What you should know about testicular cancer

April 2, 2019 in Disease Management  •  By Miles Varn, MD
testicular cancer

Although the number of men projected to be diagnosed with testicular cancer in 2019 is only 9,310 compared to a projected 174,650 new cases of prostate cancer, testicular cancer is the most commonly diagnosed cancer for boys and men between the ages of 15 and 44. This type of cancer is highly treatable, even when it has spread beyond the testicle. When the cancer has not spread, the 5-year survival rate is 99%. More than half of cases (68%) are diagnosed at this stage. If it has spread to the lymph nodes in the back of the abdomen, the 5-year survival rate is still high—96%. For men whose cancer has spread beyond this area, the 5-year survival is 73%. Eleven percent of cases are diagnosed at this stage.

Like most forms of cancer, early diagnosis before the cancer has spread can lead to better outcomes. The most common symptoms of testicular cancer include:

  • A lump in the testicle
  • Enlargement of the testicle
  • Heaviness in the scrotum
  • Dull ache in the groin or abdomen
  • Sudden build-up of fluid in the testicle
  • Discomfort or pain in the testicle or scrotum
  • Breast enlargement or tenderness
  • Back pain

There are two main types of testicular cancer. Both start in the germ cells that produce sperm. Seminoma tumors tend to grow and spread more slowly. Non-seminoma tumors often develop at a younger age (between the late teens and early 30s) and grow and spread more rapidly. There are a number of different types of non-seminoma tumors, including choriocarcinoma, embryonal carcinoma, teratoma, and yolk sac tumor.

To diagnose testicular cancer, your doctor may perform a physical exam, an ultrasound to look at the internal structure of the testicles, and blood tests that look for tumor markers such as alpha-fetoprotein or beta-human chorionic gonadotropin.

What increases the risk of testicular cancer and how is it treated?

In most cases, the cause of testicular cancer can’t be definitively determined. There are, however, several factors that have been associated with an increased risk for developing this type of cancer. These include:

  • An undescended testicle at birth
  • Conditions that cause the testicles to not develop normally, such as Klinefelter syndrome
  • A family history of testicular cancer
  • Being Caucasian
  • HIV infection

The treatment for testicular cancer depends on the type of cancer, the stage of cancer, and your overall health. Treatment may include surgery to remove the affected testicle and any nearby lymph nodes where the cancer has spread, radiation after surgery to kill any remaining cancer cells, and chemotherapy, including high dose chemotherapy followed by a stem cell transplant to replace the blood-forming cells the chemotherapy has destroyed.

If you are diagnosed with testicular cancer and think you may want to have children in the future, talk with doctor about the strategies available that can help you preserve your fertility, including banking sperm and having it cryogenically preserved before treatment begins. Although testicular cancer and treatments for the disease can increase your risk for infertility, many men are able to have biological children after treatment.

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