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Testicular cancer occurs when cells that aren't normal grow out of control in the testicles (testes). It is highly curable, especially when it is found early.
The testes are the two male sex organs that make and store sperm. They are located in a pouch below the penis called the scrotum. The testes also make the hormone testosterone.
Testicular cancer is rare. But it is the most common cancer among young men.
Most testicular cancers start in cells that make sperm. These cells are called germ cells. The two main types of testicular germ cell cancers are seminomas and non-seminomas. Seminomas grow and spread slowly and respond to radiation therapy. Non-seminomas grow and spread more quickly than seminomas. There are several different types of non-seminomas.
This topic covers seminoma and non-seminoma cancer. It does not cover non-germ cell testicular cancers, such as Leydig cell tumours.
Experts don't know what causes testicular cancer. But some problems, such as having an undescended testicle or Klinefelter syndrome, may increase a man's risk for this cancer. Most men who get testicular cancer don't have any risk factors.
The most common symptoms of testicular cancer include:
Most men find testicular cancer themselves by chance or during a self-examination. Or a doctor may find it during a routine physical examination.
Because other problems can cause symptoms like those of testicular cancer, your doctor may order tests to find out if you have another problem. These tests may include blood tests and imaging tests of the testicles such as an ultrasound or a CT scan.
If these tests show signs of cancer, you will have surgery to remove the testicle. Surgery is the only way to know for sure if you have testicular cancer and what kind of cancer it is. This information also helps in planning any other treatment you may need.
For some men, surgery to remove the testicle may be all the treatment they need. The type and stage of your cancer will help your doctor know if you need more treatment.
Treatment after surgery may include surveillance, chemotherapy, or radiation therapy. Chemotherapy is often used for cancer that has spread to other parts of the body. In some cases, surgery is used to remove that kind of cancer.
In most cases, removing a testicle doesn't cause long-term sexual problems or make you unable to father children. But if you had these problems before treatment, surgery may make them worse. And other treatments for cancer may cause you to become infertile. You may want to think about saving sperm in a sperm bank. Talk to your doctor if you have any questions or concerns about sexual problems or whether you can father children.
Some men choose to get an artificial, or prosthetic, testicle. A surgeon places the artificial testicle in the scrotum to keep the natural look of the genitals.
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Common symptoms of testicular cancer include:
Sometimes these symptoms can be caused by other problems, such as a hydrocele or epididymitis.
Testicular cancer that has spread (metastasized) beyond the testicles and regional lymph nodes to other organs may cause other symptoms depending on the area of the body affected. Symptoms of late-stage testicular cancer may include:
In most cases, the first sign of testicular cancer is a change in the size or shape of one or both testicles (testes). Often this change doesn't cause pain, though pain may be present. If unnoticed or untreated, testicular cancer may spread (metastasize) to other areas of the body.
After you are diagnosed with testicular cancer, you and your doctor will begin planning your treatment. Nearly all men with testicular cancer have surgery. After surgery, you may have other treatments, if they are needed. This depends on your choices, the type of cells involved, and the stage of your cancer.
Testicular cancer is one of the most curable forms of cancer, especially during its early stages. If you have symptoms of testicular cancer, see a doctor as soon as possible.
Some things may increase your chances of getting testicular cancer. These risk factors include:
Most men who get testicular cancer don't have any known risk factors.
Call your doctor as soon as possible if you have any symptoms of testicular cancer, including:
Some early-stage testicular cancers are successfully managed with a "wait-and-see" approach after surgery. This option involves frequent exams as well as blood tests and imaging tests to watch your condition. Surveillance may let you avoid the side effects from other follow-up treatments, such as chemotherapy and radiation therapy.
Your family doctor or general practitioner can check your symptoms and your risk of testicular cancer. You may be referred to a urologist.
Health professionals who can manage your cancer treatment include:
If testicular cancer is suspected, your doctor will do some testing. Tests may include:
If the ultrasound and blood tests suggest testicular cancer, a doctor will surgically remove your affected testicle. It will be checked for cancer. If cancer is found, you may have other tests, such as X-rays, CT scans, or MRIs, to find out the stage of your cancer.
