What is testicular cancer?
Testicular cancer starts in the cells of a testicle. The testicles are part of a man's reproductive system. They are the two egg-shaped organs found in the sac of loose skin (scrotum) at the base of the penis. The testicles are held in the scrotum by the spermatic cord. The spermatic cord contains the ductus deferens, some lymph nodes, veins and nerves.
Testicles make the male sex hormone testosterone and sperm. Sperm begins to form in "germ" cells inside the testicles. Most testicular cancers start in the germ cells and are called germ cell tumours.
There are two main types of grem cell tumours -- seminomas and non-seminomas. Each type grows differently and is treated differently. Both types can be treated successfully.
Causes testicular cancer
There is no single cause of testicular cancer but some factors seem to increase the risk of developing it:
- delayed descent of the testicles (if not corrected early)
- age - particularly between 15 and 49
- family or personal history of testicular cancer
- abnormal development of the testicle
Some men develop testicular cancer without any of these risk factors.
- It is the most common cancer in young men between the ages of 15-35
- A young man has a one-in-300 chance of developing it sometime in his life
- In the last 30 years, rates in Ontario have increased by 60%
When caught early, it is often easily treatable and curable.
Early detection of testicular cancer
All men, from the time they are 15 years old, should learn how to perform testicular self-examination (TSE). This is a simple, pain-free way to check what is normal for your testicles so that you will notice any changes. And you should do it regularly. Early detection of testicular cancer can make a difference in the treatment of the disease.
How to check your testicles
The best time to check your testicles is just after you've had a bath or shower, when the muscles in the scrotum are relaxed, making it easier for you to feel any lumps, growths or tenderness.
1. Stand in front of the mirror. Look for any swelling on the skin of your scrotum. You should not feel any pain when checking you testicles.
2. Hold your scrotum in your hands so that you can feel the size and weight of each testicle. It is common for one testicle to be slightly larger and it may also hang lower than the other.
3. Feel each testicle and roll it between your thumb and finger. It should feel smooth. You'll feel a soft, tender tube towards the back of each testicle. This is normal.
After you've become familiar with how your scrotum feels, you'll know when there are any changes. Also make sure that when you have your regular medical checkup with your doctor, you include a testicular exam.
Signs and symptoms of testicular cancer
Testicular cancer may not always create a noticeable lump on your testicle. Look out for:
- a hard lump on the front or along the sides of either testicle
- any change in size, shape, tenderness or sensation of your testicles or scrotum
- a change in the consistency or swelling of your testicles or scrotum
- pain in your testicles or scrotum
- a dull ache or heaviness in your lower abdomen
- abnormal and persistent backache
- unexplained weight loss
- breast development
- soreness or sudden, unexplained growth of the breast (around the pectoral muscles)
Go to your doctor immediately if you notice any of these changes.
Diagnosing testicular cancer
Your doctor most likely began to suspect that you had testicular cancer after talking with you about your health and completing a physical examination. To confirm the diagnosis, your doctor will arrange special tests. These tests may also be used to "stage" the cancer. You may have one or more of the following tests.
Orchiectomy and biopsy
To make a definite diagnosis of testicular cancer, it is usual to remove the entire testicle. This surgery is called an orchiectomy (or orchidectomy). The procedure is done under a general anesthetic (you will be unconscious). You can usually go home from the hospital the next day. With the healthy testicle that is left, you will still be able to have an erection and you will be able to have children.
Cells from the removed testicle are checked under a microscope. If the cells are cancerous, they may be studied further to see what type of cancer it is and how fast the cells are growing. If the cancer has not spread beyond the testicle, this may be the only treatment you need.
Blood tests
Blood is taken and studied to see if the different types of blood cells are normal in number and if they look normal. This shows the doctor if your organs are working well and may suggest whether or not there is cancer. Testicular cancer may be identified by chemicals in your blood called tumour markers. The tumour markers for testicular cancer are AFP (alpha-fetoprotein), beta-HCG (beta-human chorionic gonadotropin) and LDH (lactate dehydrogenase).
Imaging studies
Imaging studies allow tissues, organs and bones to be looked at in more detail. Using x-rays, ultrasounds, CT scans, MRIs or bone scans, your healthcare team can get a picture of the size of the tumour and see if it has spread. These tests are usually painless and do not require an anesthetic (freezing).
Staging for testicular cancer
Once a definite diagnosis of cancer has been made and your healthcare team has gathered the information it needs, the cancer will be given a stage.
The cancer stage describes the tumour size and tells whether it has spread beyond the place where it started to grow.
For testicular cancer, there are four stages.
| Stage |
Description |
| 0 |
Abnormal cells are found only in the tiny tubes where the sperm cells begin to form. The cancer cells do not invade normal tissues. This is sometimes called a precancerous condition. |
| 1 |
Cancer is in the testicle only. |
| 2 |
The cancer has spread to the lymph nodes in the abdomen, but not to a more distant part of the body. |
| 3 |
The cancer cells have spread to nearby or distant lymph nodes and maybe to one or more parts of the body, such as the lungs. |
What treatment will you have for testicular cancer?
While a diagnosis of cancer is likely to create anxiety and fear, testicular cancer can be cured in most men, even if it has spread. Your healthcare team will consider your general health and the type and stage of the cancer to recommend what treatments will be best for you. You will work together with your healthcare team to make the final treatment choices. Talk to them if you have questions or concerns.
Ask your team whether your treatment will affect your ability to have children. Sperm can be stored for use after treatment. Your healthcare team can help you plan ahead.
Your treatment may include:
- surgery
- radiation therapy
- chemotherapy
The Canadian Cancer Socitey
Learn more about treatments for testicular cancer
During treatment
Learn more about managian and controlling your pain and discomfort, side effects and stress when you are having cancer treatments.
Clinical trials
Clinical trials are scientific studies to test new ways of preventing, treating or managing cancer. Ask your doctor if there is a clinical trial suitable for you as a treatment option.
Complementary and alternative therapies
Some people choose to use complementary or alternative therapies together with or instead of their conventional treatments or medicine. Tell your doctor if you are using these therapies as they might affect tests or treatments.
Everyone's cancer experience is different. Whether you are newly diagnosed, in active treatment, or are caring for someone with cancer, you will probably need to deal with many day-to-day issues, make tough decisions, and cope with a range of emotions.
Follow-up care helps you and your healthcare team monitor your progress and your recovery from treatment. At first, your follow-up care may be managed by one of the specialists from your healthcare team. Later on it may be managed by your family doctor.
The schedule of follow-up visits is different for each person. You might see your doctor more often in the first year after treatment, and less often after that.
The end of cancer treatment may bring mixed emotions. You may be glad the treatments are over and may look forward to returning to your normal activities. But you may feel anxious as well. If you are worried about your treatment ending, talk to your healthcare team. They are there to help you through this transition period.
Many people feel anxious when the have their first appointment with their healthcare team after being diagnosed with cancer. A lot of information will be given to you and it helps to have a family member or friend with you as well as a list of questions.
If you need more information you us at email: info@tctca.org
Much of the context above courtesy of the Canadian Cancer Society (http://www.cancer.ca) June, 2007.
|
