Testicular Cancer is one of the most treatable types of cancer. Your treatment plan depends on the stage of your cancer (whether it is confined to the testicles or has spread to other parts of the body). This information is based on the results of a number of tests, including blood levels of tumour markers.
Some people with testicular cancer do not have any symptoms, but others may notice a lump in the scrotum or a pain when lying on the affected side. If these symptoms develop, it is important to see your doctor. The diagnosis is made by examining your testicles, having an ultrasound and doing blood tests.
If the cancer is in the early stages (stages 1 and 2), removal of the affected testicle (orchidectomy) is the main treatment. This can be combined with chemotherapy and radiation therapy.
The type of treatment depends on the stage of the cancer and whether it has spread. Most cases of testicular cancer start in the cells that make sperm, called Sertoli cells. These cells can also form Leydig cells, which are often benign and do not spread. Cancers that begin in other cells and spread to the testicles are not true testicular cancer and are treated differently.
A very small number of people with testicular cancer have tumors that grow very fast and cause a lot of damage before they are diagnosed. These are called choriocarcinoma. Sometimes choriocarcinoma cells are found with other types of cancer cells in the same testicle and these are called mixed germ cell tumors. Choriocarcinoma has a worse prognosis than other kinds of testicular cancer.
Other cancers can grow very slowly and do not usually cause symptoms. These include seminomas and nonseminomas, which are both very common in men of all ages. They are less likely to spread than invasive cancers and are generally treated with surgery or radiation therapy alone.
Some people are at higher risk of developing testicular cancer because of their age, health history or a genetic condition. Others may have a family history of the disease.
It is important to do self-exams of the testicles regularly, so you are aware of any changes in the size and shape of your testicles. This will help your doctor spot a problem and diagnose it early, which increases your chances of a cure. You should also let your doctor know if you have any other signs or symptoms that worry you, such as an unusual lump or pain in the scrotum.
Testicular cancer happens when cells grow out of control in 1 or both of the testicles. The testicles are the 2 male sex organs that make and store sperm and produce the hormone testosterone. They are located in a pouch (scrotum) underneath the penis. Most often, the first sign of testicular cancer is a lump or bump on the testicles.
Your doctor will take your medical history and do a physical exam. They will feel your testicles and look for a lump. If they suspect a testicular tumor, they may order an ultrasound or blood tests to check for cancer.
The blood tests will measure the levels of certain proteins in your body that can be higher when you have cancer or are being treated for it. The doctor can use these results to help diagnose testicular cancer and find out how far it has spread.
X-rays and other imaging tests may also be done to help diagnose testicular cancer or see how far it has spread. An x-ray is a type of radiation that can show a picture of your internal tissues on film. A computed tomography (CT) scan uses special x-ray equipment to make 3D and cross-sectional pictures of your testicles and other parts of your body. A CT scan shows more details than an x-ray and can be used to find out whether the cancer has spread to nearby lymph nodes or to other parts of your body.
If your doctor thinks you have testicular cancer, they may do a biopsy to remove a small piece of tissue from the affected testicle for further testing. A pathologist will examine the sample under a microscope to check for cancer cells.
You might need to have surgery to remove the affected testicle and some of the lymph nodes in your groin. They will also remove some of the surrounding tissue to get a better understanding of the size and location of the tumor. Some people with testicular cancer need to have more treatment after surgery to lower the chance that the cancer will come back or spread to other areas of the body.
Cancer that starts in the testicles (the two small, egg-shaped glands behind your penis that produce sperm). Testicular cancer can occur in one or both testicles. More than 9 out of 10 people with testicular cancer can be cured.
The chances of a cure are higher if the cancer is found early and is at a low stage. The stage of the cancer is based on its size and whether it has spread from where it started. It is also based on the levels of certain blood tests (tumor markers).
