Testicular cancer

Testicular cancer occurs when cancer cells grow in the tissues of one or both testicles (testes). It is one of the most curable types of cancer.

The testes are the two male sex organs that make and store sperm. They are located in a pouch below the penis called the scrotum. The testes also make the hormone testosterone.

Testicular cancer is rare. But it is the most common cancer among young people with testicles.

Most testicular cancers start in cells that make sperm. These cells are called germ cells. The two main types of testicular germ cell cancers are seminomas and nonseminomas. Seminomas grow and spread slowly and respond to radiation therapy. Nonseminomas grow and spread more quickly than seminomas. There are several different types of nonseminomas.

Common symptoms of testicular cancer include:

• A swelling and/or lump in one or both of the testes. You may or may not have pain in the testes or scrotum.
• A heavy feeling in the scrotum.
• A dull pain or feeling of pressure in the lower belly or groin.

Sometimes these symptoms can be caused by other problems, such as a hydrocele or epididymitis.

Symptoms of advanced testicular cancer

Testicular cancer that has spread (metastasized) beyond the testicles and regional lymph nodes to other organs may cause other symptoms depending on the area of the body affected. Symptoms of late-stage testicular cancer may include:

• Dull pain in the lower back and belly.
• Lack of energy, sweating for no clear reason, fever, or a general feeling of illness.
• Shortness of breath, coughing, or chest pain.
• Headache or confusion.

If testicular cancer is suspected, your doctor will do some testing. Tests can include a testicular ultrasound, which may be used to rule out other possible causes of an enlarged or painful testicle. Blood tests may be done to measure the levels of certain tumor markers in your blood. Or you may have a chest X-ray or CT scan of the chest, abdomen, and pelvis.

If these tests suggest cancer, you will have surgery to remove the testicle. It will be checked for cancer. If cancer is found, you may have other tests to find out the stage of your cancer.

Treatment for testicular cancer is based on the type and stage of the cancer and other things, such as your overall health. The main treatment is:

Surgery.

Surgery to remove the testicle may be the only treatment you need. In some cases, surgery may also be done to remove lymph nodes in the belly.

After surgery, you may need only active surveillance. Or you may have more treatment, such as:

Chemotherapy.

These medicines kill fast-growing cells, including cancer cells and some normal cells.

Radiation therapy.

This uses high-dose X-rays to destroy cancer cells and shrink tumors.

For advanced cancer, treatment may include a stem cell transplant or a clinical trial.

Before you have surgery or any treatment for testicular cancer, talk to your doctor about sperm banking. Some cancer treatments can cause infertility.

Your doctor will talk with you about your options and then make a treatment plan.

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss. Drink liquid meal replacements for extra calories and protein. Try to eat your main meal early.
• Get some physical activity every day, but do not get too tired.
• Get enough sleep and take time to do things you enjoy. This can help reduce stress.
• Think about joining a support group. Or discuss your concerns with your doctor, counselor, or other health professional.
• If you are vomiting or have diarrhea:
  • Drink plenty of fluids to prevent dehydration. Choose water and other clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O.
• Take care of your urinary tract to prevent problems such as infection. Limit drinks with caffeine, drink plenty of fluids, and urinate every 3 to 4 hours.
• If you have not already done so, prepare a list of advance directives. Advance directives are instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself.