testicular cancer

Testicular cancer is a disease in which cells become malignant (cancerous) in one or both testicles.

The testicles (also called testes or gonads) are a pair of male sex glands. They produce and store sperm and are the main source of testosterone (male hormones) in men. These hormones control the development of the reproductive organs and other male physical characteristics. The testicles are located under the penis in a sac-like pouch called the scrotum.

Based on the characteristics of the cells in the tumor, testicular cancers are classified as seminomas or nonseminomas. Other types of cancer that arise in the testicles are rare and are not described here. Seminomas may be one of three types: classic, anaplastic, or spermatocytic. Types of nonseminomas include choriocarcinoma, embryonal carcinoma, teratoma, and yolk sac tumors. Testicular tumors may contain both seminoma and nonseminoma cells.

Testicular cancer accounts for only 1 percent of all cancers in men in the United States. About 8,000 men are diagnosed with testicular cancer, and about 390 men die of this disease each year (1). Testicular cancer occurs most often in men between the ages of 20 and 39, and is the most common form of cancer in men between the ages of 15 and 34. It is most common in white men, especially those of Scandinavian descent. The testicular cancer rate has more than doubled among white men in the past 40 years, but has only recently begun to increase among black men. The reason for the racial differences in incidence is not known.

The exact causes of testicular cancer are not known. However, studies have shown that several factors increase a man’s chance of developing this disease.

Most testicular cancers are found by men themselves. Also, doctors generally examine the testicles during routine physical exams. Between regular checkups, if a man notices anything unusual about his testicles, he should talk with his doctor. Men should see a doctor if they notice any of the following symptoms:

These symptoms can be caused by cancer or by other conditions. It is important to see a doctor to determine the cause of any of these symptoms.

To help find the cause of symptoms, the doctor evaluates a man’s general health. The doctor also performs a physical exam and may order laboratory and diagnostic tests. These tests include:

If testicular cancer is found, more tests are needed to find out if the cancer has spread from the testicle to other parts of the body. Determining the stage (extent) of the disease helps the doctor to plan appropriate treatment.

Although the incidence of testicular cancer has risen in recent years, more than 95 percent of cases can be cured. Treatment is more likely to be successful when testicular cancer is found early. In addition, treatment can often be less aggressive and may cause fewer side effects.

Most men with testicular cancer can be cured with surgery, radiation therapy, and/or chemotherapy. The side effects depend on the type of treatment and may be different for each person.

Seminomas and nonseminomas grow and spread differently and are treated differently. Nonseminomas tend to grow and spread more quickly; seminomas are more sensitive to radiation. If the tumor contains both seminoma and nonseminoma cells, it is treated as a nonseminoma. Treatment also depends on the stage of the cancer, the patient’s age and general health, and other factors. Treatment is often provided by a team of specialists, which may include a surgeon, a medical oncologist, and a radiation oncologist.

The three types of standard treatment are described below.

Men with testicular cancer should discuss their concerns about sexual function and fertility with their doctor. It is important to know that men with testicular cancer often have fertility problems even before their cancer is treated. If a man has pre-existing fertility problems, or if he is to have treatment that might lead to infertility, he may want to ask the doctor about sperm banking (freezing sperm before treatment for use in the future). This procedure allows some men to have children even if the treatment causes loss of fertility.

Regular follow-up exams are extremely important for men who have been treated for testicular cancer. Like all cancers, testicular cancer can recur (come back). Men who have had testicular cancer should see their doctor regularly and should report any unusual symptoms right away. Follow-up varies for different types and stages of testicular cancer. Generally, patients are checked frequently by their doctor and have regular blood tests to measure tumor marker levels. They also have regular x-rays and computed tomography, also called CT scans or CAT scans (detailed pictures of areas inside the body created by a computer linked to an x-ray machine). Men who have had testicular cancer have an increased likelihood of developing cancer in the remaining testicle. Patients treated with chemotherapy may have an increased risk of certain types of leukemia, as well as other types of cancer. Regular follow-up care ensures that changes in health are discussed and that problems are treated as soon as possible.

Yes. Participation in clinical trials is an important treatment option for many men with testicular cancer. To develop new treatments, and better ways to use current treatments, the National Cancer Institute (NCI) is sponsoring clinical trials (research studies with people) in many hospitals and cancer centers around the country. Clinical trials are a critical step in the development of new methods of treatment. Before any new treatment can be recommended for general use, doctors conduct clinical trials to find out whether the treatment is safe for patients and effective against the disease.