Testicular cancer
What is testicular cancer?
Cancer that develops in a testicle is called testicular cancer. Usually only one testicle is affected, and testicular cancer is more commonly found in the right testicle than the left testicle. If left untreated, it will spread throughout the body. The 2 main types of testicular cancer are seminomas and non-seminomas.
Who may get testicular cancer?
Testicular cancer accounts for approximately 1 per cent of all cancers in men. It mainly affects men between the ages of 20 and 40. Certain types of testicular cancer may occur in younger children or older men.
Risk factors
The cause of testicular cancer is currently unknown, however, there are a number of risk factors that have been identified.
- Uncorrected, undescended testicles as an infant or young child.
- A family history of testicular cancer.
- Having an identical twin with testicular cancer.
- Men whose mothers took a hormone called DES (diethylstilbestrol) during pregnancy to prevent miscarriage may have testicular abnormalities. However, research has not concluded if there is a link between this prenatal exposure to DES and testicular cancer.
What are the signs and symptoms of testicular cancer?
Testicular cancer may cause a variety of signs and symptoms, but may also have no symptoms. Symptoms that men should watch for include:
- a small, painless lump in either testicle;
- any enlargement of the testicle;
- a feeling of heaviness in the testicle or groin;
- a dull ache in the lower abdomen or in the groin;
- pain in the testicle or scrotum;
- a change in the way a testicle feels; or
- enlargement or tenderness of male breasts or nipples.
These symptoms, however, are common, and may be caused by a variety of other conditions. It is important to see your doctor if any of these symptoms last for approximately 2 weeks. Any illness should be diagnosed and treated as soon as possible. This is particularly important in testicular cancer as the sooner this cancer is diagnosed and treated, the better the chances for complete recovery.
How is testicular cancer diagnosed?
A complete medical history is taken and a full physical examination of the scrotum is required. An ultrasound of the scrotum to examine the testicles is also usually performed.
A chest X-ray and CT scans of the chest and abdomen may also be taken to check whether the cancer has spread to the lungs, and blood and urine tests will be done. If the physical examination and blood and urine tests do not indicate any infection or other condition, cancer is then suspected.
To confirm the diagnosis, a sample of tissue is needed for examination under a microscope. Unfortunately, a tissue sample cannot be taken while the testicle is in place because if the problem is cancer, cutting through the outer layer of the testicle may lead to a spread of the disease. So, to obtain this tissue sample, the entire affected testicle is removed through the groin. This operation is called an inguinal orchiectomy. If you have only one testicle, a biopsy alone may be performed.
Treatment
Initial treatment is to remove the affected testicle by surgery as described above. Also, when treating testicular cancer, a surgeon may remove the lymph nodes situated deep in the abdomen to check if the testicular cancer cells have spread.
In some cases, radiotherapy or chemotherapy will be needed following surgery to treat the cancer.
After treatment, men need to be monitored with blood tests and X-rays to make sure the disease does not recur. Infertility can be a side effect of treatment with radiotherapy and chemotherapy, but sperm can be donated and frozen for later use before treatment begins.
The outcome for most men with testicular cancer is good, with cure rates over 90 per cent.
Last Reviewed: 27 May 2009
- 1. MayoClinic.com. Testicular cancer [updated 2007, Oct 3; accessed 2009, Jun 4]. Available at: http://www.mayoclinic.com/health/testicular-cancer/DS00046
