Testicular Cancer

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. Cancer can develop in one or both testicles.

Compared with other types of cancer, testicular cancer is rare. However, testicular cancer is the most common cancer in American males between the ages of 15 and 35. About 1 of every 263 males will develop testicular cancer at some point during his life, but only 380 men die of testicular cancer each year.

Testicular cancer is more common in men who have had abnormal testicle development, have had an undescended testicle, or have a family history of the cancer. Symptoms include pain, swelling, or lumps in your testicles or groin area. Doctors use a physical exam, lab tests, imaging tests, and a biopsy to diagnose testicular cancer.

Testicular cancer is highly treatable, even when cancer has spread beyond the testicle. Depending on the type and stage of testicular cancer, several treatments are used, including surgery, radiation, and chemotherapy. Regular testicular self-examinations can help identify growths early, when the chance for successful treatment of testicular cancer is highest.

Signs and symptoms of testicular cancer include:

• a lump or enlargement in either testicle
• a feeling of heaviness in the scrotum
• a dull ache in the abdomen or groin
• a sudden collection of fluid in the scrotum
• pain or discomfort in a testicle or the scrotum
• enlargement or tenderness of the breasts
• back pain

In most cases, it is not clear what causes testicular cancer.

In general, cancer occurs when cells develop errors (mutations) in their DNA. The errors make cells grow and divide out of control. The accumulating abnormal cells form a tumor that can grow to invade nearby structures and spread to other parts of the body.

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 to create an image of the scrotum and testicles and determine the nature of any testicular lumps, such as if the lumps are solid or fluid-filled
• blood tests to determine the levels of tumor markers in your blood
• surgery to remove a testicle (radical inguinal orchiectomy) if it is determined that the lump on your testicle may be cancerous

If you have or have had testicular cancer, you can take steps to manage the stress that accompanies the diagnosis.

• Learn about the type of cancer you have so you can make informed decisions about your care.
• Have a schedule of follow-up tests and go to each appointment.
• Take care of yourself so that you are ready to fight cancer. This includes eating a healthy that includes plenty of fruits, vegetables and whole grains, exercising for at least 30 minutes most days of the week, and getting enough sleep so that you wake feeling rested.
• Accept help and support from family and friends.

Testicular self-exams can detect cancer early, when it is most easy to treat. The best time for you to examine your testicles is during or after a bath or shower, when the skin of the scrotum is relaxed.

1. Hold your penis out of the way and examine each testicle separately.
2. Hold your testicle between your thumbs and fingers with both hands and roll it gently between your fingers.
3. Look and feel for any hard lumps or nodules (smooth rounded masses) or any change in the size, shape, or consistency of your testicles.
4. Report any changes or irregularities to your doctor.

Treatment options for testicular cancer will depend on the size, type, and stage of your cancer. Surgery, radiation therapy, and chemotherapy may be used alone or in combination to treat testicular cancer. Many treatments for testicular cancer can cause infertility, so talk to your doctor about future fertility options if you still desire to have children.

Surgery. Surgery may be used to treat testicular cancer by removing the testicle and/or the surrounding lymph nodes.

Radiation therapy. Radiation therapy involves treating cancer with high-powered beams of energy, such as X-rays or protons. Radiation may be the only treatment recommended for your cancer, or it may be used after surgery to kill any cancer cells that remain.

Chemotherapy. Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy can be administered by pill, through a vein (intravenously), or both methods may be used. Common chemotherapy drugs for testicular cancer include:

• cisplatin
• etoposide (VP-16)
• bleomycin
• ifosfamide (Ifex)
• paclitaxel (Taxol)
• vinblastine