Testicular Cancer

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What is Testicular Cancer?

Testicular cancer is cancer that starts in the testicles, the male reproductive glands located in the scrotum.



Alternative names

Cancer - testes; Germ cell tumor; Seminoma testicular cancer; Nonseminoma testicular cancer



Causes

The exact cause of testicular cancer is unknown. There is no link between vasectomy and testicular cancer. Factors that may increase a man's risk for testicular cancer include: Abnormal testicle development History of testicular cancer History of undescended testicle(s) Klinefelter syndrome Other possible causes include exposure to certain chemicals and HIV infection. A family history of testicular cancer may also increase risk. Testicular cancer is the most common form of ca...



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What is Testicular Cancer?

Testicular cancer is cancer that starts in the testicles, the male reproductive glands located in the scrotum.

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Alternative names

Cancer - testes; Germ cell tumor; Seminoma testicular cancer; Nonseminoma testicular cancer

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Causes

The exact cause of testicular cancer is unknown. There is no link between vasectomy and testicular cancer. Factors that may increase a man's risk for testicular cancer include:

Other possible causes include exposure to certain chemicals and HIV infection. A family history of testicular cancer may also increase risk.

Testicular cancer is the most common form of cancer in men between the ages of 15 and 35. It can occur in older men, and rarely, in younger boys.

White men are more likely than African-American and Asian-American men to develop this type of cancer.

There are two main types of testicular cancer: seminomas and nonseminomas. These cancers grow from germ cells, the cells that make sperm.

Seminoma: This is a slow-growing form of testicular cancer usually found in men in their 30s and 40s. The cancer is usually just in the testes, but it can spread to the lymph nodes. Seminomas are very sensitive to radiation therapy.

Nonseminoma: This more common type of testicular cancer tends to grow more quickly than seminomas. Nonseminoma tumors are often made up of more than one type of cell, and are identified according to these different cell types:

  • Choriocarcinoma (rare)
  • Embryonal carcinoma
  • Teratoma
  • Yolk sac tumor

A stromal tumor is a rare type of testicular tumor. They are usually not cancerous. The two main types of stromal tumors are Leydig cell tumors and Sertoli cell tumors. Stromal tumors usually occur during childhood.

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Symptoms & Signs

There may be no symptoms. Symptoms that may occur can include:

  • Discomfort or pain in the testicle, or a feeling of heaviness in the scrotum
  • Dull ache in the back or lower abdomen
  • Enlargement of a testicle or a change in the way it feels
  • Excess development of breast tissue (gynecomastia), however, this can occur normally in adolescent boys who do not have testicular cancer
  • Lump or swelling in either testicle

Symptoms in other parts of the body, such as the lungs, abdomen, pelvis, back, or brain, may also occur if the cancer has spread.

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Exams and Tests

A physical examination typically reveals a firm lump (mass) in one of the testicles. When the health care provider holds a flashlight up to the scrotum, the light does not pass through the lump.

Other tests include:

  • Abdominal and pelvic CT scan
  • Blood tests for tumor markers: alpha fetoprotein (AFP), human chorionic gonadotrophin (beta HCG), and lactic dehydrogenase (LDH)
  • Chest x-ray
  • Ultrasound of the scrotum

A biopsy of the tissue is usually done after the entire testicle is surgically removed.

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Treatments

Treatment depends on the:

  • Type of testicular tumor
  • Stage of the tumor

Once cancer is found, the first step is to determine the type of cancer cell by examining it under a microscope. The cells can be seminoma, nonseminoma, or both.

The next step is to determine how far the cancer has spread to other parts of the body. This is called "staging."

  • Stage I cancer has not spread beyond the testicle
  • Stage II cancer has spread to lymph nodes in the abdomen
  • Stage III cancer has spread beyond the lymph nodes (it could be as far as the liver, lungs, or brain)

Three types of treatment can be used.

  1. Surgical treatment removes the testicle (orchiectomy) and nearby lymph nodes (lymphadenectomy). This is usually performed in the case of both seminoma and nonseminomas.
  2. Radiation therapy using high-dose x-rays or other high-energy rays may be used after surgery to prevent the tumor from returning. Radiation therapy is usually only used for treating seminomas.
  3. Chemotherapy uses drugs such as cisplatin, bleomycin, and etoposide to kill cancer cells. This treatment has greatly improved survival for patients with both seminomas and nonseminomas.
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Where to get support

Joining a support group where members share common experiences and problems can often help the stress of illness. Your local branch of the American Cancer Society may have a support group. See: www.cancer.org for more information.

Lance Armstrong, a famous cyclist, is a survivor of testicular cancer. His web site -- www.laf.org -- offers support and information for patients with testicular cancer.

The National Cancer Institute website also provides further information: www.cancer.gov

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Prognosis

Testicular cancer is one of the most treatable and curable cancers.

The survival rate for men with early-stage seminoma (the least aggressive type of testicular cancer) is greater than 95%. The disease-free survival rate for Stage II and III cancers is slightly lower, depending on the size of the tumor and when treatment is begun.

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Possible Complications

Testicular cancer may spread to other parts of the body. The most common sites include the:

  • Abdomen
  • Lungs
  • Retroperitoneal area (the area near the kidneys)
  • Spine

Complications of surgery can include:

  • Bleeding and infection after surgery
  • Infertility (if both testicles are removed)

If you are of childbearing age, ask your doctor about methods to save your sperm for use at a later date.

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When to contact a medical professional

Call your health care provider if you have symptoms of testicular cancer.

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Prevention

The U.S. Preventive Services Tast Force recommends against routine screening for testicular cancer because there is no known effective screening technique.

A testicular self-examination (TSE) performed on a monthly basis, however, may help detect such cancer at an early stage, before it spreads. Finding it early is important to successful treatment and survival. Young men are sometimes taught how to perform self-exams shortly after puberty.

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References

Einhorn LH. Testicular cancer. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa : Saunders Elsevier. 2007: chap 210.

National Cancer Institute. Testicular cancer treatment PDQ. Updated Jan. 15, 2009.

Richie JP, Steele GS. Neoplasms of the testis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa : Sauders Elsevier; 2007: chap 29.

Screening for testicular cancer: update of the evidence for the U.S. Preventive Services Task Force. Agency for Healthcare Research and Quality. 2004. Accessed March 29, 2009.

Content provided by:

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch). The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Review Date: .4/5/2009

Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.4/5/2009

Testicular Cancer Articles

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  • Testicular Cancer

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  • 5 Things You Need to Know About Symptoms of Testicular Cancer

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Men, Infertility, & Cancer

A large study published in February's Archives of Internal Medicine links testicular cancer to men who are seeking fertility treatment. The researchers analyzed data from over 22,500 men in couples who sought fertility treatment between 1967 and 1998...

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Testicular Cancer Topic Guide

Topic Guide

Name: Scott Joy

Profession: Testicular Cancer Survivor & Activist

About Me: Scott is a testicular cancer survivor, first diagnosed in June 2003 with a recurrence in 2005. He and his wife Judy, author of...

Welcome to the Testicular Cancer page in the Lance Armstrong Foundation's Cancer Center! I'm a testicular cancer survivor since June 2003, and I'm here as a volunteer to help.

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Testicular cancer Images

Connect With People Who Have Testicular Cancer

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Connect with Testicular Cancer Dares & Groups

Cycling for cancer

- 709 members

Logging cycling miles to help raise funds for the Lance Armstrong Foundation.

Start a cancer diet

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Create a Cancer Diet by exploring natural and organic foodstuffs and adding them to your weekly menu. Eating a diet rich in whole grains, healthy fats and fresh foods can keep the immune system an...

LIVESTRONG: Testicular Cancer

- 68 Members

...discussion group for people affected by testicular cancer, and ready to kick it back.

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Talk

citizencog: @jacksbileduct You want to see pain? Swing by First Methodist Tuesday nights. See the guys with testicular cancer. That's pain.

WRDinc: RT @biglakermike: Sitting getting his oil checked... (Not a metaphore for a testicular cancer check up)

JenHartnett: I just made a donation to #Movember, pls support the fight against prostate & testicular cancer - http://us.movember.com/donate

stevegarfield: I just made a $50 donation to #Movember, pls support the fight against prostate & testicular cancer - http://www.helpingthecause.com

sbowmann: I just made a donation to #Movember, pls support the fight against prostate & testicular cancer - http://us.movember.com/donate



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