OverviewTesticular cancer is the cancer that affects the testicles, the organs of the male reproductive system responsible for producing the male sex hormones and sperm. Depending on the type of testicular cells affected, testicular cancer can be classified as seminoma or non-seminoma cancer. It is most common in men between 20 and 39 years of age.
Testicular cancer is a highly treatable type of cancer. The five-year survival rate exceeds 90% and, if the cancer has not spread to other parts of the body, total remission happens just about 100% of the time. Even in the rare circumstances in which the cancer has spread extensively, the cure rate reaches 80%.
Quite frequently, the first symptom of testicular cancer is the presence of a lump or an enlargement of a testicle. Cancerous mass tend to develop in only one of the testicles.
Other possible symptoms of testicular cancer include:
- Discomfort, pain and/or a feeling of heaviness in the scrotum
- Pain in the lower back or abdomen
- Enlargement or increased sensitivity of the breasts
- Collection of fluid in the scrotum
Although testicular cancer does not normally spread to other organs, when it does happen, the lungs are the most commonly affected part of the body. Symptoms associated with cancer spread include shortness of breath, cough and coughing up blood.
Risk factorsSimilarly to what happens with other types of cancer, experts cannot point to the precise cause of testicular cancer. However, certain factors are known to increase the chances of getting it:
- Cryptorchidism - a medical condition in which one of the testicles has not descended from the abdomen and into the scrotum before the birth. The risk of testicular cancer is the same in either testicle and does not decrease after the affected testicle is surgically relocated to the scrotum.
- Klinefelter syndrome, a genetic disorder in which the affected males, instead of having one Y chromosome and one X chromosome, have two or even three X chromosomes.
- A personal or family history of testicular cancer
- A young age (between 15-34 years old), although the disease can occur at any age.
- Being of Caucasian ethnicity
The presence of a lump in the testicles found by either patient or doctor usually prompts further evaluation. Diagnostic tests include the following:
- Testicular ultrasound - which helps identify the size, location and other characteristics of the lump (for example, if it is solid or filled with fluid).
- CT scan - which allows for the evaluation of the extent of the disease, i.e. for the location of any existing metastases.
- Blood tests - to assess the levels of tumor markers in the blood. Such markers include alpha fetoprotein (AFP), human chorionic gonadotrophin (hCG) and lactic dehydrogenase. Increased levels of these substances do not mean the patient has cancer, but rather help the doctor on making a diagnosis.
- Analysis of testicular tissue - to assess the cancerous nature of the growth. This only occurs if it’s determined that the testicular lump is cancerous and a recommendation for the surgical removal of the testicle is made.
TreatmentThe therapeutic approach to testicular cancer depends on the type and stage of the disease and on the patient’s overall health state.
- Surgery - Nearly all men begin their treatment by undergoing surgery to remove the affected testicle. This not only helps the doctor to get more details on the characteristics of the cancer, and thus plan the most adequate course of treatment, but also to avoid the development of another cancer. Surgical removal of the lymph nodes of the groin area may also be conducted, as a part of this procedure or on a separate occasion.
- Chemotherapy and radiotherapy - The surgical intervention may be complemented by radiation therapy and chemotherapy. The latter can be initiated before or after the removal of affected lymph nodes. Chemotherapy of testicular cancer with the drug carboplatin is highly successful.