Testicular Cancer

What are the testicles?
The testicles are the male sex glands and are part of the male reproductive system. Testicles are also called testes or gonads. They are located behind the penis in a pouch of skin called the scrotum.

The testicles produce several male hormones, including testosterone and sperm. The hormones control the development of the reproductive organs, as well as other male characteristics - body and facial hair, low voice, and wide shoulders.

What is testicular cancer?
Cancer that develops in a testicle is called testicular cancer.

When testicular cancer spreads, the cancer cells are carried by blood or by lymph, an almost colorless fluid produced by tissues all over the body. The fluid passes through lymph nodes, which filter out bacteria and other abnormal substances such as cancer cells.

What are the symptoms of testicular cancer?
The following are the most common symptoms for testicular cancer. However, each individual may experience symptoms differently. The National Cancer Institute suggests that a man see a physician if any of the following symptoms lasts two weeks or longer:

• lump in either testicle
• enlargement of a testicle
• feeling of heaviness in the scrotum
• dull ache in the lower abdomen or in the groin
• sudden collection of fluid in the scrotum
• pain or discomfort in a testicle or in the scrotum
• enlargement or tenderness of the breasts

The symptoms of testicular cancer may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

What causes testicular cancer?
The exact cause of testicular cancer is not known. However, there are a number of factors that increase the risk for the disease.

What are the risk factors for testicular cancer?
The exact cause of this disease is unknown. However, research does show that some men are more likely than others to develop testicular cancer. Possible risk factors include the following:

• age
  Most testicular cancers occur in men between the ages of 15 and 40.

• cryptorchidism - undescended testicle(s).

• occupational risks
  Miners, gas workers, leather workers, food and beverage processing workers, utility workers, and others are at increased risk.

• family history

• personal history of cancer in the other testicle

• race and ethnicity
  The rate of testicular cancer is higher in Caucasians than in other populations.

• HIV infection

• men whose mother took a hormone called DES (diethylstilbestrol) during pregnancy to prevent miscarriage

• currently, there is not a known cause for the disease.
• many of the suggested risk factors are those that cannot be changed.
• many men with testicular cancer do not have the suggested risk factors.

However, testicular self-examination can improve the chances of finding a cancerous tumor early. 

How is testicular cancer diagnosed?
In addition to a complete medical history and physical examination, diagnostic procedures for testicular cancer may include the following:

• ultrasound - a diagnostic technique which uses high-frequency sound waves to create an image of the internal organs.

• blood tests - assessment of blood samples to check for increased levels of certain proteins and enzymes to determine if cancerous cells are present, or to determine how much cancer is present.
  
  
• biopsy - a procedure in which tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope; to determine if cancer or other abnormal cells are present.

When testicular tumors are present, the entire tumor, as well as the testicle and spermatic cord, may be removed to prevent the spread of cancerous cells through the blood and lymph systems.

Staging of testicular cancer:
Staging is the process of determining if and how far the cancer has spread. Treatment options are based on the results of staging. Procedures for determining stage include the following:

• computed tomography scan (Also called a CT or CAT scan.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.

• lymphangiography - images of the lymph system in which dye is injected into a lymph vessel to improve images.

• magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

In addition to these imaging procedures, chest x-rays, bone scans, or other scans may be requested.

Treatment for testicular cancer:
Specific treatment for testicular cancer will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

There are several kinds of treatments for testicular cancer, including:

• surgery (to remove the tumor and the testicle)

• radiation therapy (to destroy cancer cells or slow the rate of growth)

• chemotherapy, or systemic therapy (drugs are used to destroy cancer cells throughout the body)

• stem cell transplantation - removing stem cells from the patient's or a donor's bone marrow and re-infusing them into the patient to help in production of healthy blood cells.

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