Testicular cancer is a relatively rare type of cancer that begins in your testicles. While it can affect males of any age, it is most typically found in men aged 20 to 34.
Symptoms of Testicular Cancer
The most common symptom of a testicular tumor is a painless lump in the testicle. Other signs include a swollen testicle or a feeling of weight in the scrotum. This may or may not feel painful, and it may just feel like a dull ache in the area.
You may feel tenderness in the male breast tissue. This also may be a symptom of testicular cancer.
If you have any signs that could be testicular cancer symptoms, make an appointment to see a urologist immediately.
Causes
The leading causes associated with testicular cancer are unavoidable. Those with the highest risk include men who have a family history of testicular cancer, and in particular, a father or brother. Men born with undescended testes are also at a higher risk of contracting testicular cancer. About 8% of men who required surgery due to an undescended testis may develop testicular cancer.
Types of Testicular Cancer
Germ Cell Tumors
The majority of testicular tumors are germ-cell tumors. According to the American Cancer Society, over 90% of testicular cancers begin in germ cells, which are the cells that help make sperm. Most germ cell tumors are either seminomas, tumors made up of cancer cells that resemble and reproduce like normal cells, or non-seminomas, tumors with abnormal cells.
- Seminomas: Seminoma cell tumors typically grow and spread slower than non-seminomas. The main sub-type is classical seminoma which usually affects men between 25 and 45 and makes up 95% of seminoma cases. The other main sub-type is spermatocytic seminoma, which is rare and typically only occurs in older men. It also grows more slowly than the classical type, so it is less likely to spread to other parts of the body.
- Non-seminomas: Non-seminomas tumors tend to occur in younger men, typically from the late teens to early 30s, and spread relatively quickly.
- The primary sub-category of non-seminomas is embryonal carcinoma. Around 40% of all testicular tumors contain these cells. Embryonal carcinomas tend to grow and spread rapidly, often beyond the testicle.
- Yolk sac carcinomas are the most common form of testicular cancer in children. They get their name from their appearance, which resembles the yolk sac of an early human embryo. These tumors are typically treated successfully in children and respond well to chemotherapy treatment. When they occur in adults, it is of more concern, mainly if the tumor is made up of only yolk sac carcinomas.
- Rarer forms of non-seminomas include choriocarcinomas, which is a fast-growing type of adult testicular cancer. Although rare, when a tumor is made up purely of choriocarcinomas, cancer will likely spread to other parts of the body, including the lungs, bones, and brain. In most cases where choriocarcinomas occur, it is part of a mixed germ tumor, and the prognosis, while still problematic, is somewhat better.
Stromal Tumors
Besides germ-cell tumors, around half of the remaining 10% of adult testicular cancer cases will be stromal tumors. These are made up of Leydig cell tumors that form from the Leydig cells that make testosterone and Sertoli cell tumors that form in the Sertoli cells that support sperm growth.
Treatment
Treatment for testicular cancer will depend on your age and health, as well as how advanced the cancer is. The most common treatment options include monitoring, surgery, radiation therapy, and chemotherapy. With any treatment, your urologist will discuss with you the issue of infertility. You may decide before you proceed with any treatment to make use of a sperm bank.
Monitoring
If you have early-stage cancer, your urologist may decide that monitoring or surveillance is the best course of action. This will involve regular check-ups, tests, and scans to monitor any changes in the spread of cancer.
Surgery
The primary treatment for testicular cancer is surgery. Your urologist may recommend an orchiectomy, which involves removing the affected testicle. This method is used both in cases of late-stage cancer as well as early-stage cancer. The risk of cancer returning after surgery is less than 5%. The chance of cancer subsequently growing in the other testicle is very small, at around 2%.
Testis-sparing surgery (TSS) is a surgical method where the surgeon will only remove tumor tissue instead of the entire testicle. This is only recommended in cases where the tumor is small and benign and not yet cancerous.
For all surgical options, monitoring or surveillance post-surgery is critical to ensure that cancer does not return.
Radiation and Chemotherapy
Radiation therapy may be used if cancer has spread to other parts of the body. It typically works best with seminoma-cell cancers, as non-seminoma-cell cancers are usually resistant to radiation.
Your urologist may also recommend chemotherapy to treat cancer cells that have spread outside the testes. They may also prescribe a course of chemotherapy as a post-surgical treatment to reduce the risk of cancer returning.
Combining radiation or chemotherapy with surgery can cure almost all early-stage tumors and around 85% of more advanced-stage cases.
According to the latest government figures, testicular cancer patients have a 95% survival rate, especially with early diagnosis.
References
- Cancer Stat Facts: Testicular Cancer
- Symptoms of testicular cancer
- Risk Factors for Testicular Cancer
- Testicular Cancer: Symptoms, Diagnosis & Treatment – Urology Care Foundation
- What Is Testicular Cancer? | Types of Testicular Cancer
- Treatment decisions for testicular cancer
- Testicular Cancer: Symptoms, Diagnosis & Treatment – Urology Care Foundation