Overview
Testicles, also known as testes, are two organs located within the scrotum, a bag of skin underneath the penis. Normally smaller than a golf ball, each testis is made up of several types of cells and produces male sex hormones and sperm. The various cells can develop into different types of testicular cancers, each with its own prognosis and treatment plans.
Testicular cancer is relatively rare and highly treatable. It occurs most often in males between the ages of 15 and 35 and is the most common cancer among this population. It usually develops in just one testicle.
Testicular cancer most often develops in germ cells, which produce sperm. There are two types of testicular cancer, seminoma and nonseminoma. Seminoma occurs more frequently in older men and is not as aggressive as nonseminoma.
- Seminoma occurs more frequently in older men and is not as aggressive as nonseminoma.
- Nonseminoma is more likely to develop in younger men and grows and spreads more rapidly.
Symptoms
- A lump or enlarged testicle
- Feeling of heaviness in the scrotum
- Dull ache in the abdomen, groin or back
- Sudden collection of fluid in the scrotum
- Pain or discomfort in a testicle
- Enlargement or tenderness in the breasts
Risk Factors
- An undescended testicle - men who had an undescended testicle at birth are at a greater risk of developing testicular cancer, though researchers do not know why.
- Family history - those with blood relatives that have the disease may have an increased risk of also developing the disease.
- Abnormal testicle development - men who have conditions that affect normal testicle development such as Klinefelter's syndrome have a higher risk of testicular cancer.
- Age - testicular cancer develops most frequently in teens and younger men, mainly between the ages of 15 and 35 but it can occur at any age.
- Race - Caucasians are more likely to develop the disease than African-American and Asian-American men.
Tests and Diagnostic
An ultrasound - sound waves used to create images - is often used as a first step in diagnosing whether a man has testicular cancer. A hand-held probe is moved over the scrotum to determine the makeup of testicular lumps, whether they are solid or fluid-filled and if they are inside or outside the testicle. It is a painless test.
Blood tests are also used to review the level of tumor markers in the blood. These markers are always present but may be elevated when cancer has developed. Blood tests are not definitive, however, and further screenings may be necessary.
Treatment
Surgery
Surgery to remove a testicle - a radical orchiectomy - is the primary treatment for almost all testicular cancer. The testicle is removed through an incision in the groin.
Having one testicle removed does not affect a man's ability to get an erection or have sex. But for men who are concerned about their appearance, a prosthesis - filled with saline - can be implanted. Prostheses come in different sizes so one can be matched to the remaining testicle.
Radiation Therapy
Radiation therapy uses high-powered energy beams to kill cancer cells. It is sometimes used in men with the seminoma type of cancer after surgery to remove the testicle.
Chemotherapy
Chemotherapy is typically used when cancer has spread outside the testicle or after surgery to help reduce the risk of it reoccurring. It is typically given intravenously with several different courses of treatment available, including a number of drugs that may be used.
Patients may experience a number of side effects, including fatigue, nausea, hair loss and an increased risk of infection. Medications are available to reduce the severity of some of these side effects. Chemotherapy may cause infertility so patients should speak to their physician about preserving sperm before beginning treatment.
