The testicles, or testes, are the male sex glands that produce sperm. Testicular cancer or cancer of the testes occurs when cancer cells form in one or both testicles. Reproductive cells called germ cells develop into sperm through a process of cellular division called meiosis. Sometimes the germ cells begin to divide uncontrollably and, instead of producing functional sperm. When this happens, the cells are considered cancerous.
Most often testicular cancer is detected as a painless lump in one of the testicles. Testicular cancer is highly treatable and one of the most curable forms of cancer. It is especially important to detect testicular cancer in the earliest stages where the cure rate is almost 100%. That is why self-exams, starting in the adolescent years, are key in early detection of testicular cancer.
Types of testicular cancer
Two main types of testicular cancer are:
Seminomas – two sub-types of seminomas:
- Classical seminomas are more likely to occur in men between the ages of 30 and 50.
- Spermatocytic seminomas are less common and are found more frequently in men 55 years and older.
Non- seminomas – Four main subtypes of non-seminomas:
- Embryonal carcinomas – This type tends to grow and spread quickly.
- Yolk sac carcinomas – This is the most common form of germ cell tumor in infants and boys.
- Choriocarcinomas –This type is very rare, tends to grow fast and often spreads quickly to other parts of the body.
- Teratomas – Under a microscope, these tumours look like the 3 layers of tissue in a growing embryo.
Common signs and symptoms of testicular cancer include:
- Painless lump or swelling of the testicle
- A change in how the testicle feels
- A dull ache in the groin or lower abdomen
- A build-up of fluid in the scrotum
- Pain or discomfort in the testicle or scrotum
- A scrotum that feels heavy or swollen
- Bigger or more tender breasts
The known risk factors of testicular cancer include:
- Family history
- HIV infection
- Abnormal testicular development
- An undescended testicle
Tests for diagnosing testicular cancer include:
- X-rays – to determine whether the cancer cells have spread to the lungs.
- Biopsy – Performed after removing the affected testicle because of the danger of cancer spreading into lymph nodes.
- Computerized tomography (CT) scan – To check if cancer has spread to other areas of the body.
- Magnetic resonance imaging (MRI) – To determine if cancer cells have spread to the brain or spinal cord.
- Positron emission tomography (PET) scan– To help find small metastases or determine if enlarged lymph nodes contain cancer cells.
- Ultrasound – To help doctors determine whether a lump in the testes is solid, or filled with fluid.
The treatments depend on the type and stage of testicular cancer as well individual preferences. The treatment options inclusive of:
- Surgery – to remove the testicle with the tumour.
- Chemotherapy– to cure testicular cancer when it has spread outside the testicle or to decrease the risk of cancer coming back after the testicle is removed.
- Radiotherapy – External beam radiation therapy (EBRT) to deliver radiation to lymph nodes in the abdomen or pelvis that may be hiding testicular cancer cells.