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 35.
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.
Signs and symptoms of testicular cancer include:
Cancer usually affects only one testicle.
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.
It's not clear what causes testicular cancer in most cases.
Doctors know that testicular cancer occurs when healthy cells in a testicle become altered. Healthy cells grow and divide in an orderly way to keep your body functioning normally. But sometimes some cells develop abnormalities, causing this growth to get out of control — these cancer cells continue dividing even when new cells aren't needed. The accumulating cells form a mass in the testicle.
Nearly all testicular cancers begin in the germ cells — the cells in the testicles that produce immature sperm. What causes germ cells to become abnormal and develop into cancer isn't known.
Factors that may increase your risk of testicular cancer include:
An undescended testicle (cryptorchidism). The testes form in the abdominal area during fetal development and usually descend into the scrotum before birth. Men who have a testicle that never descended are at greater risk of testicular cancer than are men whose testicles descended normally. The risk remains elevated even if the testicle has been surgically relocated to the scrotum.
Still, the majority of men who develop testicular cancer don't have a history of undescended testicles.
There's no way to prevent testicular cancer.
Some doctors recommend regular testicle self-examinations to identify testicular cancer at its earliest stage. But not all doctors agree. Discuss testicular self-examination with your doctor if you're unsure about whether it's right for you.
In some cases 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:
Ultrasound. A testicular ultrasound test uses sound waves to create an image of the scrotum and testicles. During an ultrasound you lie on your back with your legs spread. Your doctor then applies a clear gel to your scrotum. A hand-held probe is moved over your scrotum to make the ultrasound image.
An ultrasound test can help your doctor determine the nature of any testicular lumps, such as whether the lumps are solid or fluid-filled. An ultrasound also tells your doctor whether lumps are inside or outside of the testicle.
Your extracted testicle will be analyzed to determine the type of testicular cancer. The type of testicular cancer you have determines your treatment and your prognosis. In general, there are two types of testicular cancer:
Once your doctor confirms your diagnosis, the next step is to determine the extent (stage) of the cancer. To determine whether cancer has spread outside of your testicle, you may undergo:
After these tests, your testicular cancer is assigned a stage. The stage helps determine what treatments are best for you.
The stages of testicular cancer are indicated by Roman numerals that range from 0 to III, with the lowest stages indicating cancer that is limited to the area around the testicle. By stage III, the cancer is considered advanced and may have spread to other areas of the body, such as the lungs.
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.
Operations used to treat testicular cancer include:
If surgery is your only treatment for testicular cancer, your doctor will recommend a schedule of 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.
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.
Radiation therapy is a treatment option that's sometimes used in people who have the seminoma type of testicular cancer. Radiation therapy may be recommended after surgery to remove your testicle.
Side effects may include nausea and fatigue, as well as skin redness and irritation in your abdominal and groin areas. Radiation therapy is also likely to temporarily reduce sperm counts and may impact fertility in some men. Talk to your doctor about your options for preserving your sperm before beginning radiation therapy.
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.
Chemotherapy may be your only treatment, or it may be recommended before or after lymph node removal surgery.
Side effects of chemotherapy depend on the specific drugs being used. Ask your doctor what to expect. Common side effects include fatigue, nausea, hair loss and an increased risk of infection. There are medications and treatments available that reduce some of the side effects of chemotherapy.
Chemotherapy may also lead to infertility in some men, which can be permanent in some cases. Talk to your doctor about your options for preserving your sperm before beginning chemotherapy.
Each man comes to terms with his testicular cancer and deals with the ensuing emotions in his own way. You may feel scared and unsure of your future after your diagnosis. While feelings of anxiety may never go away, you can create a plan to help manage your emotions. Try to:
Make an appointment with your family doctor or a general practitioner if you find a lump on a testicle.
If your doctor suspects you could have testicular cancer, you may be referred to a doctor who specializes in diagnosing and treating conditions of the urinary tract and male reproductive system (urologist) or a doctor who specializes in treating cancer (oncologist).
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well-prepared. Try to:
Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time later to cover other points you want to address. Your doctor may ask:
Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For testicular cancer, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions that come to mind during your appointment.
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