About Testicular Cancer

In most cases, testicular cancer affects only one of the testicles, or testes, a pair of male sex glands that produce sperm and male hormones. The testicles are located under the penis in a loose pouch of skin known as the scrotum. Testicular cancer is the most common cancer in American males between the ages of 15 and 34; however, the disease is highly treatable when detected early. This is why regular testicular self-examination is extremely important.  

Symptoms
Testicular cancer may cause one or more of the following symptoms:

• A lump, swelling or ached in either testicle
• A feeling of heaviness in the scrotum or belly
• 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
• Unexplained fatigue or a general feeling of not being well

Risk factors
The cause of testicular cancer is not clear; however, the risk factors for the disease may include the following:

• Having an undescended testicle or even one that has been surgically descended increases one risk
• Having a family history of the disease
• Being between the ages 15 and 34 increases the odds, but the disease can affect infants as well as the elderly
• Being Caucasian rather than African American, Asian or Hispanic
• HIV infection and AIDS HIV infection and AIDS
• An occurrence of cancer in one testicle increases the risk of developing cancer in the other testicle

Diagnosis and classification
A complete medical history and physical exam are needed to determine whether a man does in fact have testicular cancer. During the exam, the physician will check the testicles for lumps, swelling or tenderness and the abdomen for enlarged lymph nodes. If any symptoms are found, diagnostic tests such as an ultrasound, blood test, and tissue sample will be needed. If cancer cells are found, a pathologist will determine their type or class after which more tests, such as X-rays, computerized tomography (CT) and magnetic resonance imaging (MRI) scans, will be needed to find out if the cancer has spread to other parts of the body. Based on these tests, a physician will determine the cancer’s stage:

• Stage I, the cancer is confined to the testicle
• Stage II, the cancer has spread to the lymph nodes in the abdomen
• Stage III, the cancer has spread beyond the lymph nodes to other parts of the body.

Treatments
Four types of treatments may be used to treat testicular cancer.

• Radical inguinal orchiectomy is a surgical procedure involving the removal of one or both testicles and possibly the lymph nodes in the abdomen. After this type of surgery it’s possible to have prosthetic, or artificial, testicles placed inside the scrotum. This surgery will not interfere with erections or orgasms; however, it may affect some men’s ability to ejaculate, at least temporarily. Please speak with your doctor about ways to treat this possible surgical side effect.
• External beam radiation therapy kills cancer cells with the use of high-dose X-rays or other sources of high-energy radiation. Because radiation may interfere with sperm production at least temporarily, many men store their sperm at a sperm bank before treatment begins.
• Chemotherapy uses anticancer drugs to kill cancer cells that have spread outside the testicles. The drugs are most often given intravenously on an outpatient basis.
• Not often used to treat testicular cancer, bone marrow transplants involve the treatment of a patient’s marrow after it has been extracted from the patient. It is treated to kill any cancer cells and later preserved by freezing. The patient then undergoes chemotherapy and possibly radiation therapy to destroy cancer cells throughout the body. The frozen marrow is later thawed and injected into the patient’s veins.