Testicular cancer begins in the male testicles, located in the male scrotum. The exact cause of testicular cancer is unknown. There isn't any link between having a vasectomy and getting testicular cancer. The things that can contribute to testicular cancer include having an abnormal testicular development, having testicular cancer in the past, having an undescended testicle and having Klinefelter's syndrome. HIV infections and chemical exposures can play a role in developing testicular cancer as can a family history of the disease. It is the most common form of male cancer between the ages of 15 and 35 years of age. It can rarely occur in younger or older individuals. It is more common in Caucasian men than in men of color or Asian men.

There are two types of testicular cancer: a nonseminoma and a seminoma. They grow from primordial cells, known as germ cells. In a nonseminoma, the cancer grows quickly. It is more common than a seminoma. It is made up of different types of cells, including choriocarcinoma, teratoma, embryonic carcinoma and a yolk sac tumor. A seminoma is a slower growing tumor that is found in older men of around 30 to 40 years. It can spread to lymph nodes but is extremely responsive to radiation therapy. A more rare type of testicular cancer is called a stromal tumour. It is essentially noncancerous. There are two types of stromal tumours: Leydig cell tumors and Sertoli cell tumors. These tend to be childhood tumours that are not that dangerous.

Symptoms of testicular cancer may be minimal to none. Men can notice a pain in the testicle or a heavy sensation in the testicle. There can be lower abdominal or back pain. There can also be enlargement of a testicle or a change in the way the testicle feels. Gynecomastia (breast tissue formation) can occur in adolescent boys. A lump or swelling can be found in the affected testicle. Both testicles can be involved at the same time. If the cancer has spread to the abdomen, pelvis, lungs, back or brain, there can be symptoms in these areas as well.

Tests for testicular cancer can determine the extent of the disease. A physical exam can show a hard lump in the testicle. Light doesn't pass through the lump when a flashlight is placed behind the lump. Doctors can then do an ultrasound of the scrotum to evaluate the lump. Abdominal and pelvic CT scans can be done to see if lymph nodes or local spread of tumor are involved. Blood tests can be done to see if there is alpha fetoprotein, human chorionic gonadotrophin, or lactic dehydrogenase. Chest x-rays can determine if there are lung metastases. A biopsy of the tumor can be done or it can be completely removed and examined under the microscope at the time of removal. Usually, the entire testicle is removed if there is a suspicious lump.

The treatment of testicular cancer depends on the type of tumor and on the stage of the tumor. The cancer is looked at under the microscope to see if it is a seminoma, nonseminoma or perhaps both. The cancer is then staged. Stage I testicular cancer means that the cancer is within the testicle only. Stage II means that it has spread to local lymph nodes. Stage III testicular cancer means that it has spread to other body areas and is metastatic.

Treatment can involve surgical removal of the testicle, called an orchiectomy. Nearby lymph nodes may also be removed. Radiation is then used to remove residual tumor cells in the testicular area or wherever the cancer happens to reside. Radiation is used to treat seminomas only as they are very sensitive to radiation. Chemotherapy with cisplatin, bleomycyin and sometimes etoposide is used to kill residual cancer cells. It improves survival in all types of testicular cancer.

The prognosis of testicular cancer is very good and it is one of the most curable cancers. The survival rate for stage I cancer is 95 percent after five years and the survival rate of those with stage II and stage III testicular cancer is nearly as good as that.

Complications of testicular cancer include spread to other body areas. The most common body areas involved in metastasis include lungs, retroperitoneal area (by the kidneys), spine and abdomen. Surgical complications include infection or postoperative bleeding, and infertility if both testes are removed at the same time. Patients can save sperm for later use in childbearing.

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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here