Testicular cancer might not be something you talk about every day, but it’s important to be aware of. The good news? It’s relatively uncommon. The even better news? If detected early, testicular cancer has very high cure rates. In this blog, we’ve outlined what testicular cancer is, what risk factors you need to be aware of, and steps to take to catch testicular cancer early.

What is Testicular Cancer?

Testicular cancer occurs when cells in the testicle multiply abnormally and form a tumor.  Over 90%, of these tumors originate in the sperm-producing germ cells so they are called germ cell tumors (GCTs). It’s important to note that while GCTs most often form in the testicle, they can be formed in other areas of the body during fetal development. The American Cancer Society explains that germ cell tumors can develop in the middle of the chest or the abdomen before birth.

Understanding Germ Cell Tumors (GCTs): Seminomas vs. Non-Seminomas

Germ cell tumors (GCTs) are further categorized into two main types: seminomas and non-seminomas.

• Seminomas: These tumors tend to grow slower than other types of testicular cancer, according to the National Cancer Institute. This slower growth rate makes them generally more responsive to treatment options like radiation or chemotherapy.
• Non-Seminomas: In contrast, non-seminomas grow faster than seminomas and may be less responsive to treatments like radiation and chemotherapy, as per the American Urological Association. There are several subtypes of non-seminomas, including choriocarcinomas, embryonal carcinomas, teratomas, and yolk sac tumors.

Less Common Testicular Cancers

Some rare testicular cancers don’t originate from germ cells. Leydig cell tumors develop from cells that are responsible for producing testosterone. Sertoli cell tumors that support sperm development. The type of testicular cancer, its location, your symptoms, and other factors will all play a role in determining the most appropriate course of treatment, so be sure to consult a medical professional.

Risk Factors

There are several risk factors associated with testicular cancer, though it’s important to remember that having a risk factor doesn’t guarantee you’ll develop the disease.

Risk factors include:

• Undescended testicles (cryptorchidism): When one or both testicles fail to descend into the scrotum before birth, it increases the risk of cancer.
• Family history: Having a father or brother with testicular cancer slightly elevates your risk.
• Previous testicular cancer: If you’ve had testicular cancer in one testicle, you’re more likely to develop it in the other.
• Klinefelter syndrome: This genetic condition increases testicular cancer risk.
• Abnormal testicular development: A condition called germ cell neoplasia in situ (GCNIS) can increase risk.

Symptoms

Testicular cancer often goes unnoticed in the earliest stages. According to Mayo Clinic, the most common sign is a painless lump in the testicle. Other potential symptoms include swelling, heaviness in the scrotum, dull aches in the groin or testicle, and tenderness or changes in the male breast tissue. If you’re experiencing these symptoms, make an appointment with your primary care physician immediately. A physical exam, ultrasound, and blood test will likely be part of the initial workup. If testicular cancer is diagnosed, you may be referred to a urologist, a surgeon specializing in testicular cancer treatment, and an oncologist for further care.

Early detection is key, so familiarizing yourself with testicular self-exams and talking to your doctor about any abnormalities is vital. Don’t hesitate to make an appointment – delaying diagnosis can allow cancer to spread. Fortunately, testicular cancer, when caught early and treated promptly, has a very high cure rate.

If you experience any of the symptoms discussed above, or are concerned you may have testicular cancer, contact your primary care physician right away.

What is a Testicular Exam?

Performing a testicular self-exam is a quick and simple way for men and teenage boys to check for abnormalities like tumors. This self-exam can be very effective for early detection and potentially lifesaving. The ideal time to perform the exam is right after a warm shower or bath, as the warmth relaxes the scrotum, making it easier to feel the testicles. The entire process can be done comfortably while standing up and only takes a few minutes.

How To Do a Testicular Exam

During the exam, focus on each testicle individually. Gently but firmly roll them between your thumb and forefingers of both hands, feeling the entire surface for any irregularities in firmness. It’s normal for one testicle to be slightly larger, but the overall consistency should be uniform throughout.  Also pay attention to the epididymis and vas deferens, the tube-like structures at the back of the testicles. Familiarize yourself with their normal feeling so you can identify any changes.  Most importantly, be on the lookout for lumps, swelling, or anything that seems unusual. Remember, lumps or pain are not normal and warrant a visit to your doctor.  Make testicular self-exams a monthly habit to regularly detect any changes in size, shape, or texture. If you notice anything concerning, always seek medical advice.

How is Testicular Cancer Treated?

Testicular cancer treatment plans are customized based on the specific diagnosis and your overall health. Often, a team of specialists, including urologists, oncologists, and radiation oncologists, collaborate to determine the best approach for each patient.

Early-Stage Management:

• For Stage 0 and some Stage I cancers, doctors may recommend surveillance. This involves regular checkups to monitor for changes. Often, surgery to remove the affected testicle (orchiectomy) becomes the primary treatment if the cancer progresses. In Stage I cases, this surgery can be curative. Following surgery, close monitoring ensures the cancer hasn’t returned.

Treatment for Advanced Stages:

• Men with Stage II and III cancers typically require more extensive treatment, which may combine chemotherapy, radiation therapy, or surgery to remove tumors that have spread to lymph nodes or other areas.
• Radiation therapy is particularly effective against seminoma cells but can have limited effectiveness against some non-seminoma cancers.
• Chemotherapy is used for any testicular cancer that has spread beyond the testicle or if tumor markers increase after orchiectomy.

Surgical Options:

• Depending on the diagnosis, different surgical approaches might be offered. Testicular-sparing surgery (TSS) is an option for children or men with benign tumors. For some men at risk of recurrence, a procedure called retroperitoneal lymph node dissection (RPLND) may be recommended. This surgery removes lymph nodes in the abdomen and requires a highly skilled surgeon.

Preserving Fertility:

• Before any treatment commences, discussing fertility with your doctor is crucial. Sperm banking may be recommended, especially for men who desire children in the future.

It’s important to note that all diagnosing processes and treatment plans described in this blog are general guides, solely intended for general education. If you suspect you have or have been diagnosed with testicular cancer, your doctors will create a highly customized plan for you based on your symptoms, age, health, care management goals, and the type and stage of tumor. Testicular cancer can be difficult to talk about, but by sharing the knowledge you need to detect and recognize it, you can help yourself and others increase the odds of beating this dangerous cancer.