Testicular cancer arises in the testicles, the male sex gland that produces hormones and sperm. The testicles are located within the scrotum at the base of the penis.

There are three types of testicular cancer: germ-cell tumors, stromal tumors and secondary testicular cancer. According to the American Cancer Society, more than 90 percent of all cases are germ-cell tumors that begin in the same cells that produce sperm and are further subdivided into seminomas and nonseminomas. 

Risk Factors

  • Undescended testicle(s), even if surgery amended the problem early on
  • Family history of testicular cancer
  • Klinefelter's Syndrome, a disorder that includes breast enlargement, sterility, low testosterone levels and small testicles
  • Irregular development of the testicles
  • Race/ethnicity may play a role, with Caucasians more likely to develop the disease

Symptoms

Those who suffer from testicular cancer may experience a combination of the following symptoms:

  • Painless swelling or lumps in one of the testicles
  • Heavy feeling in the scrotum
  • Fluid collection in the scrotum
  • Pain or discomfort in scrotum or testicle
  • Dull ache in lower back, abdomen or groin

Detection and Diagnosis

A physical exam, blood test and ultrasound are often used. 

In a biopsy, the testicle in question is removed through surgery and examined under a microscope by a pathologist. If the patient has only one testicle, the surgeon will only remove part of the testicle.

X-rays, CAT scans, and magnetic resonance imaging (MRIs) are used by physicians to detect cancerous growth by taking internal pictures of the body.

Treatment Options

Surgery removes the testicle or testicles with cancer. Lymph nodes may also be removed, depending on stage and extent of cancer. With one testicle remaining a man can still produce sperm, but if both are removed the man cannot. These patients who also wish to father children may opt to store frozen sperm before surgery. Prosthetic testicles appear and feel real and are often used to bar embarrassment after surgery.

Seminomas are particularly sensitive to this type of treatment, which kills cancer cells with intense x-rays aimed only at the cancerous growth. For testicular cancer, the beams are always emitted from a machine outside of the body aimed at the abdomen. Side effects from radiation therapy include loss of appetite, fatigue, nausea, vomiting and problems with digestion.

Chemotherapy involves taking drugs that kill rapidly growing cells, thus noncancerous cells can be killed as well. Side effects vary by type of drug but in general, hair loss, nausea, vomiting, diarrhea, loss of appetite, sores on the mouth and the lips and a lower resistance to infection are expected. Other side effects can include hearing loss, kidney, nerve, lung and small blood vessel damge. 

Prognosis

While testicular cancer is one of the most curable forms of cancer, with a cure rate in excess of 90 percent, most types will spread if left unchecked, first invading and damaging the other testicle before metastasizing and being carried by the lymph nodes to other body organs, such as the lungs. Early detection and treatment are critical for a favorable outcome.