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Testicular Cancer

Overview

The testes are the two male sex organs that make and store sperm and testosterone. They are located in a pouch below the penis called the scrotum.

Testicular cancer occurs when cells that are not normal grow out of control in the testicles, or testes. It is highly treatable and usually curable when detected and diagnosed early. In fact, testicular cancer is treated successfully in more than 95 percent of cases. Testicular cancer is most common among white males and least common in men of African or Asian background. Overall, testicular cancer is rare but is the most common form of cancer in men between the ages of 20 and 34.

Education/General Information

The majority of testicular cancer originates in undeveloped germ cells that produce sperm. These tumors, called germ cell tumors (GCTs), are most common in men between the ages of 20 and 40 and are highly curable. There are two main types of tumors: seminomas and nonseminomas. A third rare type of tumor, called stromal tumors, develops in the supporting tissues of the testicle.

Experts don’t know all the causes of testicular cancer, but there is one risk factor they agree on: a history of an undescended testicle (cryptochidism), or a testicle that has not dropped from the abdominal cavity (where they form in fetal development) down into the scrotum by birth. Normally, a baby’s testicles drop down into his scrotum before he is born or by the time he is 3 months old. Other risk factors may include Klinefelter syndrome, a genetic disorder in which males have at least two X chromosomes, instead of just one, and a family history of testicular cancer. Most men who get testicular cancer don’t have any risk factors.

The most common symptoms of testicular cancer include:

  • A change in the size or shape of one or both testes, or painless swelling
  • Pain or tenderness in the testicle, or a dull ache
  • A heavy feeling in the scrotum
  • A dull pressure or pain in the lower back, belly and/or groin

Many men delay reporting these symptoms, but it is crucial to visit your urologist immediately when you have a symptom to prevent possible spreading of the tumor.

Diagnosis

Most testicular tumors are discovered during self-exams or physician exams. Diagnosis of testicular cancer involves a patient history to evaluate risk factors; a physical examination to check for lumps, swelling or enlarged lymph nodes; and diagnostic tests. Diagnostic tests include ultrasound, CT scan and blood tests. These tests help rule out other causes of symptoms and determine the location, size and stage of the tumor.

Treatment

Nearly all cases of testicular cancer are treated surgically to remove the testicle that has cancer, which is referred to as radical inguinal orchiectomy. This helps determine the type of cancer cells that are present and any further treatment you may need. Treatment after surgery may include:

  • Watchful waiting and regular checkups to make sure the cancer is gone
  • Chemotherapy to destroy any remaining cancer cells. Chemotherapy can also be used for cancer that has spread to other parts of the body.
  • Radiation therapy to destroy remaining cancer cells. Radiation therapy can also be used to treat cancer that has spread beyond the testes.

Testicular cancer is highly curable, even when diagnosed at an advanced stage.

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