Diseases and Conditions

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.

Illustration of  the anatomy of the male reproductive tract
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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. This includes body and facial hair, low voice, and wide shoulders.

What is testicular cancer?

Cancer that develops in a testicle is called testicular cancer. It is one of the most curable forms of cancer.

What are the symptoms of testicular cancer?

The following are the most common symptoms for testicular cancer:

  • 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 look like 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, a number of factors that increase the risk for the disease.

What are the risk factors for testicular cancer?

Research shows 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.

  • Undescended testicle(s) (cryptorchidism). Even after surgical repair of an undescended testicle, there is still an increased risk.

  • 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-exam (TSE) 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. Monthly TSE is recommended by some experts for men at increased risk for testicular cancer. Risk factors include a history of cryptorchidism, a history of testicular cancer, or a family history of testicular cancer.

Testicular self-exam (TSE) procedure

  • The best time for testicular self-exam is just after a warm bath or shower when the scrotal tissue is more relaxed.

  • While standing in front of a mirror, place the thumbs on the front side of the testicle and support it with the index and middle fingers of both hands.

  • Gently roll the testicle between the fingers and thumbs. Feel for lumps, hardness, or thickness. Compare the feelings in each testicle.

  • If you find a lump, see your doctor as soon as possible.

Testicular self exam is not a substitute for routine physical exams by your doctor.

How is testicular cancer diagnosed?

In addition to a complete medical history and physical exam, other test for testicular cancer may include:

  • Ultrasound. A test 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, the testicle, and the spermatic cord, are typically removed during the biopsy. This is done 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). This 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 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

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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