Testicular cancer can be cured by surgery, radiation, or chemotherapy. Your doctor will decide what treatment is best for you. The decision is based on the type of cancer you have, its stage, and your general health. You may want to think about taking part in a clinical trial. A clinical trial is a research study meant to help improve current treatments or obtain information on new ones for patients.
Most people with testicular cancer have surgery to remove the affected testicle, along with any nearby lymph nodes. The surgeon might also remove the spermatic cord and scrotum. In some cases, your doctor might remove all the lymph nodes in the area (retroperitoneal lymph node dissection). The surgery and other treatment you receive reduces the chance that the cancer will come back. But the cancer might recur (come back) many years later, in the other testicle or in other parts of the body. Your doctor can reduce the risk of the cancer coming back by giving you chemotherapy or radiation after surgery. This is called adjuvant therapy.
Some of the treatments for testicular cancer can cause infertility. If you are thinking about having children, you should discuss sperm banking with your doctors. Sperm banking involves freezing sperm before you have treatment for testicular cancer. The sperm can then be used to father children in the future. Your doctors will explain the risks and benefits of sperm banking. They will ask for your permission before you have this procedure. You will need to sign a form saying you agree.
Following treatment, you’ll need follow-up care. This includes physical exams and tests. The tests check for the return of cancer or the spread (metastasis) of cancer. You’ll also have blood tests to look for certain substances called tumor markers. These include alpha fetoprotein (AFP), human chorionic gonadotropin (HCG or beta-HCG), and lactate dehydrogenase (LDH). Different types of testicular cancer raise different tumor markers. Your doctor will know which ones are best for you.
The chance that your cancer will come back (recur) is highest within the first two years after treatment. You’ll have follow-up appointments about twice a year. At these appointments, your healthcare team will check how you’re feeling and ask about any new symptoms. They’ll do a physical exam of your remaining testicle and may order some scans, too. Your doctor will also talk to you about how to cope with any problems that may arise.
Your healthcare team will help you find support to manage any effects of treatment, such as difficulty ejaculating, incontinence, and pain from your testicle or other parts of the body. They’ll also monitor long-term side effects of your cancer treatments and treat them if necessary.
Depending on what kind of testicular cancer you have and where it has spread, your treatment will be different. You might need surgery, radiation therapy, chemotherapy, or both. You may also need hormone therapy.
Testicular germ cell tumours (TGCTs) are rare malignancies that affect young men. The European Germ Cell Cancer Consensus Group has provided clear guidelines for primary treatment of seminoma and nonseminoma TGCTs. However, differences between clinical guidelines and institutional follow-up protocols can lead to suboptimal follow-up, with implications for the quality of life of survivors. Standardising follow-up protocols would allow for optimising risk-benefit ratios and economic use of resources. A prospective trial focusing on this question is needed. In the meantime, we should focus on educating health care professionals about the importance of high adherence to current guidelines. This will improve the quality of patient management and allow future trials to address questions related to personalised follow-up.
Testicular cancer starts in the testicles, which make hormones and sperm in men. It can also spread to lymph nodes and other parts of the body.
Blood tests. These can measure levels of tumor markers like AFP and HCG. They can help doctors find out if cancer has spread.
Testicular cancer often starts in cells that make sperm (germ cells). When these cells multiply faster than normal, they may form a lump or tumor. Some tests can help find these lumps. They can also show if a lump is cancer or not. A lump can be a single nodule or it can be multiple nodules in one or more testicles. It is also possible for the cancer to spread to other parts of the body. This is called metastasis.
Some people don’t have any signs or symptoms of testicular cancer at first. Others have them only when the cancer gets bigger. If you have any of these signs, see your doctor right away. Delays in diagnosis can let the cancer grow and make it harder to treat.
Usually, only one testicle is affected by cancer. But sometimes the cancer can spread from one testicle to another or to other parts of the body. The treatment you get depends on the type of cancer and how far it has grown.
You can help find testicular cancer early by doing monthly self-exams. Do these in the shower or after a bath, when your skin is relaxed. To do the exam, stand up and hold your penis out of the way. Then, gently but firmly roll each testicle between your thumb and fingers. If a testicle feels firm or hard, or if you notice any other change in your scrotum, talk to your doctor.
