Testicular Cancer

According to the American Cancer Society, 7,600 cases of testicular cancer are diagnosed in the U.S. each year. It is most common in men between the ages of 18 and 32. Because of advanced treatment options and early detection, testicular cancer is successfully treated in more than 95 percent of cases.

Almost 95 percent of tumors in the testes originate in undeveloped germ cells. These tumors are known as germ cell tumors and occur in three forms: seminomas, nonseminomas and stromal tumors. Stromal tumors originate in the supporting tissue of the testicles. Germ cell tumors are most common in men between the ages of 20 and 40, although patients of any age can develop testicular cancer.

Typical seminomas often cause unilateral testicle enlargement or a painless lump in the testicle. Nonseminomas typically develop in men between the ages of 15 and 35. These tumors account for 60 percent of germ cell tumors.

Testicular cancer may also develop in the stroma, the hormone producing tissue of the testicles. Stromal tumors account for 4 percent of testicular cancer in men and 20 percent in boys.

Other cancers may metastasize to the testes as secondary tumors. Typically, these tumors migrate from the lymph or lymph nodes. Testicular lymphoma is actually more common than primary testicular cancer in men over the age of 50.

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Causes & Risk Factors of Testicular Cancer

There is no known cause of testicular cancer but there are several risk factors for the disease.

  • Cryptorchudisim (undescended testicle)
  • Kilnefelter’s Syndrome
  • Family History

Symptoms of testicular cancer may include:

  • Mass or lump in the testicle
  • Hardness in the testicles
  • Feeling of heaviness or aching in the scrotum or lower abdomen
  • Increased hormonal levels (estrogen, testosterone, human chorionic gonadotropin)
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Diagnosing Testicular Cancer

Testicular Self-Examination

Monthly testicular self-examinations are recommend for men following puberty. The tests should be performed during or right after a warm bath or shower. Men should examine each testicle with both hands. Place the index and middle fingers underneath the testicle and the thumbs on top. Then roll the testicle between the thumbs and fingers. If an abnormal lump is found on the front or side of the testicle, a physician should be contacted immediately.

Ultrasounds

By producing an image of a testicle on a computer screen through sound waves, an ultrasound can determine if a mass may be identified as cancerous.

Blood Tests
Some testicular tumors raise the level of tumor markers in the blood. Therefore, blood tests can be used to diagnose testicular cancer and determine the extent of the disease.

Biopsy

Biopsies are rarely done. However, when other diagnostic tests are inconclusive, a biopsy may be performed to examine suspicious tissue under the microscope. In general, surgical removal of the entire prostate is required and a biopsy is not performed.

Treatments

Surgery

Radical inguinal orchiectomy is a surgical procedure performed to remove the testicle and spermatic cord. The one hour surgery is performed through an incision in the groin while the patient is under general or regional anesthesia.

Retroperitoneal lymph node dissection is a surgical procedure which may be performed if there is suspicion of cancer remaining in the lymph nodes. The procedure removes all of the lymph nodes connected to the affected testicle and takes approximately four to six hours to complete.

Complications associated with these procedures may include bowel obstruction and inactivity, damage to surrounding organs, blood vessels and nerves, infection, infertility or lymph-filled cysts.

Radiation Therapy

By using high energy X-rays, radiation is able to destroy cancer cells. The dose of radiation used to treat testicular cancer will vary depending on the type of tumor and stage of the disease. Side effects of radiation therapy may include diarrhea, fatigue, nausea and skin irritation resembling sunburn. To preserve fertility, a shield is place over the unaffected testicle during treatment.

Chemotherapy

Chemotherapy may be recommended following surgical removal of the testicle. Drugs may be adminstered intravenously, injected into muscle or ingested in pill form. Patients may experience some severe side effects including, gastrointestinal disturbances, low white and red blood cell count, skin disorders or neurological disorders.

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