Testicular Cancer: Symptoms, Stages, Treatment

Testis cancer is a serious problem for the male population. In fact, 8,000 to 10,000 men experience this type of health issue every year.

The chances of developing it are 1 in 270. Luckily, treatment for testicular cancer is very successful. The cure rate is 95%. 

But, many people are still unfamiliar with the condition and fail to get on-time treatment.

That’s why they need to understand this type of cancer better to have better odds of treating the disease. Here is a detailed guideline for testicular cancer that can help. 

What is Testicular Cancer?

Testicular cancer is a tumor that affects the testes in the male body. The testes are situated on the scrotum’s inner side – the loose skin bag just under the penis. Each testicle is responsible for producing sperm and the male hormone, testosterone. 

The genitourinary cancer field focuses on studying these types of cancers that affect the male urinary and reproductive systems.

Unlike other more common types of tumors, testicle cancer is relatively rare. However, it tends to affect individuals between the age of 15 to 35, experts explain. The good thing about this cancer is that it’s very treatable, even if it spread to other parts of the human body. 

The cancer treatment will vary depending on the stage of the tumor. Sometimes, patients might receive more treatments than one. 

Determining the best possible treatment depends on the type of testicular cancer a patient has developed. The testicles can be infected with various types of cancer, each with its own impact. Recognizing the type is the first step to selecting the ideal tumor treatment. This is a guideline of all the testicular cancer types a patient can experience. 

Germ Cell tumors

Over 90% of testicular cancer manifests in the germ cell, a unique type of cell located in each testicle. Because of these cells, the male human body can create sperm to reproduce. 

There are two primary germ cell tumors, nonseminomas, and seminomas. They are very similar, but different as well. In some cases, patients with testicular cancer can develop both of these germ cell tumors. This is what experts refer to as the mixed testicular germ cell tumor. 

Nonseminomas

This tumor grows a lot quicker than seminoma cases. The tumor usually affects young men in their late teens or early 30s. 

This particular tumor can be divided into four unique subgroups, each with its own effect on the human body. These subgroups include:

  • Yolk sac carcinoma: This is the most prevalent type of germ cell tumor that mostly affects boys and infants. In children, the yolk sac tumor is often managed successfully. However, if patients don’t get on-time treatment while still young, it will be much harder to treat during adulthood. 

  • Embryonal carcinoma: This type of tumor can grow very fast. When observed under a microscope, it will resemble a tissue of an embryo still in early development. 

  • Choriocarcinoma: This tumor is a rare occurrence and can grow very quickly. It can spread a lot faster to other parts of the human body. 

  • Teratoma: It is a rare health problem that features completely developed organs and tissues. When observed under a microscope, this testicle tumor will resemble a 3-layer tissue, much like a human embryo. Another nonseminoma subgroup often accompanies it. 

Note: The majority of nonseminomas are a mix of the various subgroups. In some cases, the seminoma cells can also get mixed. 

Seminomas

Seminoma cancer grows very slowly. In many patients, it responds positively to treatment and can be managed if caught on-time. This tumor is divided into two types:

  • Typical (classic): Over 95% of seminoma tumors are classic. They often affect the male population between the ages of 25 to 45. 

  • Spermatocytic: It is prevalent in the older population at the late stages of their life. 

Stromal Tumors

The stroma is the tissues located in each testicle of the male body. They are the ones responsible for making hormones that support the rest of the tissues. The stromal cell tumor makes up around 5% of the testicular cancer cases in adults. But, it makes up 20% of all cancer cases in children, statistics show.

The stroma tumor is divided into two primary subgroups, such as:

  • Sertoli cell tumor: This is a rare tumor that can appear in the testis. It usually affects people between the ages of 35 and 50

  • Leydig cell tumor: This tumor will often manifest from the testicle cells responsible for nourishing and supporting the germ cells. It comprises of 1% to 3% of testicular neoplasms in adults and 3% of tumors in children and infants. It is often a benign tumor, but around 10% can be malignant. 

Secondary Testicular Tumor

This particular tumor starts in a different section in the male body and spreads towards the testicle. 

For instance, a lymphoma (cancer that affects the lymph nodes) can spread to either testicle. Lymph nodes are tiny structures tasked with filtering the harmful substances from the system. Simultaneously, the lymph vessel directs that lymph fluid to leave the body through the nodes. 

The older population who develop lymphoma cancer are at high risk of having testicular cancer. In other words, the older the patient, the more vulnerable they are of developing secondary testicular tumors. The tumor is prone to spreading to the testes, which could have serious repercussions on a patient’s overall health. 

What Causes Testicular Cancer?

The exact causes for testicular cancer have yet to be determined. For now, experts can only speculate what could have led to cancer to grow. Doctors are familiar with the typical reason for cancer development. The healthy cells grow and divide for the system to function normally. 

