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The testicles are an essential part of the male reproductive system. There are typically two testicles, and they are located in a sac-like pouch beneath the penis that is known as the scrotum or testes, or gonads. The primary function of the testicles is to produce sperm and male hormones such as testosterone. The testosterone hormone aids in the growth of the male reproductive system and other characteristics associated with masculinity.

Testicular cancer develops when malignant (cancer) cells grow in the tissues of one or both testicles. Almost all testicular cancers originate in germ cells. Seminomas and non-seminomas are the two most prevalent types of testicular germ cell cancers. Non-seminomas grow and spread more rapidly than seminomas. They are treated differently and grow and spread in distinct ways.

Types of Testicular Cancer

Germ cell tumors: Most testicular cancers begin in a germ cell that produces sperm. There are two types of germ cell tumors (GCTs): seminomas and non-seminomas. Many testicular cancers have both seminoma and non-seminoma cells and are called mixed germ cell tumors.

Seminomas tend to grow slower than non-seminomas. It can increase blood levels of a protein called human chorionic gonadotropin (HCG). There are two subtypes:

  • Classical (typical): More than 95% of seminomas are classical. These are mostly found in men between the ages of 25 and 45.
  • Spermatocytic: This uncommon kind of seminoma is more common in older men. (About 65 years old is the average.) Spermatocytic tumors grow more slowly than classical seminomas and are less prone to spread to other body regions.

Non-seminomas begin in the cells which form sperm or eggs. It commonly occurs in men between their late teens and early 30s. Our main types of non-seminoma tumors include:

  • Embryonal carcinoma: This type of cancer usually begins in the testicles, which are located in the scrotum. It tends to grow and spread quickly outside the testicle. It can raise blood levels of alpha-fetoprotein (AFP) as well as human chorionic gonadotropin (HCG).
  • Yolk sac carcinoma: This rare type of cancer begins in germ cells that form sperms or eggs. It tends to grow and spread to other body parts if not treated properly. It always secretes alpha-fetoprotein (AFP), and it is the most commonly occurring tumor in children.
  • Choriocarcinoma: This is a rare and aggressive form of testicular cancer in adults. It often spreads quickly to other body parts, like the bones, lungs, and brain. It increases blood levels of HCG (human chorionic gonadotropin).
  • Teratomas: Under a microscope, these tumors look like the three layers of tissue in a growing embryo: the endoderm (innermost layer), mesoderm (middle layer), and ectoderm (outer layer). Teratomas do not increase the levels of AFP (alpha-fetoprotein) or HCG (human chorionic gonadotropin).

Stromal tumors can develop from the supportive tissues around the germ cells in the testicle, and these tumors are otherwise known as gonadal stromal tumors. The main types of stromal tumors include:

  • Leydig cell tumors: These tumors start in Leydig cells that normally make male sex hormones (testosterone). It occurs in both children and adults. They are usually not benign.
  • Sertoli cell tumors: These tumors start in normal Sertoli cells, which support and nourish the sperm-making germ cells. They are usually benign.

Secondary testicular tumors are cancers that begin in another organ and spread to the testicles. Lymphoma is the most common secondary testicular cancer, which is common in men older than 50. The testicles may also be affected by prostate, melanoma, kidney, and lung cancer.

Causes & Risk Factors of Testicular Cancer

Testicular cancer develops when cells multiply more rapidly, eventually producing a lump or tumor. However, the exact cause of testicular cancer is not known.

The various risk factors for testicular cancer include,

Age: Testicular cancer risk most commonly occurs between the age of 20 and 34. It can affect any age of males, including infants and older men.

Race: The risk of testicular cancer is more common in white men than in black men.

Family history: If anyone of your family members had testicular cancer, which increases the risk of this disease. Certain inherited genetic conditions, like Klinefelter Syndrome, may also raise the risk of testicular cancer.

Personal history: People who already have cancer in one testicle have an increased risk of developing cancer in the other testicle.

Human immunodeficiency virus (HIV): People with acquired immune deficiency syndrome (AIDS) or HIV have an increased risk of developing testicular cancer.

Undescended testicles: Cryptorchidism or undescended testicle means one or both testicles do not move from the abdomen (belly) into the scrotum before birth. This condition raises the risk of developing testicular cancer and requires surgery.

Symptoms of Testicular Cancer

  • Swelling or sudden fluid build-up in the scrotum
  • Painless lump or swelling in the testicle
  • Feeling of heaviness in the scrotum
  • Dull ache in the lower abdomen or the groin
  • Pain or discomfort in the scrotum or a testicle
  • Shrinking testicle (testicular atrophy)
  • Back pain

Testicular Cancer Screening

There is no routine, or standard screening tests are suggested for early detection of testicular cancer. The best screening method for testicular cancer is self-examination by a patient and a routine physical examination by a physician. Testicular cancer is usually cured at any stage, and early detection of testicular cancer makes it easier to treat.

Testicular Cancer Diagnosis

A testicular cancer diagnosis is usually made after symptoms appear or if screening tests indicate cancer risk. To diagnose testicular cancer, your healthcare provider may ask about your medical and family history and conduct a physical exam. Diagnostic procedures and tests for testicular cancer include:

Physical Examination: Your doctor examines any lumps or swelling, as well as any soreness or swelling, in the testicles. A thorough examination of your body's lymph nodes, abdomen, and other areas could indicate the spread of cancer. The physician will examine the legs for swelling and look for growth in the breasts and nipples.

Blood tests: Your doctor may conduct tests to detect the amounts of tumor markers in your blood. Tumor markers are substances that normally appear in your blood, but their levels might rise in testicular cancer. A high tumor marker level in your blood does not necessarily indicate that you have cancer, but it may assist your doctor in making a diagnosis.

Radical inguinal orchiectomy: A surgeon will perform a radical inguinal orchiectomy if testicular cancer is suspected. During this procedure, a groin incision is used to remove the entire testicle. Then, a pathologist will examine very thin slices of testicular tissue under a microscope to diagnose the type of cancer.

Imaging tests: Various imaging tests are performed to diagnose testicular cancer. Those are:

  • X-rays provide images of the structures inside the body by using a small amount of radiation. If more detailed images are required, the doctor may recommend a chest x-ray. It is used for follow-up screening and determining the cancer stage.
  • Computed tomography (CT) scan uses x-ray machines and computers to create more detailed images of the abdomen, chest, and pelvis. CT scans are performed to investigate the extent of cancer spread.
  • Ultrasound involves using sound waves to create an image of the scrotum and testicles. It can help to detect the nature of testicular lumps and examines whether the lumps are present inside or outside the testicle.

Testicular Cancer Treatment

Depending on the individual's age, type, stage of testicular cancer, and general and overall health, the physician may recommend the treatment options. The major treatment types for testicular cancer include surgery, radiation therapy, and chemotherapy.

Surgery removes a part or entire tumor that has spread to other body parts. It is an important treatment for testicular cancer. The testicle and a few lymph nodes are removed during diagnosis and staging. Types of surgery used in testicular cancer include:

Radical inguinal orchiectomy is the major treatment for seminoma and non-seminoma testicular cancers. Your medical professional will make an incision in your groin during this procedure to remove the testicle containing the tumor. Additionally, they will close off lymphatic tissue and blood vessels to prevent cancer from spreading from the tumor site to other body parts.

Retroperitoneal lymph node dissection (RPLND) is commonly used in non-seminoma testicular cancers. During this procedure, your physician creates an incision in your belly (abdomen) and removes the lymph nodes below your abdominal organs. RPLND can be used to treat and stage cancer.

Radiation therapy uses high-energy x-rays and protons to damage the DNA of cancer cells and shrink tumors, and prevents tumor cells from proliferating and spreading. Radiation therapy may be performed following surgery to prevent the tumor from recurring, and it is often only used to treat seminomas.

Chemotherapy uses medications to kill cancer cells or prevent them from dividing by stopping the growth of cancer cells. These medicines enter the bloodstream and can reach cancer cells throughout the body when administered orally or injected into a vein (systemic chemotherapy). Depending on the type of cancer, you might need chemotherapy rather than surgery.

Testicular Cancer Prognosis:

Testicular cancer prognosis depends upon various factors such as:

  • Age
  • Gender
  • Type of cancer
  • Stage of cancer
  • Patient's general health and response to the treatment

The survival rate of testicular cancer is five years in patients who have been diagnosed early. If the cancer stage has localized, then the five-year survival rate lowers to 99%.

Prevention of Testicular Cancer

There is currently no way to prevent testicular cancer, but the risks can be avoided to reduce the chance of developing testicular cancer. Regular self-examination and physical examination can help to detect and treat testicular cancer. Early detection and screening is the best way to prevent testicular cancer. Consult your physician if you have potential risk factors for testicular cancer.

Testicular Cancer FAQs

1. Will I be able to have sex after testicular cancer?

Yes, It is safe to have sex once your body has recovered from testicular cancer treatment. However, I should restart my normal sex life after a few months. Depending on the course of treatment, side effects could develop.

2. Does my family history of testicular cancers put me at risk?

Yes, having a family history of testicular cancer is one of the risk factors for developing testicular cancer. Early detection and regular screening can assist in preventing the progression of testicular cancer.

3. How do I check myself for testicular cancer?

Regular self-exams are the best way to find a testicular tumor early. The self-exams only take a few minutes and should be performed during standing up. The following step-by-step procedures are used for self-examination which includes:

  • Check the testicles immediately after a hot bath or shower.
  • Hold your penis aside and examine each testicle separately.
  • Roll your testicle lightly while holding it between your thumbs and fingers.
  • Look and feel your testicles for changes in size, shape, or consistency and hard lumps or nodules (smooth, spherical masses).

4. Can testicular cancer be passed on through sperm?

No. Cancer is not a contagious disease, and it cannot transmit to your partner through sex. However, taking precautions such as using condoms can help to avoid disease transmission.

5. What is the most common type of testicular cancer?

The most prevalent type of testicular cancer is germ cell cancer, which begins in the germ cell that produces sperm. Seminoma and non-seminoma are the two types of germ-cell cancer.

6. What symptoms might I observe if I have testicular cancer?

Swelling or sudden fluid build-up in the scrotum, painless lump or swelling in either testicle, feeling heaviness in the scrotum, dull ache in the lower abdomen or the groin, pain or discomfort in the scrotum or a testicle, shrinking testicle (testicular atrophy) and back pain are the common symptoms of testicular cancer.

7. What are my risk factors for testicular cancer?

The risk factors of testicular cancer include:

  • Age
  • Being white
  • Family history
  • Personal history
  • Undescended testicles
  • Human immunodeficiency virus (


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