Testicular cancer occurs in the testicles (testes), which are located inside the scrotum, a loose bag of skin underneath the penis. The testicles produce male sex hormones and sperm for reproduction. Compared with other types of cancer, testicular cancer is rare. But testicular cancer is the most common cancer in American males between the ages of 15 and 34. Testicular cancer is highly treatable, even when cancer has spread beyond the testicle. Depending on the type and stage of testicular cancer, you may receive one of several treatments, or a combination. Regular testicular self-examinations can help identify growths early, when the chance for successful treatment of testicular cancer is highest.
Causes of Testicular Cancer
Signs & Symptoms of Testicular Cancer
Signs and symptoms of testicular cancer include:
Cancer usually affects only one testicle.
Diagnosis of Testicular Cancer
Most men discover testicular cancer themselves, either unintentionally or while doing a testicular self-examination to check for lumps. In other cases, your doctor may detect a lump during a routine physical exam.
To determine whether a lump is testicular cancer, your doctor may recommend:
Treatments of Testicular Cancer
The options for treating your testicular cancer depend on several factors, including the type and stage of cancer, your overall health and your own preferences. Treatment options may include:
Surgery to remove your testicle (radical inguinal orchiectomy) is the primary treatment for nearly all stages and types of testicular cancer. To remove your testicle, your surgeon makes an incision in your groin and extracts the entire testicle through the opening. A prosthetic, saline-filled testicle can be inserted if you choose. You'll receive anesthetics during surgery. All surgical procedures carry a risk of pain, bleeding and infection.
You may also have surgery to remove the lymph nodes in your groin (retroperitoneal lymph node dissection). Sometimes this is done at the same time as surgery to remove your testicle. In other cases it can be done later. The lymph nodes are removed through a large incision in your abdomen. Your surgeon takes care to avoid severing nerves surrounding the lymph nodes, but in some cases severing the nerves may be unavoidable. Severed nerves can cause difficulty with ejaculation, but won't prevent you from having an erection. In cases of early-stage testicular cancer, surgery may be the only treatment needed. Your doctor will give you a recommended schedule for follow-up appointments. At these appointments — typically every few months for the first few years and then less frequently after that — you'll undergo blood tests, CT scans and other procedures to check for signs that your cancer has returned. If you have a more advanced testicular cancer or if you're unable to adhere closely to the recommended follow-up schedule, your doctor may recommend other treatments after surgery.
Radiation therapy is a treatment option that's frequently used in people who have the seminoma type of testicular cancer. Radiation therapy is also used in certain situations in people who have the nonseminoma type of testicular cancer. Radiation therapy uses high-powered energy beams, such as X-rays, to kill cancer cells. During radiation therapy, you're positioned on a table and a large machine moves around you, aiming the energy beams at precise points on your body. Side effects may include fatigue, as well as skin redness and irritation in your abdominal and groin areas. You may experience infertility as a result of radiation therapy. However, as the treated area heals, you may regain your fertility.
Chemotherapy treatment uses drugs to kill cancer cells. Chemotherapy drugs travel throughout your body to kill cancer cells that may have migrated from the original tumor. Your doctor might recommend chemotherapy after surgery. Chemotherapy may be used before or after lymph node removal. Side effects of chemotherapy depend on the drugs being used. Ask your doctor what to expect. Common side effects include fatigue, nausea, hair loss, infertility and an increased risk of infection. There are medications and treatments available that reduce some of the side effects of chemotherapy.
Prevention of Testicular Cancer
There's no sure way to prevent testicular cancer. Some doctors recommend regular testicle self-examinations to identify testicular cancer at its earliest stage. Not all doctors agree, though, so discuss testicular self-examination with your doctor if you're unsure about whether it's right for you. If you choose to do a testicular self-examination, a good time to examine your testicles is after a warm bath or shower. The heat from the water relaxes your scrotum, making it easier for you to find anything unusual.
To do this examination, follow these steps:
When to seek Medical Advice
See your doctor if you detect any pain, swelling or lumps in your testicles or groin area, especially if these signs and symptoms last longer than two weeks. Make an appointment with your doctor even if a lump in your testicle isn't painful. Only a small percentage of testicular cancers are painful from the outset.