About Testicular Cancer

When treated in its early stages, testicular cancer can be cured in nearly all patients. Even if the disease has spread, surgery and chemotherapy can result in survival rates of 85%. Surgery to remove the cancerous testicle is the primary treatment for localized testicular cancer. Seminoma cells are extremely sensitive to radiation, so doctors frequently use external beam radiation therapy following surgery to sterilize any cancer cells that may have spread to the pelvic or abdominal lymph nodes.

Risk Factors

The cause of testicular cancer is unknown, and while the following factors seem to increase the risk of developing the disease, many men who develop this cancer have no known risk factors.

• Before Birth: The testicles develop inside the abdomen and normally descend into the scrotum before birth. In about 3% of boys the testicles do not descend but remain in the abdomen or in the groin area. About 14% of testicular cancers occur in men with this condition.
• Family History: The brothers of a man with testicular cancer are at increased risk for the disease.
• Personal History: Men who have had cancer in one testicle have a greater chance of developing cancer in the other testicle.
• Workplace Exposure: Men who work in oil and gas refineries, leather processing plants, and who work for power utilities appear to have a higher risk of one form of testicular cancer.
• Lifestyle, Mother: A sedentary lifestyle and having been born to an older mother MAY BE relative risk factors for testicular cancer.

Early Detection, Screening, and Diagnosis

Testicular examination should be a routine part of a physical examination. Any hard lump, swelling or tenderness found on self-examination should be evaluated by a physician promptly. If testicular cancer is suspected, doctors may use any of the following several methods to confirm the diagnosis as well as to determine the stage (spread) of the disease.

• Blood Tests: Some testicular cancers secrete high levels of certain proteins, including alpha-fetoprotein, B-MCG, or enzymes, including lactic acid dehydrogenase. Blood tests measure the level of these proteins and can indicate the size of the tumor.
• Ultrasound: This imaging test uses sound waves to help locate a mass and to determine if it is solid and therefore likely to be cancer or if it is a benign mass or fluid-filled cyst.
• Biopsy: During a biopsy doctors remove a tissue sample for examination under a microscope. Pathologists interpret the biopsy specimen to determine the stage of the cancer as well as guide the need for additional tests and treatment options.
• Chest X-Ray: Used to determine the stage of the cancer once testicular cancer has been confirmed by one of the above tests.

Staging

Staging of testicular cancer is necessary to determine the most effective therapy. It takes into account the size of the tumor, the extent it has spread to lymph nodes, and whether it has metastasized or spread to other organs.

• Stage I: Cancer is confined to the testicle.
• Stage II: Cancer has spread to lymph nodes in the abdominal cavity only but not to lymph nodes in other parts of the body or to distant organs.
• Stage III: Cancer has spread to lymph nodes in the chest or to the lungs.
• Stage IV: Cancer has spread to other distant organs such as the liver, bones, or brain.