Testicular Cancer

What are the testicles?

The testicles are the male sex glands and are part of the male reproductive system. Testicles are also called testes or gonads. They are located behind the penis in a pouch of skin called the scrotum.

The testicles produce sperm and several male hormones, including testosterone. The hormones control the development of the reproductive organs, as well as other male characteristics--body and facial hair, low voice, and wide shoulders.

What is testicular cancer?

Cancer that develops in a testicle is called testicular cancer. The American Cancer Society estimates that in the year 2012 about 8,590 new cases of testicular cancer will be diagnosed in the United States. An estimated 360 men will die of testicular cancer in the year 2012.

Testicular cancer is one of the most curable forms of cancer.

When testicular cancer spreads, the cancer cells are carried by blood or by lymph, an almost colorless fluid produced by tissues all over the body. The fluid passes through lymph nodes, which filter out bacteria and other abnormal substances such as cancer cells.

What are the symptoms of testicular cancer?

The following are the most common symptoms for testicular cancer. However, each individual may experience symptoms differently:

• Lump in either testicle, which is usually not painful
• Enlargement of a testicle
• Feeling of heaviness in the scrotum
• Dull ache in the lower abdomen or in the groin
• Sudden collection of fluid in the scrotum
• Pain or discomfort in a testicle or in the scrotum

The symptoms of testicular cancer may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

What causes testicular cancer?

The exact cause of testicular cancer is not known. However, there are a number of factors that increase the risk for the disease.

What are the risk factors for testicular cancer?

The exact cause of this disease is unknown. However, research does show that some men are more likely than others to develop testicular cancer. Possible risk factors include the following:

• Age. About half of all testicular cancers occur in men between the ages of 20 and 34.
• Cryptorchidism. This refers to undescended testicle(s).
• Family history
• Personal history of cancer in the other testicle
• Race and ethnicity. The rate of testicular cancer is higher in whites than in other populations.
• HIV infection

Can testicular cancer be prevented?

Currently, there is no sure way to prevent the disease because:

• There are few known causes for the disease.
• Many of the suggested risk factors are those that cannot be changed.
• Many men with testicular cancer do not have the suggested risk factors.

However, testicular self-examination can improve the chances of finding a cancerous tumor early. Some doctors recommend doing them monthly, although it is not clear if they can reduce the death rate for testicular cancer.

How is testicular cancer diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for testicular cancer may include the following:

• Ultrasound. A diagnostic technique which uses high-frequency sound waves to create an image. This test can be used to determine if a lump on a testicle is solid or filled with fluid. (Solid lumps are more likely to be cancerous.)
• Blood tests. Assessment of blood samples to check for increased levels of certain proteins and enzymes to help determine if cancerous cells are present, or to determine how much cancer is present.
• Biopsy. A procedure in which tissue samples are removed (during surgery) from the body for examination under a microscope to determine if cancer is present.

When testicular tumors are present, the entire tumor, as well as the testicle and spermatic cord, is typically removed during the biopsy to prevent the spread of cancerous cells through the blood and lymph systems.

Staging of testicular cancer

Staging is the process of determining if and how far the cancer has spread. Treatment options are based on the results of staging. Procedures for determining stage include the following:

• Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
• Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. It is sometimes used to look for spread of the cancer to the brain.
  

In addition to these imaging procedures, chest X-rays, positron emission tomography (PET) scans, or other scans may be requested.

Treatment for testicular cancer

Specific treatment for testicular cancer will be determined by your doctor based on:

• Your age, overall health, and medical history
• Type of testicular cancer
• Extent and location of the disease
• Your tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease
• Your opinion or preference

There are several kinds of treatments for testicular cancer, including:

• Surgery. This is done to remove the tumor and the testicle, and possibly lymph nodes in the back of the abdomen.
• Radiation therapy. This treatment helps to destroy cancer cells or slow the rate of growth.
• Chemotherapy. These drugs are used to destroy cancer cells throughout the body.
• High-dose chemotherapy and stem cell transplantation. These are done to remove stem cells from the patient's or a donor's bone marrow and reinfuse them into the patient to help in the production of healthy blood cells.

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