Testicular Cancer

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KEY POINTS

• Testicular cancer is a growth of abnormal cells in one or both testicles, which are part of the male reproductive system.
• Treatment may include surgery, chemotherapy, radiation, or medicine designed to help your immune system fight cancer. More than 1 treatment may be used.
• After treatment, you will need to have regular follow-up visits with your healthcare provider.

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What is testicular cancer?

Testicular cancer is a growth of abnormal cells in one or both testicles. The testicles are part of the male reproductive system. They make sperm and the male hormone testosterone. They are in the scrotum, which is the sac of loose skin below the penis.

The sooner cancer is found and treated, the better your chances for recovery. However, even advanced cancer can usually be treated. Treatment may slow or stop the growth of the cancer and ease symptoms for a time. Ask your healthcare provider what you can expect with the type of cancer that you have.

What is the cause?

The cause of testicular cancer is not known. However, some things do seem to increase your risk, such as:

• A testicle that did not move from inside the belly down into the scrotum before birth (undescended testicle) even if it was later corrected surgically
• Cancer of the other testicle
• A family history of testicular cancer
• Your testicles, penis, or kidneys did not develop in a normal way during childhood
• HIV infection

Testicular cancer is most common in men between the ages of 15 and 35. It is unusual after the age of 40 and in African-Americans and Hispanics.

What are the symptoms?

Sometimes you will not have any symptoms. If you do have symptoms, they may include:

• A lump in a testicle that is usually not painful
• A testicle that has gotten bigger or has changed in the way it feels
• A dull ache or a feeling of heaviness in the scrotum, lower back, or lower belly

Testicular cancer can spread to other parts of the body such as the lungs, liver, and bones. Sometimes your first symptoms of cancer are in the part of the body where the cancer has spread.

Many of these symptoms can be caused by problems other than cancer.

What is metastasis?

The spread of cancer cells from one part of the body to other parts is called metastasis. What causes cancer to spread is not known. Cancer cells can:

• Grow into the area around the tumor
• Travel to other parts of the body through the bloodstream or the lymph system. The lymph system is part of your body's system for fighting infection. The lymph system consists of lymph nodes that store blood cells (lymphocytes) to fight infection and vessels that carry fluid, nutrients, and wastes between your body and your bloodstream.

New tumors then grow in these other areas. When testicular cancer spreads, it is most often found in the lymph nodes of the belly, chest, brain, and within the lungs.

Sometimes your first symptoms of cancer are in the part of the body where the cancer has spread. The symptoms of testicular cancer that has spread to another part of your body depend on where the tumors are. For example:

• If the cancer has spread to the lungs, you may have a cough or trouble breathing.
• If the cancer has spread to the belly, you may have pain or swelling in your belly.
• If the cancer has spread to the lymph nodes, you may have heaviness, aching, and swelling in your arms, legs, or belly

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You may have tests such as:

• Blood tests
• Ultrasound, which uses sound waves to show pictures of the testicles
• CT scan, which uses X-rays and a computer to show detailed pictures of the testicles

How is it treated?

Some things to think about when making treatment decisions are:

• Your age
• Your overall health
• Your desire to have more children
• The stage of the cancer (how advanced the cancer is)
• Whether the cancer has spread to other parts of your body

Possible treatments are:

• Surgery to remove the testicle through a cut in the groin
• Chemotherapy (anticancer drugs), which uses medicine to kill cancer cells
• Radiation therapy, which uses high-energy X-rays to kill cancer cells
• Surgery to remove lymph nodes if the cancer has spread. The lymph nodes in the area around the bones of the lower spine may be removed. Testicular cancer usually spreads to these lymph nodes first. Lymph nodes that are removed are examined under a microscope to check for cancer.
• Stem cell transplant that uses your own cells. First, you are given high-dose chemotherapy to destroy your old blood-forming cells. The new transplanted cells grow in to healthy blood cells.

Ask your healthcare provider about your ability to have children after treatment. After some treatments your testicles will not make sperm, which means you cannot father a child. This may last only a short time, or it may last the rest of your life. Your provider may recommend that you put some sperm in a sperm bank before you start treatment. The sperm might then be used later if you want to have children.

Your treatment will also include:

• Preventing infections
• Controlling pain or other symptoms you may have
• Controlling the side effects from treatments
• Helping you manage your life with cancer

Often, more than 1 treatment is used. After treatment, you will need to have regular follow-up visits with your healthcare provider.

Ask your healthcare provider about clinical trials that might be available to you. Clinical trials are research studies to find effective cancer treatments. It’s always your choice whether you take part in one or not.

How can I take care of myself?

If you have been diagnosed with testicular cancer:

• Talk about your cancer and treatment options with your healthcare provider. Make sure you understand your choices.
• Follow the full course of treatment prescribed by your healthcare provider.
• Ask your healthcare provider:
  • How and when you will get your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

Other things that may help include:

• Eat a healthy diet and get regular exercise as recommended by your healthcare provider.
• Get plenty of rest.
• Try to reduce stress and take time for activities that you enjoy. It may help to talk with a counselor about your illness.
• Talk with your family and your healthcare providers about your concerns. Ask your healthcare provider any questions you have about the disease, treatments, side effects of the treatments, sexual activity, support groups, and anything else that concerns you.
• If you smoke, try to quit.
• Ask your provider if you need to avoid drinking alcohol. It may interfere with medicines you are taking. Alcohol can also make it harder for white blood cells to fight infections.
• Tell your provider if your treatment causes discomfort. Usually there are ways to help you feel more comfortable.

For more information, contact:

• American Cancer Society, Inc.
  800-227-2345
  http://www.cancer.org
• National Cancer Institute
  800-422-6237 (TTY: 800-332-8615)
  https://www.cancer.gov/