Testicular Cancer

• History of an undescended testicle (cryptorchidism)
• Abnormal development of testicles
• Caucasian American men younger than 45
• Family history
• History of cancer in the other testicle
• HIV infection

• Seminomas:
  • Classical seminomas occur in men 25-45
  • Spermatocytic seminomas are common in men about 65
• Non-seminomas occur in men 15-35. There are four types:
  • Embryonal carcinoma
  • Yolk sac carcinoma
  • Choriocarcinoma
  • Teratoma

The following are the most common signs and symptoms of testicular cancer:

• Painless lump or swelling in either testicle
• Enlargement of a testicle
• Feeling of heaviness in the scrotum
• Dull ache in the lower abdomen or the groin
• Sudden collection of fluid in the scrotum
• Pain or discomfort in a testicle or in the scrotum
• Back pain

The prognosis is excellent if testicular cancer is caught early. It is important to contact your urologist as soon as you have a symptom. He will meet with you to discuss concerns and to conduct a thorough evaluation. Diagnostic tests and procedures may include:

• Medical history
• Physical examination
• Blood tests to check for increased levels of certain proteins and enzymes indicating cancerous cells.
• Ultrasound (sonography), computerized high-frequency sound waves to create an image and determine if a testicle lump is solid or filled with fluid.
• Biopsy, a surgical procedure that involves removing tissue samples and examining them under a microscope to determine if cancer is present.
• Computerized tomography scan (CT-scan) uses a combination of x-rays and computer technology to produce horizontal, or axial, images of the body.

Your urologist will order additional tests to determine the size of the cancer and whether cancer cells have spread within the body. This is called staging. Testicular cancer stages include:

• Stage I: Cancer is found only in the testicle.
• Stage II: Cancer has spread to abdominal lymph nodes.
• Stage III: Cancer has spread beyond the lymph nodes to other parts of the body such as the lungs and liver.

Treatment for testicular cancer depends on many factors including the stage of the cancer. Your urologist will discuss the best treatment for your particular situation. These include:

Surgery for testicular cancer

• Surgery to remove the testicle (radical inguinal orchiectomy) involves an incision in the groin and removal of the entire testicle. A prosthetic testicle can be inserted if desired.
• Surgery to remove lymph nodes in the abdomen (retroperitoneal lymph node dissection).

Radiation therapy for testicular cancer

• To destroy cancer cells. Used for Stage II seminomas.

Chemotherapy for testicular cancer

• Most testicular tumors respond very well to chemotherapy.

You will receive a thorough diagnostic evaluation and receive clinically-proven treatment by a board-certified urologist who specializes in testicular cancer. After surgery and any treatment, routine surveillance by your urologist will be necessary.

Brigham and Women’s Faulkner Hospital practices a multidisciplinary approach to patient care, collaborating with colleagues in other medical specialties. Specialists also include radiologists, pathologists, nurse specialists, social workers, palliative care specialists and dietitians.