Testicular Cancer

Cancer in the Male Organs That Make Male Hormones and Sperm (Testicles)

Testicular cancer may be a well-known type of cancer, but it is not very common. The American Cancer Society estimates that only 1 out of 263 males will be diagnosed with testicular cancer in his lifetime. Each year, roughly 8,800 new cases are diagnosed.

Testicular cancer begins in the testicles, as its name suggests. The testicles are part of the male reproductive system. Most types of testicular cancer are found in germ cells, which are cells that make sperm. The two most common types of germ cell tumors (GCTs) are seminomas and non-seminomas.

Seminomas

There are two types of seminomas: classical seminomas and spermotocytic seminoma. Classical seminoma is the most common type of seminoma and is usually found in men ages 25-35. Spermotocytic seminomas are more rare. It is usually found in older men, ages 65 years or older.

Non-seminomas

Non-seminomas are more common in young men, in their late teens or early 20s. There are four types of non-seminomas. Sometimes, tumors are a mix of these types of non-seminomas:

Embryonal carcinoma: Grows rapidly and often spreads outside the testicle
Yolk sac carcinoma: More common in children and often easily treated; however, these types of cells can be harder to treat when found in older men
Choriocarcinoma: An aggressive and rare type of testicular cancer that is more likely to spread to other organs in the body, including the lungs, bones and brain
Teratoma: Rare, and includes three types of teratomas - mature teratomas, immature teratomas and teratomas with somatic type malignancy.

Other types of testicular cancer may include:

Carcinoma in situ of the testicle, which is a noninvasive type of testicular cancer. However, it is hard to diagnose before it spreads outside where sperm cells are made because it does not cause any symptoms
Stromal tumors, which develop in hormone-producing tissues of the testes
Secondary testicular cancer, which is a cancer that starts in another organ and spreads to the testicles

Treatment

Testicular cancer is often easily treated and in the majority of patients, it is curable, even in advanced stages. Your doctor will work with you to create a treatment plan that is right for the type of testicular cancer you have, its stage, your personal and family medical history, and your preferences. Your plan may include one or more of the following treatments:

Surgery
Chemotherapy
Radiation

Surgery can often effectively treat early testicular cancer by removing the cancerous cells. Some testicular cancer can be cured by chemotherapy alone. Advanced testicular cancer would require combination of chemotherapy, surgery or radiation. Additionally, some advanced testicular cancer patients may require bone marrow transplant. Penn State Cancer Institute has experts available in all areas.

At Penn State Cancer Institute, our urologic team includes three fellowship-trained surgeons. They have extensive surgical experience in all urological cancers, including testicular cancer. Our highly skilled team delivers the latest advances in care:

Minimally-invasive surgical procedures (robotic surgery)
Standard, open surgery
Salvage surgeries following radiation
Surgery to address locally advanced cancer
Retroperitoneal lymph node dissections after chemotherapy

Symptoms and Diagnosis

Testicular cancer may be a well-known type of cancer, but it is not very common.

Symptoms

Symptoms of testicular cancer include:

A lump in the testicle
Swelling in the testicle
Sore or growing breasts

Advanced symptoms may include low back pain, shortness or breath, stomach pain, headaches or confusion.

Schedule an appointment with your doctor right away if you notice a lump in your testicle or any other symptoms. Don’t wait until your annual physical.

Diagnosis

Your doctor will give you a complete exam and ask you about your personal and family medical history. Then, your doctor will closely exam your testicle for lumps. She or he will also check your stomach and lymph nodes to see if the cancer has spread.

Your doctor may also order tests to help identify and diagnose testicular cancer, including:

An ultrasound to see if a lump is solid, which may indicate cancer
A blood test to check tumor markers; elevated levels may suggest testicular cancer

These tests will help your doctor determine if you have testicular cancer. If results suggest you do, in fact, have cancer, then your doctor may recommend surgery to remove the cancer. Once the tumor is removed, it will be studied at a lab. This information will help your doctor decide what additional treatments you will need, such as radiation, chemotherapy or hormone treatments.