Testicular Cancer

Cancer of the testis is the most common cancer in men aged 20 to 39, but can occur in older men as well. Survival is now nearly 100 percent for low-stage disease. Since the discovery of effective chemotherapy drugs for this type of cancer in the 1970s, even patients with advanced disease have a good chance for survival. Detection of a lump in the testis, which may or may not be painful, is the most common presenting symptom. Monthly testicular self-exam is recommended by the American Urological Association.

Treatments for Testicular Cancer

When testicular cancer is detected on physical examination, the first treatment is generally surgical removal. The treatment plan then varies greatly based on the cancer stage and type. The next appropriate steps in certain situations are either surgical removal of the abdominal lymph nodes, radiation to this area, or systemic chemotherapy. Evaluation by multiple cancer specialists is appropriate. Excellent outcomes can be expected even if the cancer is detected at an advanced stage.

Chemotherapy
This well-known cancer treatment uses medicines taken intravenously or by mouth to kill cancer cells throughout the body. Chemotherapy may be given before surgery to shrink tumors, or after to fight cancer cells that have potentially spread.

Radiation Oncology
A team of medical professionals with advanced training deliver radiation treatment and care.

Testicular Cancer Surgery
A surgery designed specifically to remove the abdominal lymph nodes.

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What Is Testicular Cancer?

Testicles (testes) are male sex glands that make and store sperm. Testicular malignancies are cancers that start in one of the testicles. About 7500 new cases are diagnosed each year in the United States. Most occur in men between 15 and 40 years old.

What Causes Testicular Cancer?

The cause is unknown. Men with a greater chance of getting it include those born with an undescended testicle and those who have fathers or brothers with testicular cancer. Testicular cancer isn’t contagious.

What Are the Symptoms of Testicular Cancer?

The most common first symptom is a painless lump or swelling on or around the testicle. Other symptoms are a feeling of fullness or heaviness in the scrotum (the sac or pouch that holds the testicles), swollen lymph glands (nodes) in the groin or thigh, back pain, and testicular or scrotal pain.

How Is Testicular Cancer Diagnosed?

The best way to find testicular cancer is by doing self-examination of the testicles. A health care provider will diagnose testicular cancer by doing a physical examination (including testicles) and ordering an ultrasound scan to find the mass. Ultrasound uses sound waves to see inside testicles; it’s painless and harmless. If ultrasound shows a mass (lump), a urologist will operate to remove the testicle.

Staging is done to find out how far the disease has spread. Staging involves blood tests, computed tomography (CT), and possibly surgery to remove lymph nodes (called retroperitoneal lymph node dissection, or RPLND).

Stage I disease means the cancer is only in the testicle. Stage II disease has spread to nearby lymph nodes. Stage III disease has spread far from the testicles.

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How Is Testicular Cancer Treated?

Treatment depends on the type of cancer (seminomatous or nonseminomatous) and its stage. Seminomatous tumors without spread are treated with radiation. With distant spread, chemotherapy is used.

Surgery (RPLND) is used for early-stage nonseminomatous tumors. For more advanced disease, chemotherapy is added.

Having one testicle removed shouldn’t affect having sex or children.

Almost 90% of newly diagnosed testicular cancers are curable. Even cancers that spread have very good cure rates of 70% to 80%.

DOs and DON’Ts in Managing Testicular Cancer:
  • DO ask your health care provider if you need to save sperm for the future.
  • DO learn and perform testicular self-examinations twice monthly.
  • DO ask about emotional support groups.
  • DO call your health care provider if you feel a lump on your testicle.
  • DO call your health care provider if you have swelling or pain in your testicle.
  • DO call your health care provider if you have a fever after chemotherapy.
  • DO call your health care provider if you have excess drainage from the surgical area.
  • DON’T stop taking medicine or change dosage because you feel better unless your health care provider says to.
  • DON’T have sex until your health care provider says you can.
  • DON’T miss follow-up health care provider appointments. These are important to monitor for recurrence of the cancer.
  • DON’T forget to do self-examinations on the remaining testicle; it may also get cancer.
  • DON’T be afraid to ask about sex.
FOR MORE INFORMATION

Contact the following source:

  • American Cancer Society
    Tel: (800) ACS-2345 (227-2345)
    Website: http://www.cancer.org
  • National Cancer Institute
    Tel: (800) 422-6237
    Website: http://www.cancer.gov

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor