What is testicular cancer?

Testicular cancer is a disease caused by the uncontrolled growth of abnormal cells in the testicle. This uncontrolled growth causes a lump or tumor. Cells can break away from the initial tumor to form new growths elsewhere in the body. Testicular cancer is most common in men under age 35 but can also occur in older men.

How does it occur?

The actual cause of testicular cancer is unknown. An abnormal growth of cancer cells in the testicle eventually causes the testicle to become enlarged or to develop a lump that can be seen or felt.

Men who have or have had an undescended testicle, whether or not it was surgically corrected, have an increased risk of developing testicular cancer.

An undescended testicle is a condition in which one or both testicles do not complete the natural passage from inside the abdomen down into the scrotum, which should occur before birth. There is also a 10% chance of developing a tumor on the opposite side of the undescended testicle.

What are the symptoms?

Signs of a tumor in the testicle include:

• a lump in the testicle itself that usually is not painful but may cause slight discomfort at times

• enlargement of one testicle after puberty

• enlargement of the breasts (with some types of testicular tumors).

If the cancer has spread, there may also be other symptoms, such as:

• low back pain and discomfort

• difficult urination

• a cough

• breathing problems.

How is it diagnosed?

Your doctor evaluates the details of your history, examines your testicles, and, if needed, other parts of the body.

In some cases your doctor may order these tests:

• blood work

• intravenous pyelogram (x-ray of the kidneys and ureter)

• chest x-ray

• CT scan and/or ultrasound scan of the abdomen or pelvis

• bone scan.

How is it treated?

Treatment may include one or more of the following:

• chemotherapy

• radiation therapy

• surgery to remove the testicle.

How long will the effects last?

The chance for cure varies, depending on:

• how soon the cancer is diagnosed

• how large the tumor is and which type of cells are involved

• whether it has spread to other parts of the body

• your overall physical condition.

In certain kinds of testicular cancer, when the testicle is removed before obvious signs of spread of the cancer, prompt drug therapy may prove highly effective.

How can I take care of myself?

Because the chance for cure depends on finding the cancer early and treating it before it spreads, it is important to examine your testicles monthly. Support your testicles with one hand and feel each one with your other hand. You will feel the smooth bump, or epididymis, which covers the top, back, and bottom of each testicle. Gently separate it from the testicle with your finger and feel the testicle itself. If you find a hard usually painless mass in either testicle, you should see a doctor promptly. At first, such a mass might feel like a piece of gravel or a peanut.

It is important to have regular checkups with your doctor. Regular checkups are especially important for men who have had an undescended testicle. Any lump in the scrotum, pain or discomfort, or enlargement of the breasts should be reported to the doctor right away.

How can I help prevent recurrence of testicular cancer?

After treatment the doctor will recommend monthly checkups for the first year, then less often for the next 2 years, to see if the cancer has returned. It is important to follow the doctor's recommendations so that any recurrence can be spotted early. Most recurrences take place in the first 2 years after treatment.