Testicular cancer — cancer that is found in the testicles — is a rare disease most often diagnosed in men between 15 and 34 years old. Approximately 8,500 cases will be diagnosed this year and 350 men will die from the disease, according to the National Cancer Institute.
The cause of testicular cancer is unknown, although certain conditions can increase the risk that healthy cells will become abnormal. For example, individuals with a family history of the disease are at increased risk.
Any condition that causes abnormal development of the testicle can increase risk. These include Klinefelter's syndrome and a condition called cryptorchidism. Individuals with cryptorchidism have an undescended testicle.
Testicular cancer typically forms in one testicle and individuals may notice certain changes in the scrotum, which contains the testicles. The scrotum may feel heavy or filled with fluid. Also, a lump may form in the testicle. Some individuals may experience pain and achiness in the areas of the abdomen, groin and breasts, as well as fatigue.
Diagnosis & Tests
Men find most cases of testicular cancer when they notice a lump. A physician may also detect a lump during a physical exam. Additional tests are required to confirm a cancer diagnosis.
An ultrasound can be used to identify whether the lump is filled with fluid and if it is located in or out of the testicle. If there is a possibility that the testicle is cancerous, a surgeon may remove it in a procedure called radical inguinal orchiectomy so that it can be analyzed in a lab.
There are two possible types of testicular cancer: the less-aggressive seminoma, and nonseminoma (some men have both types at once).
Once the type of cancer is known, additional testing is required to determine how far it has spread, if at all. A computerized tomography (CT) scan will highlight any cancer cells in the lymph nodes and blood tests will show levels of tumor markers, which can also indicate the presence of remaining cancer cells after testicle removal.
Earlier this year, a team of Greek researchers showed that magnetic resonance imaging (MRI) is extremely effective at staging testicular tumors, as well as differentiating between benign and malignant tumors. Their results, published in the American Journal of Roentgenology, showed that the less-invasive MRI test corresponded with traditional tissue testing and surgery 93 percent of the time.
Treatments & Medications
Testicular cancer is treatable with surgery, radiation therapy and chemotherapy. Up to 95 percent of cases are curable, according to the National Cancer Institute.
Depending on the type of cancer and how far it has spread, the treatment may vary. For example, seminoma cancers are more sensitive to radiation and nonseminoma cancers are more sensitive to chemotherapy. Individuals with both types of cancer are treated as if they have a nonseminoma cancer.
If the cancer is caught early enough, surgery to remove the testicle may be all that is required. Patients have the option to get a prosthetic testicle to replace the removed testicle. A surgeon may also take out the lymph nodes located in the groin. This surgery is performed via an incision in the abdomen, though a complication in the surgery can lead to difficulty with ejaculation (but not erection).
Radiation and chemotherapy treatments may be necessary for more advanced testicular cancer. Radiation can cause fatigue and temporary infertility. Chemotherapy — sometimes performed prior to lymph node removal — can cause nausea, hair loss and infertility.
Eating a healthy diet, getting a normal night's sleep and exercising can help individuals cope with a cancer diagnosis and the treatment process. In addition, quitting smoking and learning how to manage stress can improve recovery.
Testicular cancer is not preventable but the earlier it is caught, the more likely it is curable. Regular self-examination may be the easiest way to detect the presence of this type of cancer; however, concerned individuals should speak with a physician about the best method.
The shower (or bath) is the best place to perform a self-exam, according to the Mayo Clinic. In front of a mirror, look for signs of swelling of the scrotum. Using both hands, place the thumbs on the top of the testicle with the index and middle fingers beneath. Move the testicle between the fingers and thumbs and pay attention to the shape and feel. Healthy testicles are firm to the touch, smooth and oval in shape. Do not worry about slight differences in size between testicles.