Your doctor will check for a lump or bump in your scrotum and the area around it. Then your doctor will do a blood test and an imaging test to find out what kind of cancer you have. These include an ultrasound or a CT scan. An ultrasound uses sound waves to create pictures of your scrotum and nearby tissues. A CT scan uses x-rays and a computer to make detailed pictures of your testicles and the area around them.
These tests can also show if the cancer has spread from the testicle to other parts of the body. Your doctor will use these results to decide on your treatment. You may want to talk to your doctor about taking part in a clinical trial. These are research studies that test new treatments for cancer. Some of these trials can give you better, more effective treatments than the standard treatment.
Many conditions and health problems can cause pain in the testicles or groin area. Talking to a doctor or nurse can help you figure out what the cause is and whether it’s something to be worried about or not. If the pain is new or gets worse, it may be a sign of cancer. A heaviness in the scrotum, the sac that holds the testicles, can also indicate testicular cancer.
The testicles are the male sex glands and part of the male reproductive system. The testicles are inside the scrotum, which is a bag of skin under the penis. The testicles make sperm and male hormones, including testosterone. Testicular cancer starts in the cells that make up a testicle. It’s not common, but it can happen to anyone who has testicles and is assigned male at birth — usually those ages 15 to 35.
When cancerous cells start in a testicle, they grow quickly and can spread to other parts of the body. The most common type of testicular cancer is a tumor that grows from germ cells, which are the cells that make sperm. There are two kinds of germ cell tumors in the testicles: seminoma and nonseminoma. Seminomas are slower-growing and less likely to spread. Nonseminomas are more likely to grow faster and spread.
Testicular cancer can often be treated successfully, especially when it’s found early. But some patients’ cancers come back even after treatment. The chance of this is higher if the cancer was in a larger part of the testicle or if it spread to nearby lymph nodes.
It’s important to go to follow-up appointments with your doctor or nurse. If you have any new symptoms between your visits, get them checked right away. It’s also important to check your remaining testicle once a month for any signs of a new lump or swelling.
In many cases, a person diagnosed with testicular cancer may experience pain and discomfort due to inflammation or a tumor of the testicle. However, these symptoms can also be caused by noncancerous conditions such as orchitis and epididymitis. In some cases, a medical procedure such as an ultrasound or X-ray can uncover a testicular lump that could be cancerous. A dull ache in the groin or lower abdomen may be another symptom of testicular cancer, especially for older men. If you notice this symptom, it’s important to schedule an appointment with your doctor.
Most testicular cancers occur in the germ cells in one or more (less commonly) of the two walnut-shaped sex glands that produce sperm and the hormone testosterone. These glands are located in the scrotum, which sits below the penis. Cancerous cells in the germ cells can clump together to form a mass or tumor. Testicular cancer can be broadly classified into two types based on the type of germ cell that is involved: seminoma and nonseminoma. Seminomas make up about 40 percent of all testicular cancers, and nonseminomas include choriocarcinoma, embryonal carcinoma and teratoma. In some cases, a testicular cancer will have a mixture of seminoma and nonseminoma cells.
Many people report difficulty sleeping as a symptom of testicular cancer. If sleep loss continues for a long time, it can lead to chronic sleep deprivation, which is linked to many health problems including substance abuse and increased risk of chronic pain, depression, heart disease, and diabetes. If you have trouble getting to sleep or staying asleep, talk with your doctor. They will ask about your sleep history and symptoms and do a physical exam. They may suggest a sleep study at a lab to learn more about your sleep patterns. They may also prescribe medication to help you fall and stay asleep. These include sedatives and hypnotic drugs, both prescription and non-prescription, as well as some herbs and supplements.
There are stories in the popular press about people who supposedly never sleep, but these cases appear to be rare and isolated. Most people need to sleep. Insomnia is a real medical condition that can be successfully treated, but it requires a commitment from the patient to try and develop good sleeping habits.
