The Basics

Testicular cancer is cancer that forms in the tissues of the testis, or gonad, one of two egg-shaped glands inside the scrotum that make sperm and male hormones.

About 8,000 men are diagnosed with testicular cancer, and about 390 men die of this disease each year.

Testicular cancer is rare, but it is the most common form of cancer in men between the ages of 15 and 34.

More than 95% of testicular cancers can be cured, and chance for cure is much higher if the cancer is detected early. Check out the Self Exam 101 section and learn the right way to do self-exam.

Undescended testicle - You may be a higher risk if you were born with an undescended testicle. Your risk wouldn't change even if you had surgery to fix the problem, and your increased risk would apply to both testicles.

Congenital abnormalities - You may be at higher risk if you were born with an abnormality of the testicles, penis, or kidneys, or if you have had an inguinal hernia (a hernia in the groin area, where the thigh meets the abdomen).

Personal or family history - If you've had testicular cancer already, you are at higher risk of developing it on the other side, and you are also at higher risk if your brother or father had testicular cancer.

Signs & Symptoms

Doctors generally examine the testicles during routine physicals, but most of the time, men find testicular cancer themselves. Check out the Self Exam 101 section and learn the right way to do self-exam.

If you notice any of the following, you should check with your doctor:

• a painless lump or swelling in a testicle
• pain or discomfort in a testicle or in the scrotum
• any enlargement of a testicle or change in the way it feels
• a feeling of heaviness in the scrotum
• a dull ache in the lower abdomen, back, or groin
• a sudden collection of fluid in the scrotum

Don't let fear keep you from seeing a doctor. These can all be caused by something other than cancer. Testicular cancer is rare. BUT, if it is cancer, catching it early will give you a greater chance of being cured, potentially with less aggressive treatment and fewer side effects.

Diagnosis

The doctor will do a physical exam and order laboratory and diagnostic tests to determine what's causing the symptoms. These might include:

• Blood tests to measure levels of tumor markers, found in higher amounts when cancer is present. Tumor markers for testicular cancer may include alpha-fetoprotein (AFP), beta-human chorionic gonadrotropin (ßHCG), and lactate dehydrogenase.
• Ultrasound, which bounces high-frequency sound waves off internal organs and tissues to produce a picture called a sonogram. Ultrasound may reveal a mass in the testicle, or rule out other conditions such as swelling due to infection or collection of fluid from other causes.
• Biopsy, in which a microscopic piece of testicular tissue is examined by a pathologist to see if cancer is present. In almost all cases of suspected cancer, the entire affected testicle is removed through an incision in the groin.

If testicular cancer is found, more tests are needed to find out if the cancer has spread from the testicle to other parts of the body. Determining the extent or stage of disease is important to planning appropriate treatment.

Treatment

More than 95 percent of testicular cancers can be cured. With early detection, treatment is more likely to be successful AND may be less aggressive and cause fewer side effects.

Most men with testicular cancer can be cured with surgery, radiation therapy or chemotherapy. The specific treatment plan may differ depending on the stage of disease (whether it has spread beyond the testicles) and whether the cells are seminomas, nonseminomas or a combination.

Sexuality & fertility

Testicular cancer and its treatment may affect sexuality and fertility. If you have testicular cancer, you should discuss this with your doctor. Men with testicular cancer often have fertility problems even before their cancer is treated.

If you have pre-existing fertility problems, or will have a treatment that might lead to infertility, you may want to talk to your doctor about sperm banking, which will freeze sperm before treatment for use in the future. This allows some men to father children even if the treatment causes loss of fertility.

Where to learn more

• The National Cancer Institute's overview of testicular cancer
• The American Cancer Society's "All About Testicular Cancer" web pages
• Planned Parenthood Federation of America's overview of testicular cancer
• The Testicular Cancer Resource Center

Sources: American Cancer Society, National Cancer Institute