop into healthy blood cells.