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Testicular Cancer

Most common in young men and those in early middle age, cancer of the testicles is usually easily cured when diagnosed and treated early. The most common testicular cancers are classified as seminomas or nonseminomas, depending on the type of cells in the tumor. Seminomas grow slowly and are more sensitive to radiation therapy than nonseminomas, which are cancers of different cell types and which grow more rapidly than seminomas.

Common symptoms of testicular cancer are:
Pain or discomfort in the scrotum or testicles
A lump or swelling in a testicle, even if not painful
Discomfort or aching in the lower back, abdomen or genital area
Sudden occurrence of fluid in the scrotum

These symptoms can also be caused by a variety of other conditions. If you experience any of these symptoms, you should consult your urologist for diagnosis and treatment as soon as possible.

Causes

The exact cause of testicular cancer is not known, although some risk factors have been identified. The highest risk is among men with undescended testicles – testicles that remain inside the body where they developed before birth, instead of moving down into the scrotum as usual.

Your risk may be higher if there is a history of testicular cancer in your immediate family, or if you have already had cancer in one testicle. The disease is most common among men between the ages of 20 and 39 and occurs most frequently in white males, especially those of Scandinavian descent.

There is some indication that men born with abnormalities of the kidneys or genitals may have slightly higher risk for testicular cancer, as do many men with HIV or AIDS.

Diagnosis

Most testicular cancers are found during routine physical exams, or by self examination.  If you notice a lump or swelling in your testicles, or if other symptoms occur, your doctor will perform diagnostic tests to determine the cause. These include blood tests to measure levels of chemical markers that rise when cancer is present, as well as ultrasound to show the presence of any unusual mass in the testicles.

If cancer is found, additional tests will help determine whether it has spread to other parts of the body.

Treatment

If you are diagnosed with testicular cancer, you and your doctor will develop a treatment plan appropriate for the type of cancer, its stage or extent, and your age and general health.

Surgery is most often used, in which the testicle is removed through an incision in the groin (radical inguinal orchiectomy). Some lymph nodes in the area may also be removed. Radiation therapy may be used after surgery to destroy any remaining seminoma cells, but is seldom used with nonseminomas, which do not respond well to radiation.

Chemotherapy may also be used after surgery to eliminate any remaining cancerous cells; or it may be the first treatment for cancer, which has spread to other areas of the body.

FAQ

Are there any steps I can take to prevent testicular cancer?
A monthly self-examination is important to help find any unusual lumps or swellings. If you notice anything out of the ordinary, consult your urologist immediately. Early detection and diagnosis are key to successful treatment.

If I experience discomfort in my testicles, is that a sign of cancer?
Possibly, but it can also be caused by other conditions such as infection, muscle spasms or a hernia. If your self-examination finds no lumps or hardened spots, cancer is unlikely. However, it is wise to consult your doctor to rule out the possibility.

Will surgery for testicular cancer make me impotent or sterile?
Removal of one testicle does not change your ability to have sex or impair your fertility. A man with one healthy testicle can function normally and may father children. Radiation and chemotherapy can interfere with sperm production, but the infertility that results is usually temporary.