Testicular Cancer (Part One)

Compared to other cancers, testicular cancer is rare, but usually affects ages between 15 and 35 years old. Testicular cancer has a high chance of being treated even when it has spread beyond the testicles. Depending on the type and stage of the cancer, the treatment varies.

Symptoms

The signs and symptoms of testicular cancer are:

• Enlargement of the testicle or feeling a lump in it
• A sensation of heaviness in the scrotum
• An annoying pain in the abdomen or groin area
• A sudden accumulation of fluid in the scrotum
• Enlargement or tenderness of the breast
• Back pain

Usually, cancer affects only one testicle

Causes

In most cases, the causes of testicular cancer are not clear. In general, it is known that cancer occurs when healthy cells in the testicle undergo abnormal changes. Healthy cells grow and divide in a regulated manner to keep the body functioning normally. Sometimes some cells develop abnormally, causing this growth to go out of control. These cancerous cells continue to divide and multiply even when new cells are not needed. The accumulation of these cells forms a mass in the testicle. Almost all testicular cancers start from germ cells that produce sperm. The reasons why these cells become abnormal and turn into cancer are not known.

Predisposing Factors

Factors that present a risk for developing cancer are:

• An undescended testicle in the scrotum. (Cryptorchidism). The testicles are formed inside the male abdomen during fetal development and descend into the scrotum before birth. Males who have a testicle that has never descended into the scrotum are more predisposed to developing cancer in both testicles compared to other men who have a normal descent. This risk is significant even in cases where they are surgically placed in the scrotum. It should be emphasized that the majority of men with testicular cancer do not have a history of undescended testicles.
• Abnormal development of the testicle. Some conditions that influence abnormal development of the testicles, such as Klinefelter syndrome, may increase the risk of testicular cancer.
• Family history. If a family member has had testicular cancer, this increases the possibility of developing cancer in other family members.
• Age. Testicular cancer usually affects young ages, especially those aged 15 to 35 years, although it can occur at any age.

Examinations and diagnosis

In some cases, the man discovers testicular cancer himself either accidentally or by doing a self-examination of the testicles with the aim of finding a mass in them. In other cases, it is discovered by the doctor during a routine physical examination. To determine whether a mass in the testicle is cancer, the doctor may recommend:

• Testicular ultrasound. The ultrasound probe moves across the scrotum to capture images of the testicle. Through these, the doctor can determine the nature of any mass in the testicle, such as whether they are solid or filled with fluid. Simultaneously, the ultrasound shows whether the mass is inside or outside the testicle.
• Blood tests. These tests are needed to determine the level of tumor markers in the blood. Tumor markers are substances that normally circulate in the blood, but in some situations including testicular cancer, they can increase. A high level of markers in the blood does not necessarily mean cancer, but it helps in determining the diagnosis.

Type of cancer

The type of testicular cancer determines its treatment and prognosis. Generally, there are two types of testicular cancer:

• Seminoma. This appears in all age groups, but is more likely in older men. Seminomas, in general, are not as aggressive as non-seminomas.
• Non-seminoma. Non-seminoma tumors tend to develop early and grow and spread more quickly. There are several types of non-seminoma tumors including choriocarcinoma, embryonal carcinoma, teratoma, etc.