Testicular cancer, though relatively rare, primarily affects younger men. This type of cancer develops when abnormal cells form in the testicles, which are the male sex glands responsible for producing sperm and testosterone. Testicular cancer is highly treatable and often curable, especially when detected early. Awareness of its signs and prompt medical attention are important for a positive outcome.
Visual and Palpable Signs
Recognizing changes in the testicles is an important step, and a monthly self-examination can help individuals become familiar with what feels normal for them. The most common indicator of testicular cancer is the presence of a painless lump in a testicle. This lump might feel like a small, firm, pea-sized mass, or it could be larger and harder.
Beyond a distinct lump, other noticeable changes can include swelling or a sudden collection of fluid in the scrotum. One testicle might also appear enlarged or feel heavier than the other, even if there is no specific lump detected. While often painless, some individuals may experience a dull ache or discomfort in the testicle, scrotum, or lower abdomen.
It is normal for testicles to be slightly different in size, and a cord-like structure known as the epididymis is typically felt behind the top of each testicle. This soft, coiled tube can sometimes be mistaken for a lump, but cancerous growths usually present on the sides or front of the testicle. Performing a self-exam during or after a warm shower can help relax the scrotal skin, making it easier to feel for any abnormalities. If any of these changes are noticed, consulting a healthcare professional is advised, as these signs do not definitively confirm cancer but warrant medical evaluation.
Diagnosis and Medical Evaluation
When an individual identifies a potential concern, a healthcare professional will conduct a thorough physical examination of the testicles, feeling for any lumps, swelling, or unusual areas. This initial assessment is followed by specific diagnostic tests to determine the cause of the symptoms. A common diagnostic tool is a scrotal ultrasound, which uses sound waves to create detailed images of the testicles and scrotum. This imaging helps differentiate between cancerous masses and benign conditions like cysts.
Blood tests are also used to measure specific proteins known as tumor markers, which may be elevated in the presence of testicular cancer. These markers include alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and lactate dehydrogenase (LDH). While elevated levels of these markers can indicate cancer, their presence alone does not confirm a diagnosis, as other conditions can also cause increases.
If the ultrasound and blood tests suggest testicular cancer, surgical removal of the affected testicle, known as an orchiectomy, is often performed. This procedure serves both as a diagnostic step to confirm the presence of cancer cells through microscopic examination and as a primary treatment. Biopsies are generally not recommended for testicular cancer due to the risk of spreading cancer cells.
Understanding Testicular Cancer Types
Testicular cancer primarily originates from germ cells, which are the cells responsible for producing sperm. These germ cell tumors account for about 95% of all testicular cancer cases and are broadly categorized into two main types: seminomas and non-seminomas. Some tumors may contain a mix of both types, and these are generally treated as non-seminomas due to their more aggressive growth patterns.
Seminomas
Seminomas tend to grow and spread at a slower rate compared to non-seminomas. The most common subtype is classic seminoma, which typically affects men in their 30s to 50s. Spermatocytic seminoma is a rarer subtype, usually seen in older men, and is generally slow-growing with a favorable prognosis.
Non-Seminomas
Non-seminomas generally grow and spread more rapidly and are more common in younger men, often in their late teens to early 30s. There are four main subtypes of non-seminomas, which can occur individually or as part of a mixed tumor. Embryonal carcinoma is an aggressive type. Yolk sac carcinoma is the most common type in children and often secretes AFP. Choriocarcinoma is a very rare and aggressive form that can secrete hCG and spreads quickly, often to the lungs, bones, or brain. Teratoma cells are also found in mixed tumors and typically require surgical removal.
Beyond germ cell tumors, stromal tumors develop from the supportive tissues within the testicle. These include Leydig cell tumors and Sertoli cell tumors. Stromal tumors are often benign and typically cured with surgical removal.
Risk Factors and Prognosis
Several factors can increase a person’s risk of developing testicular cancer. One of the most significant is cryptorchidism, or an undescended testicle, where one or both testicles fail to move into the scrotum before birth. The risk remains elevated even if surgery is performed to correct the condition. A family history of testicular cancer also increases an individual’s likelihood of developing the disease.
Previous testicular cancer in one testicle also raises the risk of developing it in the other. Certain genetic conditions, such as Klinefelter syndrome, have been associated with an increased risk. Other factors like abnormal testicle development, infertility, and low birth weight may also contribute to risk.
The prognosis for testicular cancer is very positive, with high cure rates, especially when detected early. The overall 5-year survival rate is around 95% or higher for all stages. For localized cancer, the cure rate is nearly 100%.
Even if the cancer has spread to nearby lymph nodes or distant parts of the body, the cure rates remain high, often exceeding 85%. Advances in treatment, including surgery and chemotherapy, have significantly improved these survival rates over time. Individual outcomes vary, but the general outlook for individuals diagnosed with testicular cancer is very favorable.