During your treatment for testicular cancer, your doctor will schedule a thorough follow-up program to monitor your recovery, especially if you are doing surveillance. These examinations and tests may continue for several years. In addition to physical examinations, your follow-up program may include:
Testicular self-examination may help detect testicular cancer. These cancers may be first found as a painless lump or an enlarged testicle during a self-examination.
Some doctors recommend that men ages 15 to 40 perform monthly testicular self-examinations (TSE). But many doctors don't believe that monthly TSE is needed for men who are at average risk for testicular cancer. Monthly TSE may be recommended for men who are at high risk for this kind of cancer. This includes men who have a history of an undescended testicle or a family or personal history of testicular cancer.
If you are diagnosed with testicular cancer, your doctor will explain what type of cancer you have, whether it has spread beyond the testicle (metastasized), and the potential for curing it. You and your doctor will discuss your treatment options and possible outcomes of those treatments. Testicular cancer is highly curable, especially when it's diagnosed at an early stage.
If the cancer isn't treated during its early stages, it may spread (metastasize) to the lymph nodes and to the lungs, liver, brain, and bones. But often testicular cancer that has spread can still be treated successfully.
Some cancer treatments raise your risk of infertility. Unless you are sure you won't want to father a child in the future, talk to your doctor about sperm banking before any treatment for testicular cancer.
Treatment begins with surgery (orchiectomy) to remove the affected testicle. After surgery, depending on which type of cancer cells are present and whether your cancer has spread to other areas of your body (stage), you may need only surveillance. Or you may need further treatment.
Most testicular cancers are either seminomas or non-seminomas. The main difference between the two is that seminomas grow and spread slowly and respond to radiation therapy. Non-seminomas grow and spread more quickly than seminomas. They don't respond to radiation.
Seminomas are the kind of testicular cancer that grow and spread slowly. After surgery, treatments may include:
For seminomas that are more advanced (stage II or stage III cancers), treatments begin with surgery (orchiectomy) and may include radiation, chemotherapy, or combination chemotherapy. After chemotherapy, tissue masses that remain may need to be removed with surgery.
Non-seminomas are the kind of testicular cancer that grow and spread more quickly than seminomas. They don't respond well to radiation therapy. After surgery, treatments may include:
For non-seminomas that are more advanced (stage II or stage III cancers), treatments begin with surgery (orchiectomy) and may include surgery to remove lymph nodes, chemotherapy, or combination chemotherapy. After chemotherapy, any tissue masses that remain will be removed with surgery, if possible.
If your cancer was found early, you may have a choice about further treatment. Talk with your doctor about the risks and possible side effects of each treatment option.
After treatment, it is important to receive follow-up care. This care may lead to early identification and management of cancer that comes back. Your regular follow-up program may include:
A diagnosis of testicular cancer means that you will be seeing your doctor regularly for years to come. It's a good idea to build a relationship based on trust and the sharing of information. Your doctor may give you some advice on changes to make in your life to help treatment succeed.
Testicular cancer that has come back (recurred) may be found during a physical examination, through an imaging test, or as a result of increasing tumour marker levels. In some cases, recurrent cancer can be successfully treated. This is especially true if the cancer has spread only to the lymph nodes in the pelvis, belly, or lower back and pelvis.
Recurrent testicular cancer may be treated with chemotherapy, surgery to remove lymph nodes, or radiation. Chemotherapy may be followed by surgery to remove any remaining cancer.
Cancer treatment has two main goals: curing cancer and making your quality of life as good as possible. Hospice palliative care can improve your quality of life by helping you manage your symptoms. It can also help you with other concerns that you may have when you are living with a serious illness.
Testicular cancer can almost always be cured, even if it comes back (recurrent) or has spread (metastasized). But if you do have cancer that can't be cured, a time may come when treatment to cure cancer no longer seems like a good choice. This can be because the side effects and time of treatment are greater than the promise of cure or relief. But this isn't the end of treatment. Hospice palliative care providers will work to help manage pain and other symptoms or side effects. They may help you decide what treatment you want or don't want. And they can help your loved ones understand how to support you.
