Quick Facts: Testicular Cancer

What is Testicular Cancer?

About 8,000 men are diagnosed with testicular cancer and 390 die each year in the US. Testicular cancer originates in the part of the male reproductive system known as the testes, or testicles. The various types of testicular cancer differ by types of cells where cancer begins. Over 90% of testicular cancer cases are germ cell carcinoma, which begins in the germ cells that are located in the testes and are precursors to sperm cells. The two main types of germ cell carcinoma are seminoma (normally grow slowly and rarely metastasize) and nonseminoma (normally occur at an early age and grow more aggressively).

Stromal cell tumors arise from the stroma, which is the hormone-producing tissue of the testicles. The two main types of stromal tumors are Leydig cell tumors and Sertoli cell tumors. Leydig cell tumors develop from cells that produce androgen (male sex hormone) and rarely metastasize. Sertoli cell tumors develop from cells that nourish & support germ cells and rarely spread. However, when Leydig or Sertoli cell tumors do spread, they are tough to treat.

Who's at risk?

• Age: Most common in men 15-40 years old.
  
• Caucasians are at greater risk than Asians or African-Americans
  
• Family history of testicular cancer
  
• Personal history of testicular cancer
  
• Occupation: Miners, oil/gas workers, janitors, & utility workers are at high risk due to exposure to certain chemicals.
  
• Carcinoma in situ: Symptom-less condition that almost always progresses to cancer.
  
• Cryptorchidism: "Undescended testicle" is a condition that affects about 3% of newborns. Even men who have the condition corrected early in life are at higher risk.
  

Prevention

Certain lifestyle & dietary habits can reduce your risk, including:

• Not smoking
  
• Regular exercise
  
• Moderate, if any, alcohol consumption
  
• Low fat, high fiber diet
  

Symptoms

Testicular cancer normally is detected by the patient himself. Other symptoms include:

• Heaviness or aching in the lower back or scrotum
  
• Breast tenderness or growth
  
• Fluid accumulation in the scrotum
  

How is it diagnosed?

If the patient or doctor suspects testicular cancer, a number of tests can be done to determine if cancer is present, including:

• Self-Exams: Periodic self-exams of the testicles are an important way to detect changes/abnormalities. Males should begin performing self-exams in adolescence.
  
• Ultrasound: Sound waves used to create an image of the testicle and surrounding tissue; normally used to rule out non-cancerous causes of the symptoms.
  
• MRI: An imaging test that allows the physician to see the structure of the testicle & identify any abnormalities.
  
• Blood test: High levels of certain proteins indicate cancer.
  
• Biopsy: A tissue sample is removed surgically & examined for presence of cancer cells. Sometimes a testicle is removed.
  
• Lymphangiography: A special dye injected into the lymph vessels travels to the lymph nodes. This helps the doctor determine if the cancer has spread.
  
• CT scan: X-ray beams are used from a variety of angles to create an image of the infected area.
  

Treatment options

Treatment options for testicular cancer vary with stage of diagnosis. Treatment plans differ by individual, but surgery is usually part of the treatment. Here are several common options:

• Radical Inguinal Orchiectomy: A testicle is removed by making an incision through the groin and cutting the spermatic cord, which attaches the testicle to the body.
  
• Retroperitoneal Lymph Node Dissection: A large incision is made in the abdomen to access the affected area and remove lymph nodes from the groin area. Often this is done at the same time as radical inguinal orchiectomy or is performed later.
  
• Radiation Therapy: External beam radiation or x-rays are used to kill or shrink cancer cells. It affects only a specific area of the groin where the tumor is located.
  
• Chemotherapy: Drugs given by mouth or injection enter the blood stream & kill cancer cells; affects all areas of the body.
  
• Clinical Trials: Experimental treatments are always being tested. The effectiveness & side effects aren't always known. They can offer hope, especially for end-stage patients. Talk to your doctor or the RI Cancer Council for more information.
  

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