But, when there are certain abnormalities in the body, they can force the cells to grow out of control.

As a result, the cells keep dividing and dividing, which ends up forming a mass in either testicle. Almost all cancers that affect the testes start from germ cells. The abnormalities in these cells are the ones that form the tumor.

What Are the Symptoms?

Testicular cancer symptoms are often easy to recognize. However, they can also be misinterpreted for other health problems. Plenty of other health conditions that have nothing to do with cancer can cause these symptoms. 

For example, testicle inflammation or injury. That’s why it’s important to consult with a doctor if someone experiences these signs. The typical symptoms include:

  • Tenderness or discomfort in the testicles

  • A lump on any testicle

  • A heavy feeling in the scrotum

  • Dull pain in the groin or abdomen

  • Constant fluid accumulation in the scrotum

  • Pain in the back

In most cases, cancer affects just a single testicle. But, it can spread to the other, including further from the testes. 

Note: It’s possible for cancer to be asymptomatic or have no symptoms at all. 

Risk Factors

Although the causes for the tumor are unknown, some factors might increase your risk of developing testicular cancer. These risks are:

  • Genetics – Testicular cancer often runs in the family. Those who have a history with the tumor are at a high risk of developing the illness. They also have a 4.7 times higher chance for prostate cancer and 5.2 times the risk of severe or intermediate prostate cancer, which starts in the prostate gland.

  • Testicle complications – People who have an undescended testicle since birth are vulnerable to testicular cancer. The undescended testes must descend properly if they are to reduce the risk of this particular tumor. 

  • Serious abnormalities – If the testicle is not developing properly like it is the case with Klinefelter syndrome, individuals are at risk of developing cancer. 

  • Race – As unlikely as it seems, race plays a predominant role in cancer development. White individuals are more prone to the tumor than dark-skinned individuals. 

The Primary Cancer Stages

After a person has been diagnosed with the condition, the urologic oncologist will need to determine the stage of cancer. They will need to collect more substantial data to select the ideal treatment. 

Since the health condition is very unpredictable, it is essential to get a proper diagnosis. Recognizing the various stages can help. This type of cancer has multiple stages, and it can spread. Here is a detailed analysis of each stage. 

Stage 1: This is the pre-stage of carcinoma or the CIS stage. It is a precancerous health condition where the germ cells have yet to form into cancer. They do not behave as cancer does. The CIS will become cancer when the cells start to spread to other areas of the testes. 

Stage 2: This is the first stage. The tumor is affecting a single testicle and might affect the rete testis. It hasn’t affected the lymph or blood vessels yet. However, the tumor could grow into the inner layer of the membrane that surrounds the testicle. The tumor is inside the testicle and can affect the rete testis. By the second stage, it has already spread to the lymphatic system and blood vessels. It can grow into the fatty tissue and spread.


Stage 3: By the third stage, the tumor will have spread to the spermatic cord.

Stage 4: The tumor is already growing into the scrotum. 

Treatment

A typical treatment plan for testicular cancer will vary depending on the cancer stage, type of tumor, the lymph nodes’ effect, and a patient’s overall health. The primary line of treatment is often surgery. 

However, in some cases, people might have to get chemotherapy, especially if cancer has spread to other parts of the human body. Here is a list of all the different types of testicular cancer treatment people can expect.

Surgery

Almost all testicle cancers are treated with surgery. The surgical removal gets rid of the affected testicle together with the tumor and spermatic cord. This cord is the one that features a section of the vas deferens, lymph, and blood vessel. 

If, for example, the lymph nodes are affected, the doctor will recommend a lymph node dissection. This is a surgery that removes any section of the affected nodes, including those that are vulnerable to cancer. If not removed with surgery, the tumor can spread to other areas of the body. 

Another example is the inguinal orchiectomy. This is a surgical procedure that removes one or both testes together with the spermatic cord. Simply put, surgery stops the spread of the disease and removes the affected area to recover properly. 

Radiation Therapy

Radiation therapy relies on X-ray and gamma rays or particles to wipe out or stop the active cancer cell’s progression. The radiation oncologist will determine the ideal treatment based on the cancer diagnosis.

This type of therapy’s primary role is to kill the cells that have already affected the lymph nodes. With external beam radiation, the therapy can work its way into the cancer cell and manage the disease. 

The treatment is usually done to individuals with seminoma since the cancer is incredibly vulnerable to the radiation. With time, radiation therapy will destroy the cancer cells a bit by bit, until they’ve been completely removed. 

Chemotherapy

Chemo or chemotherapy involves the use of medication to manage testicular cancer. They come in the form of an injection or a pill and are a practical systemic therapy. The goal of chemo is to break off any tumor sections that might have affected other parts of the system, aside from the testes. 