It can be hard to decide when to stop treatment aimed at prolonging your life and shift the focus to end-of-life care. You and your doctor can decide when you may be ready for hospice palliative care.
For more information about types of care, see:
You can find additional information about testicular cancer online at the:
There are no proven ways to prevent testicular cancer.
Home treatment can help you manage the side effects that may occur from your treatment. Some treatments for testicular cancer, such as chemotherapy or radiation, can have serious side effects. Be sure to follow any instructions and take medicines given to you by your doctor.
Finding out that you have cancer can change your life. You may feel like your world has turned upside down and you have lost all control. Talking with family, friends, or a counsellor can really help. Ask your doctor about support groups. Or visit the Canadian Cancer Society website at www.cancer.ca.
Healthy habits such as eating a balanced diet and getting enough sleep and exercise may help control your symptoms.
To learn more, see the topic Getting Support When You Have Cancer.
Chemotherapy treatment uses medicines to kill the cancer cells in your body.
Chemotherapy can cause nausea and vomiting. Your doctor may prescribe medicines to control nausea and vomiting to take before, during, or after your treatments.
You may be given a choice between receiving chemotherapy or another treatment. When making your decision, talk to your doctor about the risks and possible side effects of chemotherapy.
Some common medicines used to treat testicular cancer include:
Testicular cancer may be treated with:
Radiation therapy for testicular cancer uses high-dose X-rays or other types of radiation to kill cancer cells. The type of radiation used to treat testicular cancer is external beam radiation. This means the radiation comes from a machine outside the body and is aimed at a specific part of your body.
Radiation therapy may be used to treat the seminoma type of testicular cancer. Because the lymph nodes in the pelvis and lower back are the most common areas for testicular cancer to spread, radiation is often focused on that area.
You may have a choice between radiation therapy or another treatment. When making your decision, talk to your doctor about the risks and possible side effects of radiation therapy.
People sometimes use complementary therapies along with medical treatment to help relieve symptoms and side effects of cancer treatments. Some of the complementary therapies that may be helpful include:
Mind-body treatments like the ones listed above may help you feel better. They can make it easier to cope with cancer treatments. They also may reduce chronic low back pain, joint pain, headaches, and pain from treatments.
Before you try a complementary therapy, talk to your doctor about its potential value and side effects. Let your doctor know if you are already using any such therapies. These therapies aren't meant to take the place of standard medical treatment. But they may improve your quality of life and help you deal with the stress and side effects of cancer treatment.
Other Works ConsultedCornett PA, Dea TO (2012). Cancer. In SJ McPhee, MA Papadakis, eds., 2012 Current Medical Diagnosis and Treatment, 51st ed., pp. 1548–1614. New York: McGraw-Hill.Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.Kollmannsberger C, et al. (2010). Evolution in management of testicular seminoma: Population-based outcomes with selective utilization of active therapies. Annals of Oncology. Published online October 6, 2010 (doi:10.1093/annonc/mdq466).National Cancer Institute (2012). Testicular Cancer Screening PDQ—Patient Version. Available online: http://www.cancer.gov/cancertopics/pdq/screening/testicular/patient.Wood L, et al. (2010). Canadian consensus guidelines for the management of testicular germ cell cancer. Canadian Urological Association Journal, 4(2): E19–E38.
Current as of: August 21, 2019
Author: Healthwise StaffMedical Review: E. Gregory Thompson MD - Internal MedicineBrian D. O'Brien MD - Internal MedicineKathleen Romito MD - Family MedicineChristopher G. Wood MD, FACS - Urology, Oncology
Current as of: August 21, 2019
Author: Healthwise Staff
Medical Review:E. Gregory Thompson MD - Internal Medicine & Brian D. O'Brien MD - Internal Medicine & Kathleen Romito MD - Family Medicine & Christopher G. Wood MD, FACS - Urology, Oncology
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