Testicular cancer forms when malignant cells develop in the tissues of one or, less commonly, both testicles. The testicles are two walnut-shaped glands located within the scrotum, responsible for producing sperm and the hormone testosterone. Like many other cancers, testicular cancer can spread beyond its initial site, a process known as metastasis. Understanding how and where this cancer might spread is important for early detection and effective treatment.
How Testicular Cancer Spreads
Testicular cancer cells can travel from the original tumor in the testicles to other parts of the body through two primary pathways: the lymphatic system and the bloodstream. The specific type of testicular cancer can influence its growth and spread rate; for instance, seminomas generally grow and spread slower than non-seminomas.
The most common initial route of spread is through the lymphatic system. Cancer cells can enter lymphatic vessels, which are part of the body’s immune system, and travel to nearby lymph nodes. These bean-sized collections of immune cells can become hosts for cancerous cells, filtering them from the lymph fluid.
Cancer cells can also enter the bloodstream, a process known as hematogenous spread. Once in the bloodstream, these cells can travel to distant organs throughout the body. While this typically occurs after lymphatic spread, it can sometimes happen directly.
Where Testicular Cancer Commonly Spreads
Once testicular cancer cells leave the testicle, they often spread to specific areas of the body in a predictable pattern. The first and most common site for spread is the lymph nodes, particularly those located in the retroperitoneal area, which is behind the abdominal organs near the kidneys. This is because the testicles develop near the kidneys, and their lymphatic drainage pathways originate in this abdominal region.
Beyond the retroperitoneal lymph nodes, the lungs are a frequent destination for distant spread, often via the bloodstream. The liver is another potential site for spread, particularly in more advanced stages. The liver’s role in filtering blood makes it susceptible to circulating cancer cells.
Less commonly, testicular cancer can spread to the brain and bones, usually in more advanced cases. The pattern of spread is often predictable, which aids medical professionals in diagnosis and treatment planning.
Recognizing Signs of Spread
When testicular cancer spreads to other parts of the body, it can cause various symptoms depending on the affected area. Certain signs can indicate that the cancer has metastasized.
If the cancer has spread to the retroperitoneal lymph nodes in the abdomen, it may cause lower back pain or discomfort in the abdominal area due to the enlarged nodes. Spread to the lungs can lead to respiratory symptoms such as a persistent cough, shortness of breath, or even coughing up blood.
Spread to lymph nodes in other areas, such as the neck or above the collarbone, might be noticed as a lump or swelling in those regions. When cancer reaches the brain, symptoms can include headaches, seizures, or changes in vision. If the cancer has spread to the bones, bone pain may occur. These symptoms are not exclusive to testicular cancer spread and can be caused by many other conditions, but they warrant medical evaluation, especially if there is a history or suspicion of testicular cancer.
Diagnosing Testicular Cancer Spread
Medical professionals use several methods to determine if testicular cancer has spread and to assess the extent of the disease. These diagnostic tools help guide treatment decisions.
Blood tests are used to measure specific tumor markers, which are proteins produced by some cancer cells. The tumor markers commonly associated with testicular cancer include Alpha-fetoprotein (AFP), Human Chorionic Gonadotropin (HCG), and Lactate Dehydrogenase (LDH). Elevated levels of these markers can indicate the presence of cancer, its spread, or recurrence.
Various imaging tests are also employed to visualize potential areas of spread. Computed tomography (CT) scans are frequently used to check for spread to lymph nodes in the abdomen and pelvis, as well as to assess the lungs and liver. Magnetic Resonance Imaging (MRI) scans are particularly useful for examining the brain if spread to this area is suspected. Positron Emission Tomography (PET) scans, often combined with CT (PET/CT), can help identify metabolically active cancer cells throughout the body. Bone scans may be performed if there is a suspicion of bone involvement.