Almost all testicular cancers start in the germ cells. The germ cells are the cells in the testicles that produce immature sperm. Cancer usually affects only one of the testicles but it can attack both.
Signs and Symptoms
There are many signs to look for if a man worries he has testicular cancer. They include:
- A lump
- Heavy scrotum
- Abdomen or groin pain
- Sudden fluid in the scrotum
- Testicle or scrotum pain/discomfort
- Enlargement and tenderness of breasts
Risk Factors
Although researchers do not know the cause of testicular cancer the risk factors can include:
- An undescended testicle
- Abnormal testicle development
- Family history of cancer
- Age: most men affected are teenagers and young adults
- Race: Caucasian men have a higher rate of testicular cancer
Testing
If a man finds a lump in his testicle, the doctor will perform tests to see if the lump is in fact cancer. A doctor will perform an ultrasound. This test uses sound waves to create a picture of the scrotum and can tell the doctor many things about the lump. The ultrasound can determine whether the lump is solid or filled with fluid as well as whether the lump is inside or outside the testicle.
Another test is a blood test. The blood test will determine the levels of tumor markers in the blood. This means that if a high level exists, cancer may be a possibility.
The last test is a surgery to remove the testicle. If there is a chance the lump is cancer, the testicle will be removed and sent to a laboratory for analysis. In a very small percentage of men, a biopsy or lump removal will be done if cancer is suspected. This is usually only done, however; if a man only has one testicle.
Types of Cancer
If in fact the lump is deemed cancerous, there are two types of testicular cancer: seminoma and nonseminoma.
Seminoma cancer is sensitive to radiation therapy and can occur in men of all ages. If an older man develops testicular cancer, it is most likely this type of cancer.
Nonseminoma is also sensitive to radiation therapy but not as well as seminoma. Chemotherapy is a more effective option for dealing with this type of cancer. Nonseminoma cancers develop earlier in life, grow and spread very quickly.
Stages
After a doctor performs a computerized tomography (CT), an x-ray and more blood tests, the doctor can determine what stage the cancer is in.
In Stage I the cancer is confined to the testicle. In Stage II the cancer has spread to the lymph nodes in the abdomen and Stage III means the cancer has spread to other parts of the body.
Treatment
There are three treatment options to pursue when faced with a diagnosis of testicular cancer. The primary treatment is surgery to remove the testicle. This is done for nearly all stages and types of testicular cancer. The doctor may also remove the groin lymph nodes. It of course carries the risk of pain, bleeding and infection. If desired, a prosthetic, saline-filled testicle can be inserted to replace the cancerous testicle.
The next treatment option is radiation therapy. This therapy kills the cancer cells by high-powered energy beams. The side effects to this treatment option include fatigue, redness and irritation.
The last treatment option is chemotherapy. This therapy also kills the cancer cells but by drugs. Some common side effects include fatigue, nausea, hair loss and infection although it does depend on what drugs are being used.
If the testicular cancer is advanced or has returned, the doctor may refer the patient to enroll in a clinical study. One clinical study being studied is stem cell transplant.
Infertility
Depending upon what treatment the male used, infertility may be a possible side effect. If both testicles are removed, the male will be left infertile. If a man feels he is not done making his family or wants to create a family in the future, he can store sperm before treatment even begins. According to the Mayo Clinic, storing sperm for later use has been more successful than trying to restore fertility later.
Self Exam
The best way to notice a lump is to do a self-exam. The best time to do a self-exam is after a warm shower or bath. To perform a self-exam, do the following as stated by the Mayo Clinic:
- Stand in a mirror and look for any swelling on the scrotum.
- Place the index and middle fingers under the testicle while placing thumbs on top.
- Gently roll the testicle between the thumb and the fingers.
Do remember, it is normal for one testicle to be larger than the other as well as the cord that leads upward from the top of the testicle.
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