Testicular Cancer

Testicular Cancer Symptoms

The following are the most common symptoms for testicular cancer. However, each individual may experience symptoms differently. The National Cancer Institute (NCI) suggests that a man see a physician for any of the following symptoms:

  • Lump in either testicle
  • Enlargement of a testicle
  • Feeling of heaviness in the scrotum
  • Dull ache in the lower abdomen or in the groin
  • Sudden collection of fluid in the scrotum
  • Pain or discomfort in a testicle or in the scrotum

The symptoms of testicular cancer may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

Types of Testicular Cancer

Germ cell tumors

More than 90% of cancers of the testicle develop in special cells known as germ cells. These are the cells that produce sperm. There are 2 main types of germ cell tumors (GCTs) in men:seminomas and non-seminomas. These 2 types occur about equally.

Some cancers contain both non-seminoma and seminoma cells. These are treated as non-seminomas because they grow and spread like non-seminomas.

Seminomas

Seminomas

Seminomas develop from the sperm-producing germ cells of the testicle. The 2 main subtypes of these tumors are classical (or typical) seminomas and spermatocytic seminomas.

  • Classical seminoma: More than 95% of seminomas are typical. These usually occur in men when they are between their late 30s and early 50s.
  • Spermatocytic seminoma: This rare type of seminoma tends to occur in older men. The average age of men diagnosed with spermatocytic seminoma is about 55. Spermatocytic tumors tend to grow more slowly and are less likely to spread to other parts of the body than classical seminomas.

Some seminomas can increase blood levels of a protein called human chorionic gonadotropin (HCG). HCG can be detected by a simple blood test and is considered a tumor marker for certain types of testicular cancer. It can be used for diagnosis and to check for response to therapy.

Non-seminomas

Non-Seminomas

This type of germ cell tumor usually occurs in men between their late teens and early 40s. There are 4 main types of non-seminoma tumors:

  • Embryonal carcinoma
  • Yolk sac carcinoma
  • Choriocarcinoma
  • Teratoma

Most tumors are mixed with at least 2 different types, but this does not change treatment. All non-seminoma germ cell cancers are treated the same way.

Diagnosing Testicular Cancer

In addition to a complete medical history and physical examination, diagnostic procedures for testicular cancer may include the following:

Ultrasound

What Is an Ultrasound?

Ultrasonography, which is sometimes called sonography, uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. The sound waves bounce off body parts and send back an image, like sonar on a submarine. A computer then looks at the signals sent back by the sound waves and creates an image of the body using those signals.

Ultrasounds are used to view internal organs as they function, and to assess blood blow through various vessels. Ultrasound procedures are often used to examine many parts of the body such as the abdomen, breasts, female pelvis, prostate, scrotum, thyroid and parathyroid, and the vascular system. During pregnancy, ultrasounds are performed to evaluate the development of the fetus.

Blood tests

Blood Tests

Assessment of blood samples to check for increased levels of certain proteins and enzymes (also called serum tumor markers) to determine if cancerous cells are present, or to determine how much cancer is present. Tumor markers that may be used to detect testicular cancer include alpha-fetoprotein (AFP), lactate dehydrogenase (LDH), and human chorionic gonadotropin (HCG).

Biopsy

What Is a Biopsy?

A biopsy is a procedure in which tissue samples are removed from the body by a needle or during surgery, for examination under a microscope to determine if cancer or other abnormal cells are present.

By examining and performing tests on the biopsy sample, pathologists and other experts can determine what kind of cancer is present, whether it is likely to be fast or slow growing, and what genetic abnormalities it may have. This information is important in deciding the best type of treatment. Open surgery is sometimes performed to obtain a biopsy, but in most cases, tissue samples can be obtained without open surgery using interventional radiology techniques.

Some biopsies can be performed in a doctor’s office, while others need to be done in a hospital setting. Most biopsies require use of an anesthetic to numb the area and may require sedation.

When testicular tumors are present, the entire tumor, as well as the testicle and spermatic cord, may be removed to prevent the spread of cancerous cells through the blood and lymph systems.

Testicular Cancer Staging

When testicular cancer is diagnosed, tests will be performed to determine how much cancer is present, and if the cancer has spread from the testis to other parts of the body. This is called staging, and is an important step toward planning a treatment program.

As defined by the National Cancer Institute (NCI), the stages of testicular cancer include the following:

  • Stage I the cancer is limited to the testis
  • Stage II the cancer involves the testis and has spread to lymph nodes in the lower abdomen
  • Stage III the cancer has spread to lymph nodes outside of the lower abdomen, to the lungs, or to another organ

Procedures for determining stage include the following:

  • Computed tomography scan (CT or CAT scan)
  • Lymphangiography: Images of the lymph system in which dye is injected into a lymph vessel to improve images.
  • Magnetic resonance imaging (MRI)

In addition to these imaging procedures, chest X-rays, positron emission tomography (PET) scans, or other scans may be requested.

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