Testicular cancer is often one of the most curable cancers when detected early, which is why it’s important to do regular self-exams and notify your GP of any changes in your testicles. In addition to examining your testicles, your doctor will likely run several tests including blood work and chest X-rays. These tests can help determine if the cancer has spread, as well as check your overall health.
Once the cancer is confirmed, your doctor will give you a stage number that describes how far the disease has spread from where it began. The stage of your testicular cancer will influence your treatment plan, which may include surgery, chemotherapy or radiation. You may need to wear a condom while undergoing these treatments to reduce the chances of getting a woman pregnant, and you should wait to father a child until after your treatment is over.
Testicular cancer is a cancer that starts in the testicles, which are in the scrotum. The testicles make sperm and the hormone testosterone. Testicular cancer is very rare. It usually affects people in their teens or young adults.
You may need many tests to find out if you have testicular cancer. These include:
Chemotherapy uses powerful medicines that travel through the bloodstream and kill cancer cells that may have spread beyond the testicle. It is usually given by mouth or vein (intravenous, or IV) and is based on the type of testicular cancer you have. Your doctor will also consider your overall health and other factors when choosing a chemotherapy regimen.
The most common treatment for stage I seminoma is surgery to remove the testicle (inguinal orchiectomy). Radiation therapy may be used in addition, to help prevent the cancer from coming back or to destroy any cancer cells that might have spread from the testicle to nearby lymph nodes.
Your doctor may also recommend a procedure called retroperitoneal lymph node dissection (RPLND). This involves removing the lymph nodes at the back of your abdomen (belly). If the cancer has not spread, RPLND is associated with high initial cure rates. However, the procedure is invasive and carries risks of complications such as infection and loss of ability to ejaculate. Depending on your overall health, your doctor may recommend 1 or more cycles of chemotherapy instead of surgery to reduce the risk of relapse.
For stage II seminoma, a combination of chemo and radiation is recommended. This is because this cancer is very radiosensitive, and the combined use of radiation and chemo is more effective than either alone.
Surgical removal of the testicle is also possible for stage III seminomas. However, a more common approach is to treat them with BEP or EP chemotherapy and monitor them with CT scans.
Because the treatments for testicular cancer can damage sperm, your doctor will probably recommend that you consider using contraception during treatment and for some months afterward. In addition, you should ask your doctor about sperm banking before receiving treatment. This is the process of storing your sperm so that you can try to have children later. Whether this is an option for you depends on your personal and family situation, as well as the impact of infertility on your quality of life. You can learn more about sperm banking by talking to your urologist or contacting a specialist fertility clinic.
The most common treatment for testicular cancer is surgery to remove the affected testicle (orchidectomy). Sometimes doctors also use chemotherapy or radiation afterward, depending on the stage of your cancer and whether it has spread. This treatment is called adjuvant therapy.
During surgery, you’ll be given anesthesia or sedation. You won’t feel any pain during the operation, but you may wake up in the recovery room when the sedation wears off. Your doctor will let you know what to expect before the surgery.
After your surgery, you’ll have a health care team check for signs of cancer or its spread. They’ll do a CT scan of your abdomen and pelvis to see if the cancer has spread to the lymph nodes in the back of your tummy. They’ll also test your blood for elevated levels of cancer markers, such as AFP, beta-hCG, or LDH.
If your cancer is stage 1 or 2, you may not need further treatment. But your doctor will probably recommend surgery to remove the other testicle (bilateral inguinal orchiectomy) and nearby lymph nodes. This is a standard treatment for seminomas and nonseminomas. It reduces the chance that the cancer will come back in the other testicle and the spermatic cord, and it lowers the chances that the cancer will spread to other parts of the body.
For stages 2C and 3 testicular cancer, you’ll usually have chemotherapy after surgery to remove the testicle. You’ll get BEP chemotherapy or a similar type of cancer-killing drug. These drugs travel through your blood to kill cancer cells that may have spread.
