What is Testicular Cancer?
Testicular cancer is a form of cancer that is located in either one or both testicles.
There are two types of testicular cancer-
Germ cell tumours– located in the cells of the testicle that produce sperm. Germ cell tumours are the more common type of testicular cancer, and there are two main types of germ cell tumours;
- Seminomas (slower growing cancer which mostly occur in men 25-45 years, where the subtype is purely seminoma)
- Non-seminomas (occurs in men from teenage years to early 30s, where subtypes can include embryonal carcinoma, choriocarcinoma, yolk sac tumour, teratoma, or combinations of each).
Stromal cell tumours– located in the supportive tissue of the testicles. Stromal tumours are rare, occurring is less that 5% of testis cancers.
How common is testicular cancer?
Testicular cancer is uncommon in Australia. Cancer Australia estimates an incidence rate of 1 in 181 (or 0.55%) risk of being diagnosed with testicular cancer by the age of 85.
What are the risks for testicular cancer?
Whilst a diagnosis of testicular cancer is uncommon there are known risks. These include people who have:
- Family history of testicular cancer
- Undescended testicles (cryptorchidism)
- Previous testicular cancer
- Down Syndrome
- HIV or AIDS
- Infertility
- Abnormality of the penis or urethra (hypospadias)
It is a myth that testicular cancer can be due to tight-fitting underwear or previous groin injuries.
What are the symptoms of testicular cancer?
Common indications of testicular cancer can include-
- A painless lump or swelling of one or more testicles.
- Change in testicle size or shape.
- Pain or discomfort to the scrotum or testicle
How is testicular cancer screened?
- Self-checks- a testicular self-examination is fast and can assist in noticing any early changes to the size and feel of the testicle (usually best when taking a shower).
- Book an appointment with your GP to discuss any concerns you have after a self-examination.
- Ultrasound- if your GP is also concerned, they will order an ultrasound which will provide imaging of both testicles to assist in a diagnosis.
- Blood tests- are also ordered by the GP to assess for the presence of tumour-markers in the blood.
- After reviewing your ultrasound and blood tests, your GP may refer you to a Urologist or sometimes a Medical Oncologist for an expert opinion if abnormalities are detected.
- Your specialist may then order additional tests such as X-rays or a CT scan if required.
How is testicular cancer treated?
The results of a number of tests will determine the ‘stage’ of the cancer.
- Stage 1- the cancer is only in the testicle itself.
- Stage 2- the cancer is in the testicle and also the lymph nodes.
- Stage 3- the cancer has spread to other organs in the body.
The treatment for testicular cancer depends on the stage of the cancer.
- Stage 1- surgical removal of the cancerous testicle (Orchidectomy)
- Stage 2 and 3- surgery plus chemotherapy and/or radiation therapy depending on how far the cancer has spread.
Expert Opinion: Associate Professor Ben Tran, Medical Oncologist- Peter MacCallum Cancer Centre Melbourne.
Testicular cancer is a highly curable cancer. It is the most common cancer in young men. Most new diagnoses are stage 1, where often the only treatment required is to have a testicle removed. The remaining testicle usually is able to produce enough testosterone and sperm, so that there is no long-term effect of having had one testicle removed.
Some patients have stage 2 or 3 testicular cancer, where the testicular cancer has spread beyond the testicle to other parts of the body. Thankfully, due to the development of platinum-based chemotherapy several decades ago, even if testicular cancer spreads, it is highly curable. We would expect most of our patients to return to normal life after being cured of testicular cancer.
However, it is much easier to treat and cure testicular cancer when it hasn’t spread beyond the testicle. For that reason, we encourage all young men to examine themselves once a month, get to know what their testicles feel like, and if there is any change, whether it gets bigger or smaller, or firmer or softer, go see their GP to make sure all is ok.
Acknowledgement
Real Men’s Health thanks ANZUP for contributing to the development of this article.
