Testicular Cancer: Information on Causes, Diagnosis & Treatments
Testicular Cancer affects the testes (testicles) inside the male’s scrotum located underneath the penis. Testicular cancer is extremely rare and tends to affect males 15 to 35 years of age in the United States. When caught in its initial stages, before it has metastasized to other areas, testicular cancer can be treated effectively through a single treatment, or a combination of several treatments.
Many men who have been diagnosed and treated for testicular cancer can still have children even if the affected testicle was removed. Less than 3% of all men who developed testicular cancer will have the condition in both testicles. The level of recurrence of testicular cancer is relatively low (less than 1%) compared to other cancerous conditions. Some recent medication recalls have been associated with testicular cancer. For additional information, review our Valsartan lawsuit and Zantac lawsuit pages.
Testicular Cancer Symptoms
Usually, testicular cancer only affects a single testicle. The first indicators of testicular cancer usually involve:
- A painful or painless enlargement or lump on the testicle
- A sensation of heaviness in the patient’s scrotum
- An unexpected acute collection of fluid inside the scrotum
- A dull achy sensation in the groin or abdomen
- Back pain
- Shortness of breath
- Bloody phlegm or sputum
- Chest pain
- Deep vein thrombosis (DVT)
- Pulmonary embolism (PE)
- Tenderness or enlargement in the breast area
- Family history where the patient’s brother or father experienced testicular cancer
- Men diagnosed with cryptorchidism (undescended testicles before or after birth)
- Men diagnosed with germ cell neoplasia in situ typically identified in an infertility test
Many of the symptoms associated with testicular cancer mimic other non-cancerous conditions that affect the testicle. Some of these non-cancerous conditions could include:
- A spermatocele cyst in the epididymis attached to the testicle.
- Blood vessel enlargement (varicocele)
- Membrane fluid buildup surrounding the testicle (hydrocele)
- Abdominal muscle opening (hernia)
- Pain associated with testicle infection (orchitis)
- Pain associated with epididymis infection
- Pain associated with injury or twisting (testicular torsion) of the testicle
The doctor may treat the patient’s infection using aggressive antibiotics before or while testing for testicular cancer. Fortunately, small testicle calcifications (microlithiasis) are not considered a risk factor for the development of cancer of the testes.
Every male is encouraged to self-examine their testes after a warm shower or bath while in a standing position. The testes are easier to examine when the scrotum is relaxed. Men are encouraged to examine their testicles by:
- Checking Both Testicles – Using a gentle motion, firmly roll each testis between the forefinger and thumb to examine the entire surface. It is not uncommon for one testicle to be larger than the other.
- Searching for Unexpected Swelling or Lumps – Many abnormal lumps or bumps are not painful. However, pain when touching the testes is not a normal condition and should be checked immediately by your doctor.
- Identify Vas Deferens and Epididymis – These structures inside the scrotum, the soft areas behind and above the testicle that are used to collect and carry sperm to the ejaculation.
- Perform the Testicular Examination At Least Monthly – It is important to routinely check the scrotum area for any unusual texture, shape, or size.
If you detect any change, including a lump or bump in the scrotum, it is essential to seek out immediate medical attention. The doctor may determine there is nothing out of order during a physical examination. However, testicular cancer usually spreads quickly. When the condition is found in its early stage, the cancer is nearly always curable.
Diagnosing and Staging Testicular Cancer
Your urologist will typically handle every aspect of your medical examination to determine if you have testicular cancer at nearly any stage. The medical examination will usually involve:
- A Health Record Review and Physical Examination – The urologist will examine the abdomen, scrotum, lymph nodes, and other areas of the reproductive area for indicators of cancer. The exam can identify unexpected firmness, lumps, and bumps. It is essential to discuss any history of undescended testicles you have experienced.
- Testicle Ultrasound – The urologist will perform imaging tests to identify every internal component of the scrotum and identify suspicious bumps and lumps. X-rays and other scans can also help detect problems in the abdomen or chest. The doctor may be able to detect that cancer has spread to other areas including the liver, lungs, or lymph nodes. Typically, an MRI is used sparingly but might be involved in detecting the spread of testicular cancer to the spinal cord or brain.
- Blood Tests – Extensive blood tests can help identify tumor markers, including hormones and proteins produced by testicular cancers.
Staging Testicular Cancer
If cancer is detected through physical examinations, ultrasound, and blood tests, the urologist will want to identify the specific cell-type of cancer and stage its progression. Unlike other forms of cancer, the physician avoids obtaining a biopsy (tissue sample) before surgery. Usually, surgery is performed to directly remove the cancerous tissue to determine the level or staging progression. The urologist will identify the different stages that include:
Stage 0 – Often referred to as Germ Cell Neoplasia in Situ, Stage 0 testicular cancer is not a form of cancer, but the early warning signs that a cancerous growth could appear soon.
Stage I – This stage of cancer is identified only in the testicle before it can spread to nearby lymph nodes.
Stage II – At this stage, cancer had spread to at least a single lymph node in the belly (abdomen) before spreading to other parts of the body.
Stage III – At this advanced stage, the cancerous growth has spread past the lymph nodes, into the abdomen and found in areas far from the testes, including the lungs and distant lymph nodes. Usually, the tumor marker levels are extremely high in testing.
Treating Testicular Cancer
A team of highly educated medical specialists usually work concomitantly to ensure the patient receives the best treatment for curing or managing testicular cancer, including an oncologist, radiation oncologist, and urologist. These doctors will typically build an effective plan for treatment that involves:
- Surgical options
- Radiation Therapy
Before any treatment can begin, the patient needs to talk to the urologist to discuss the desire or lack of desire to have a child in the future. Many treatments can result in significant changes in the male hormones, directly affecting fertility. The urologist may recommend sperm banking to ensure that the male can produce offspring in the future.
If the removal of the testicle is necessary as a part of an effective treatment plan, the urologist may recommend a testicular prosthesis implanted in the scrotum to produce a more normal sensation once the testis has been excised.
The doctor also might recommend surgical procedures including orchiectomy (removal of the entire testicle and spermatic cord), testis-sparing surgery where only the tumor tissue is removed, and a retroperitoneal lymph node dissection is performed. The surgical option can be complex but often limits the side effects of removing lymph nodes in the abdomen.
Radiation is also an effective solution for killing the cancerous cells in the testicle or lymph nodes nearby the scrotum. Chemotherapy is also an effective option to ensure the cancerous cells never spread beyond the testes. Usually, chemotherapy is an option used after or before a surgical procedure to minimize the potential of reoccurrence of the disease in the future. The type of treatment recommended will be determined by the progression of the disease and the length of time it has been developing. Testicular cancer found in the initial stages usually produce a desirable outcome.