Testicular Cancer

Testicular cancer is a fairly rare form of cancer and typically affects men aged 15 to 35. When detected early, it can be treated successfully in more than 95% of cases. Any lumps or changes in your testicles should be reported immediately to your doctor. Testicular self-exams (TSE) should be done at least once a month.

Risk Factors

While the cause of testicular cancer is not known, the following factors increase your risk:

  • Young men aged 15 to 35 are at highest risk
  • History of an undescended testicle
  • Klinefelter's Syndrome
  • Family or personal history of testicular cancer
  • Race - Caucasian men are at higher risk

Symptoms

Men with testicular cancer usually have no symptoms except for a lump in a testicle, which is often painless. Symptoms may include:

  • Testicular swelling, hardness or pain
  • Heavy or aching feeling in the scrotum or lower abdomen
  • Pain is not always a sign of cancer but should still be evaluated
  • Night sweats
  • Weight loss

Diagnosis and Staging

Following a thorough history and physical examination, your doctor may order additional imaging and lab tests including:

  • Ultrasound, CT Scan, or MRI
  • Blood tests
  • X-ray or bone scan
  • Biopsy of the mass is usually not needed

Learn more about Testicular Cancer staging here

Treatment

Surgical removal of the testicle is the primary method of treatment and diagnosis. This is usually performed fairly soon after finding a testicle that is suspicious for cancer. Prolonged delay in removal of the testicle is not advisable. While surgery to remove one testis should not affect your fertility, you may wish to store your sperm in a sperm bank as a precaution. Both radiation and chemotherapy (if needed after surgery) may cause temporary or permanent infertility.

Radical Orchiectomy – the first treatment needed is an outpatient procedure to remove the cancerous testicle through a small incision in the groin. Men may elect to have a saline prosthesis, similar to a breast implant, implanted into the scrotum to look and feel like a real testicle.

Retroperitoneal Lymph Node Dissection (RPLND) - if the cancer has spread to your lymph nodes or the diagnosis of the tumor is high grade or unfavorable, your doctor may perform this procedure to remove affected nodes. In most cases, this procedure is performed laparoscopically, using several small incisions.

External Beam Radiation Therapy - high energy radiation beams are targeted at any cancerous cells that have spread to lymph nodes.

Chemotherapy - drugs are given intravenously (IV), by mouth or by injections into a muscle to destroy any cancer cells that remain after surgery. This is done under the direction of an oncologist, a specialist in cancer chemotherapy.

Follow Up

Since testicular cancer may recur, you will need continued surveillance with lab tests and routine imaging. However, the cure rate for testicular cancer is extremely high and full recovery is expected.

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