Knowledge | Testicular Cancer: Symptoms, Types, and Treatment



Knowledge | Testicular Cancer: Symptoms, Types, and Treatment


Testicular Cancer: A Rare, Highly Curable Cancer

Testicular cancer is the uncontrolled growth of abnormal cells in the tissue of one or both testicles. The testicles are two oval organs located in the scrotum at the base of the male torso. Slightly smaller than golf balls, they primarily produce sperm and hormones such as testosterone.

Although relatively rare, testicular cancer is one of the most common cancers in men ages 15 to 34 and one of the most curable.


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Symptoms of Testicular Cancer

Symptoms include:

A change in how a testicle feels; one may be larger or firmer than the other.

A painless lump on a testicle.

Swelling or heaviness in the scrotum, with or without pain.

Fluid buildup in the testicle.

Pain or a dull ache in the scrotum or groin.

Tenderness or changes in breast tissue.

Signs of early puberty in adolescents.

Swelling in one or both legs.

A blood clot that may travel to the lungs and cause shortness of breath.

If testicular cancer spreads, it may cause:

Abdominal pain

Lower back pain

Shortness of breath

Chest pain

Coughing up blood

Headache or confusion

Some symptoms may also indicate other conditions, such as a spermatocele, varicocele, hydrocele, abdominal wall hernia, orchitis, epididymitis, injury, or torsion. Seek medical care promptly for any testicular change, especially one lasting more than two weeks.


Types of Testicular Cancer

Most testicular cancers are germ cell tumors arising from sperm-producing cells. The two main types are seminomas and nonseminomas.

Seminomas

Classic seminoma: The most common type, usually occurring in men ages 25 to 45.

Spermatocytic seminoma: More common in older men and less likely to spread.

Nonseminomas

Embryonal carcinoma: Resembles embryonic tissue under a microscope.

Yolk sac carcinoma: Its cells resemble the yolk sac surrounding an embryo; it is the most common testicular cancer in children.

Choriocarcinoma: Very rare and spreads rapidly.

Teratoma: Its cells resemble embryonic cells.


Causes and Risk Factors

The exact cause is unknown, but factors that may increase risk include:

Age: Most cases occur in men in their 20s and 30s.

Race: White men are five times more likely to develop testicular cancer than African American and Asian American men.

Undescended testicle: Surgery before puberty may reduce the risk.

Abnormal testicular development, such as Klinefelter syndrome.

Family history, especially a brother with testicular cancer.

People with HIV have a slightly higher risk.

Diagnosing Testicular Cancer

Self-examination

Men are advised to perform a testicular self-examination at least once a month, preferably after a warm bath or shower:

Stand and move the penis aside.

Gently but firmly roll each testicle between the thumbs and fingers.

Check for hard lumps or changes in how a testicle feels.

Medical examination

A doctor checks the testicles during a routine physical examination. If an abnormality is found, ultrasound and blood tests may be used to confirm cancer and assess its type and spread.


Stages of Testicular Cancer

Stage 0: Cancer is confined to the tiny tubules inside the testicle.

Stage I: Cancer is limited to the testicle and surrounding tissue.

Stage II: Cancer has spread to lymph nodes in the abdomen.

Stage III: Cancer has spread to distant lymph nodes or organs such as the lungs, liver, or brain.

Treatment of Testicular Cancer

Treatment depends on the diagnosis, overall health, and fertility plans. Common options include:

Surveillance: Early-stage cancer may require only regular monitoring.

Surgery: Most patients need surgery to remove the affected testicle.

Radiation therapy: Used to kill cancer cells in the testicle or lymph nodes.

Chemotherapy: Medications can kill or suppress cancer cells throughout the body.


Complications

Chemotherapy may affect the lungs, kidneys, heart, blood vessels, nerves, or hearing and may damage testosterone-producing cells. Discuss ways to manage these risks with your doctor.


Prognosis

Testicular cancer is one of the most curable cancers. Overall, 95% of patients survive at least 5 years after diagnosis. If the cancer has not spread beyond the testicle, nearly all patients survive more than 5 years.


Sexual Function and Fertility

Removing one testicle usually does not affect sexual function or fertility, but testicular cancer may increase the risk of infertility and low testosterone. Sperm may be frozen before treatment.


Cancer Recurrence

About 3% to 4% of patients may later develop cancer in the other testicle after treatment. Regular examinations and attention to physical changes are essential.


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