Testicular cancer

• seminomas (about 40% of all testicular cancers)
• spermatocystic embryonal carcinomas (about 20% of testicular cancers)
• yolk sac tumor (about 60% of all testicular cancers in young boys)
• teratomas (about 7% of testicular cancers in adult men and 40% in young boys)
• choriocarcinoma (rare)

Testicular cancers can also develop in specialized cells within the gonads such as the Leydig cells (cells that produce testosterone ) and Sertoli cells (cells that provide nurishment for the sperm).
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Prevention:
Immunization against the mumps should be done at 15 months and again between 4 to 6 years old. This prevents the potential of developing mumps orchitis (inflammation of the testicles ), which is believed to be a predisposing factor for testicular cancer.

Young men should be taught to perform testicular self-examination (TSE) shortly after puberty, and the procedure should be re-emphasized upon all routine health examinations of young men (such as sports, school, or camp physicals). A TSE, performed on a monthly basis, may play a major role in detecting tumors at earlier stages, prior to metastasis .

Symptoms:

• testicular enlargement
• testicle lump
• pain in the back or abdominal discomfort
• breast enlargement ( gynecomastia )
• blood in the semen
• testicular discomfort/pain (rare, but may occur occasionally)

Note: There may be no symptoms.

Signs and Tests:
A physical examination typically reveals a firm, non-tender testicular mass (aggregation of cells) that does not transilluminate (light from flashlight held to scrotum does not pass through mass).

Other tests include:

• Scrotal ultrasound is used to confirm solid mass.
• alpha-fetoprotein ( AFP ) may be elevated with some types of tumors.
• A chest X-ray is done to look for potential metastasis to the lungs.
• An abdominal CT scan may be done to look for potential metastasis.
• Tissue biopsies to determine the type of cancer .

This disease may also alter the results of the following tests:

• testosterone
• HCG (quantitative)
• HCG (qualitative - urine)
• HCG (qualitative - serum)
• estriol - urine
• estriol - serum
• 17-ketosteroids

Treatment:
Treatment depends on the type of tumor , the stage of the tumor, and the extent of the disease.

Surgical treatment includes orchiectomy and lymphadenectomy (removal of the testicle and associated lymph nodes).

Radiation therapy is frequently used following lymphadenectomy of non-seminomatous tumors. It may also be used as the primary treatment for seminomas, especially those in the earlier stages.

Chemotherapy has greatly enhanced the survival rate of non-seminomatous testicular tumors.

The stress of illness can often be helped by joining a support group where members share common experiences and problems. See cancer - support group .

Prognosis:
The survival rate for men with early stage seminoma (the least aggressive type of testicular cancer) is approximately 97%. The disease-free survival rate for Stage I non-seminomatous cancer is nearly 99%; for Stage II 87%; and for Stage III 57%. Choriocarcinoma is an aggressive form of tumor. Advanced signs of metastasis may be present before a testicular mass is noted.

Complications:
Metastasis (spreading) to other parts of the body may occur with testicular cancer. The most common sites include the retroperitoneal area, the abdomen, the spine, and the lungs.

Call Your Healthcare Provider:
Call for an appointment with your health care provider if symptoms of testicular cancer occur.

Also call if you are a male over 15 years old who has not been taught testicular self examination (TSE), or who has not had testicular screenings performed by your health care provider during routine physical examinations.


This is an internal view of the male reproductive system.