Surgery and certain types of chemotherapy can cause infertility, but you’ll still be able to father children. If you hope to have children in the future, talk to your doctor about saving, or “banking,” some of your sperm before beginning treatment. Your doctor will give you a referral to a fertility specialist if necessary. Long-term follow-up is important. You’ll need to have regular exams and tell your doctor right away if you notice any new or unusual symptoms. These include a lump in your scrotum or a feeling that one of your penis is larger than the other.
Radiation is a localized treatment that destroys cancerous cells in the area of a testicular tumor. At Moffitt, we use a three-dimensional conformal radiation technique (IMRT), which uses a linear accelerator to deliver high-energy X-rays that match the size and shape of your tumor, using advanced computer software to minimize damage to surrounding healthy tissue. Radiation may be used alone or in combination with surgery and chemotherapy.
Testicular cancer is most common in men in their 20s and 30s, and is usually found in a single testicle. It can be hard to spot, and many cases of testicular cancer are only diagnosed when men go to their doctor because of pain or a lump in the scrotum or a change in the appearance of a testicle. Early diagnosis and treatment can greatly improve your chances of a cure.
For most testicular cancers, the first treatment is removal of the affected testicle, a procedure called a radical inguinal orchiectomy. Your health care team will discuss the benefits and risks of this procedure with you. Your doctor will also perform a blood test and an imaging test to look for elevated levels of certain proteins that indicate the presence of testicular cancer or other diseases.
In cases of stage I testicular germ cell cancer, the best treatment option is to use radiotherapy in combination with a chemotherapy drug to treat the cancer at its most likely point of spread. Our multispecialty team will work together to determine the best treatment plan for you, which could include a combination of surgery, chemotherapy and radiation.
A small amount of radiation also gets to the lymph nodes near the affected testicle, which can help prevent recurrence. Our doctors will take into account the position of your nipples, and the location of the lymph nodes in your abdomen, to minimize any side effects.
Radiation can temporarily affect sperm, and you will need to use contraception until your sperm are completely restored after treatment. Our urologists will advise you about how to manage this side effect and how long you should use protection.
Adjuvant therapy is treatment that is given after primary treatment, such as surgery, to lessen the chance that cancer will come back (recur). This type of therapy can include chemotherapy, radiation, or other treatments.
The goal of adjuvant therapy is to eradicate any lingering microscopic bits of cancer that may have survived surgery. The decision to give adjuvant therapy is often based on how much risk the patient wants to take. Some patients want to do everything possible to reduce the chance that their cancer will return, even if this means taking more medicines with potentially serious side effects. Other patients choose to take a more cautious approach and only accept treatment that is likely to be effective.
There are many ways that a doctor can treat a testicular cancer with chemo, radiation, or other types of drugs. Most often, doctors use a combination of these therapies. The type of therapy that is used depends on the type of tumor, its location and if any cells have spread to other parts of the body.
Before surgery, doctors may also give a type of chemotherapy called neoadjuvant therapy to help prevent or reduce the size of any tumors. Doctors can also give neoadjuvant therapy before a patient has surgery to see how well it works and make sure that any remaining tumors will be easily removed with the surgeon.
Some types of chemo have also been shown to be effective in treating a variety of other cancers. These include a combination of chemotherapy and targeted therapy, which targets the specific biological activity of certain genes in cancer cells. Targeted therapy is usually more effective than a standard chemo regimen.
For clinical stage I germ cell testicular tumors, a simple procedure called orchidectomy cures 80% of pure seminomas and 70%-75% of nonseminomatous germ cell testicular tumors (NSGCTT). Patients who have vascular invasion (VI+) in their TGCT are at greater risk of recurrence. A series of trials suggests that adjuvant chemotherapy with two cycles of bleomycin, etoposide, and cisplatin can be given safely to these patients to reduce the risk of recurrence.
