by LaRusso L
(Cancer of the Testicle; Cancer, Testicular; Seminoma; Germinoma)

Definition

Testicular cancer is a growth of cancer cells in one or both testicles. The testicles are a pair of male sex glands. They make and store sperm and male hormones. Types of testicular cancer include:

  • Seminomas
  • Non-seminomas (embryonal cell carcinoma, teratomas, and choriocarcinoma)
  • Stromal cell tumors

Causes

Cancer occurs when cells in the body divide without control or order. They grow to form a tumor. These growths can invade nearby tissue and can later spread to other areas of the body.

It is not clear what the exact cause is. Genetics and environment may both play a role.

Risk Factors

Testicular cancer is more common in men aged 25 to 35. Other things that may increase your chance of testicular cancer are:

Undescended Testes
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Symptoms

Testicular cancer may cause:

  • A painless lump or swelling in either testicle
  • Swelling of a testicle or change in the way it feels
  • Feeling of heaviness in the scrotum
  • A dull ache in the lower belly or groin
  • Sudden appearance of fluid in the scrotum
  • Pain or discomfort in a testicle or in the scrotum
  • Lower back pain
  • Growth of breast not due to weight gain

Early diagnosis will improve outcomes. Your doctor may do testicular exams at check ups. They may also talk about self examinations to look for any changes. Changes should be checked out by a doctor.

Diagnosis

The doctor will ask about your symptoms and past health. A physical exam will be done. Your doctor may order:

  • Blood tests
  • Ultrasound—to find or examine growths
  • Biopsy—small piece of tissue is removed and looked at in lab

More tests may be done once cancer is found:

The tests will help to find the type and stage of cancer. Staging is used to guide a treatment plan. Testicular cancer is stage 1 to 3. Stage 1 cancer is only in local tissue. Stage III cancer has spread to other parts of the body.

Treatment

Cancer treatment will be based on the stage and type of cancer. The plan will often have more than one type of therapy. Steps may include:

Surgery

The goal is to remove as much cancer as possible. Some local healthy tissue may also be removed. Lymph nodes in the area may also need to be removed. They may be tested for cancer. More nodes may be removed if cancer is found in the nodes.

Radiation Therapy

Radiation therapy will kill cancer cells and shrink tumors. It may be used on the area after surgery. It can help to kill any cancer cells that could not be seen. It may also be used to treat tumors that are causing problems but cannot be removed with surgery.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. It may be given as pills, injections, or by IV. The drugs travel through the body. The drugs targets cancer cells, but some healthy cells can be damaged as well. It may be used along with radiation therapy for some types of testicular cancers. It may also be used for cancer that has spread.

Treatment can cause fertility problems. Sperm banking and other treatments may help.

Treatment can cause fertility problems. Sperm banking and other treatments may help.

Prevention

There are no steps for testicular prevention in most men.

RESOURCES

American Cancer Society  https://www.cancer.org 

National Cancer Institute  https://www.cancer.gov 

CANADIAN RESOURCES

BC Cancer Agency  http://www.bccancer.bc.ca 

Canadian Cancer Society  http://www.cancer.ca 

References

General information about testicular cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/testicular/patient/testicular-treatment-pdq. Updated July 7, 2016. Accessed December 4, 2019.

Hanna NH, Einhorn LH. Testicular cancer--discoveries and updates. N Engl J Med. 2014 Nov 20;371(21):2005-2016

Management of nonseminoma testicular cancer. EBSCO DynaMed website. Available at:  https://www.dynamed.com/management/management-of-nonseminoma-testicular-cancer . Updated August 20, 2018. Accessed December 4, 2019.

Management of seminoma. EBSCO DynaMed website. Available at:  https://www.dynamed.com/management/management-of-seminoma . Updated August 20, 2018. Accessed December 4, 2019.

Motzer RJ, Jonasch E, et al. Testicular Cancer. Version 2.2016. In: National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology (NCCN Guidelines). NCCN 2016 Feb from NCCN website

Testicular cancer. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/testicular-cancer . Updated July 6, 2018. Accessed December 4, 2019.

3/3/2011 DynaMed Plus Systematic Literature Surveillance  https://www.dynamed.com/condition/testicular-cancer : Ilic D, Misso M. Screening for testicular cancer. Cochrane Database Syst Rev. 2011;(2):CD007853.

12/14/2016 DynaMed Plus Systematic Literature Surveillance  https://www.dynamed.com/condition/testicular-cancer : Yacoub JH, Aytekin O, et al. American College of Radiology ACR Appropriateness Criteria. Staging of testicular malignancy. Available at: https://acsearch.acr.org/docs/69375/Narrative. Updated 2016.

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