Testicular Cancer

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Testicular Cancer

(Cancer of the Testicle; Cancer, Testicular; Seminoma; Germinoma)

Definition

Testicular cancer is a disease in which cancer cells grow in one or both testicles. The testicles are a pair of male sex glands that make and store sperm. The testicles also make male hormones. They are located under the penis in a sac-like pouch called the scrotum.

There are three main types of testicular cancer:

Seminomas
Nonseminomas (yolk sac, embryonal cell carcinoma, teratomas, and choriocarcinoma)
Stromal cell tumors

Treatment will vary depending on the cell type.

Cancer occurs when cells in the body (in this case testicular cells) divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant tumors, which can invade nearby tissues and spread to other parts of the body. A benign tumor does not invade or spread.

Causes

The causes of testicular cancer are unknown. However, research shows that certain risk factors are associated with the disease.

Risk Factors

These factors increase your chance of developing testicular cancer. Tell your doctor if you have any of these risk factors:

Personal or family history of testicular cancer
Race: White
Age: 25-35
Abnormal testicular development, such as that seen in Klinefelter syndrome
Undescended testicle that did not move down into the scrotum before birth

Undescended Testicle

Symptoms

If you have any of these symptoms do not assume it is due to testicular cancer. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

A painless lump or swelling in either testicle
Enlargement or swelling of a testicle or change in the way it feels
Feeling of heaviness in the scrotum
A dull ache in the lower abdomen or groin
Fluid in the scrotum that appears suddenly
Pain or discomfort in a testicle or in the scrotum
Lower back pain (in later stages of the cancer)
Enlarged breasts

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:

Blood tests
Ultrasound—a test that uses sound waves to find or examine tumors
Excisional biopsy—removal of testicles to test for cancer cells

Once testicular cancer is found, tests may be done to find out if the cancer has spread and, if so, to what extent. These imaging tests of the body may include:

Treatment

Surgery

Surgery requires removing the cancerous testicle. This is done through an incision in the groin. The surgeon may also remove nearby lymph nodes to check for metastasis.

Radiation Therapy

Radiation therapy is the use of radiation to kill cancer cells and shrink tumors. Radiation therapy for testicular cancer comes from a machine outside the body that directs radiation at the abdomen.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms including: pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells.

Prevention

If you were born with undescended testicles , having surgery to correct this condition may reduce your risk of getting testicular cancer.

The United States Preventive Services Task Force (USPSTF) does not recommend regular screening by a doctor or self-screening in men who do not have any symptoms. However, the American Cancer Society recommends that your doctor at your routine cancer-related check-ups should do a testicular exam. No studies have been done that look at the benefit or harm of screening for testicular cancer. Discuss screening with your doctor, especially if you are at high risk for testicular cancer.

Keep in mind that if you notice any symptoms of testicular cancer, such as a lump or swelling in the testicles, it is important that you see your doctor for an evaluation.

RESOURCES

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

CancerCare http://www.cancercare.org

CANADIAN RESOURCES

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

Cancer Care Ontario http://www.cancercare.on.ca

References

Can testicular cancer be found early? American Cancer Society website. Available at: http://www.cancer.org/Cancer/TesticularCancer/DetailedGuide/testicular-cancer-detection. Updated January 19, 2011. Accessed March 2, 2011.

General information about testicular cancer. National Cancer Institute, National Institutes of Health (NIH) website. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/testicular/patient. Accessed July 2, 2008.

United States Preventive Services Task Force. Screening for testicular cancer. United States Preventive Task Force website. Available at: http://www.uspreventiveservicestaskforce.org/3rduspstf/testicular/testiculrs.pdf. Accessed March 2, 2011.

What causes testicular cancer? American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI%5F2%5F2%5F2x%5FWhat%5FCauses%5FTesticular%5FCancer%5F41.asp?sitearea=. Updated December 4, 2007. Accessed July 2, 2008.

Walsh TJ, Dall'Era MA, Croughan MS, Carroll PR, Turek PJ. Prepubertal orchiopexy for cryptorchidism may be associated with lower risk of testicular cancer. J Urol. 2007 Oct;178(4 Pt 1):1440-6; discussion 1446.

3/3/2011 DynaMed's Systematic Literature Surveillance http://www.dynamicmedical.com/what.php : Ilic D, Misso M. Screening for testicular cancer. Cochrane Database Syst Rev. 2011;(2):CD007853.

2/1/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: American College of Radiology. ACR Appropriateness Criteria. 2012; Jun 16. Available at http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/StagingTesticularMalignancy.pdf. Updated June, 2012. Accessed February 2, 2013.

Revision Information

Reviewer: Igor Puzanov, MD
Review Date: 09/2012 -
Update Date: 02/01/2013 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Cartersville Medical Center