It’s often the typical solution for the type of tumor that has spread outside of the testicles. Doctors don’t prescribe such medications if patients only have to treat one testicle. 

Stem Cell Transplant & Chemotherapy

In most cases, cancer responds positively to chemo. However, not all tumors can be cured. To avoid damaging the bone marrow with high chemo doses, doctors often suggest a stem cell transplant. 

It’s a practical option for promoting blood cell formation and amplifying the effects of chemo. Although it doesn’t require surgery, patients still need to be in a medical facility where their health will be monitored continuously. 

Monitoring

No matter the type of treatment a patient receives, doctors will have to monitor their health for any changes. That includes a regular physical exam, imaging, and tumor marker tests. Patients will receive an ultrasound that will assess the scrotum. They will also get a CT scan and chest X-ray to make sure that the treatment was successful. 

Monitoring is often suggested to patients with Stage 1 or 0 tumors. Here is a typical monitoring example:

  • Seminoma Stage I: involves regular imaging, physical, and analysis of the tumor marker levels every 4 to 6 months for the span of 2 years. For the next 3 to 5 years, patients should get checked every 6 to 12 months.

  • Non-seminoma, germ cell tumor, Stage I: involves a tumor marker test and physical exam every 2 to 3 months for 1 year. For the next 2 years, patients should get a check-up every 2 to 4 months. The need for check-ups reduces with age. 

If the tumor continues to grow after surgery, or patients experience hormonal fluctuations, further treatment will be necessary. Otherwise, regular monitoring will suffice.

Fertility and Sex Life Post-Treatment

The surgery shouldn’t affect a patient’s libido or sperm count. Even though the testicle has been removed, men can still conceive a child. The majority of men have a normal erection post-surgery. It will take time for the remaining testicle to heal. When it does, the testosterone is expected to find its balance. 

However, cancer can affect your fertility rates before treatment. If the seminal vesicles and prostate have been removed, men can no longer create semen. The tumor can also affect testosterone levels and make it difficult to ejaculate.

For those dealing with ejaculation difficulties, certain medicines can help. Consult with your doctor first before adding any drugs to your diet. 

Prevention

It’s impossible to prevent a testicular tumor. But, patients can increase their odds for successful treatment if they practice a regular testicular self-examination. That way, they can detect cancer in its earliest stage and start with the treatment as soon as possible.   

Another practical preventive is getting a regular blood test. Blood tests for tumor markers can help detect the health issue. When the tumor marker is present in the blood, it is a clear indication for testes cancer. 

Conclusion 

Testicle cancer is a manageable health issue. You can treat and control it, often with surgery. Although there are multiple types of this particular cancer, certain treatments can help alleviate the discomfort and promote healthy living.

It’s essential to detect the tumor early on for those who want to boost their quality of life and protect their fertility. That way, patients can avoid the spread of the disease and preserve their reproductive system. 

Next Up

testicular cancer treatment

Learn How to Do a Testicular Self Exam.

Sources

  1. Loma Linda University. (2020). Testicular Cancer: Introduction. Retrieved from: https://lluh.org/conditions/testicular-cancer
  2. Robert H. Young. (2005). Sex cord-stromal tumors of the ovary and testis: their similarities and differences with consideration of selected problems. Modern Pathology. Retrieved from: https://www.nature.com/articles/3800311
  3. Thomas Calvert. (2019). Leydig Cell Tumors. Medscape. Retrieved from: https://emedicine.medscape.com/article/437020-overview#
  4. Johns Hopkins Medicine. (2020). Types of Testicular Cancer. Retrieved from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/testicular-cancer/types-of-testicular-cancer
  5. Mayo Clinic. (2020). Testicular Cancer. Retrieved from: https://www.mayoclinic.org/diseases-conditions/testicular-cancer-care/symptoms-causes/syc-20352986
  6. American Cancer Society. (2018). Surgery for Testicular Cancer. Retrieved from: https://www.cancer.org/cancer/testicular-cancer/treating/surgery.html
  7. Urology Care Foundation. What is Testicular Cancer. The Official Foundation of the American Urological Association. Retrieved from: https://www.urologyhealth.org/urologic-conditions/testicular-cancer
  8. Johns Hopkins Medicine. (2020). Testicular Cancer Statistics. Retrieved from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/testicular-cancer/testicular-cancer-statistics
  9. Dr. David Samadi. (2016). Hidden Link Between Prostate Cancer and Testicular Cancer – Dr. David Samadi. Robotic Oncology. Retrieved from: https://www.roboticoncology.com/news/hidden-link-between-prostate-cancer-and-testicular-cancer-dr-david-samadi/
  10. John Wayne Cancer Institute. (2020). What Is Testicular Cancer. Retrieved from: https://www.saintjohnscancer.org/urology/conditions/testicular-cancer/#layer-4-4

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