Testicular Cancer: Causes, Types, Symptoms, Diagnosis & Treatment

Testicular cancer is a relatively rare but highly treatable form of cancer that occurs in the testicles (testes), the male reproductive glands responsible for producing sperm and testosterone. It typically affects younger men between the ages of 15 and 40, though it can occur at any age. Early diagnosis and effective treatment make testicular cancer one of the most curable cancers, especially when detected at an early stage. Testicular cancer may present as a painless lump or swelling in one of the testicles, and in most cases, it is found by men themselves during self-examination or accidentally during routine physicals. Understanding the causes, symptoms, diagnostic tools, and treatment options is essential to managing this condition effectively and ensuring a high survival rate.

Types of Testicular Cancer

Testicular cancer is categorized based on the type of cells where the cancer begins. The main types include:

• Germ Cell Tumors (GCTs)
  • These account for over 90% of testicular cancers.
  • Two subtypes:
    • Seminomas – Grow slowly and are sensitive to radiation therapy.
    • Non-seminomas – Grow faster and include embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma.
• Stromal Tumors
  • Arise from hormone-producing cells.
  • Less common and include Leydig cell tumors and Sertoli cell tumors.
• Secondary Testicular Cancer
  • Rare; occurs when cancer spreads to the testicles from other parts of the body such as lymphoma.

Causes and Risk Factors

The exact cause of testicular cancer remains unknown, but certain risk factors may increase a man’s likelihood of developing it:

• Undescended Testicle (Cryptorchidism)
  • Major risk factor; even after surgical correction.
• Family or Personal History
  • Having a father or brother with testicular cancer increases the risk.
• Age
  • Most common in men aged 15 to 40.
• Race and Ethnicity
  • More prevalent among Caucasian men compared to men of African or Asian descent.
• Infertility
  • Men with infertility issues may have a higher risk of testicular tumors.
• HIV Infection
  • Slightly increased risk has been observed in men with HIV.

Common Symptoms of Testicular Cancer

Early detection is key to successful treatment. Some common signs and symptoms include:

• A painless lump or swelling in either testicle
• A feeling of heaviness in the scrotum
• Dull ache in the lower abdomen or groin
• Sudden collection of fluid in the scrotum
• Pain or discomfort in the testicle or scrotum
• Breast tenderness or growth (due to hormonal changes)
• Back pain (in advanced cases)

Diagnostic Tests for Testicular Cancer

Timely diagnosis of testicular cancer involves a combination of physical examinations, imaging tests, and lab evaluations:

• Physical Examination
  • A doctor checks for lumps, swelling, or tenderness in the testicles.
• Ultrasound
  • High-frequency sound waves help visualize any abnormal masses in the testicles.
• Tumor Marker Tests
  • Blood tests for elevated levels of:
    • Alpha-fetoprotein (AFP)
    • Beta-human chorionic gonadotropin (β-hCG)
    • Lactate dehydrogenase (LDH)
• CT Scan of Abdomen and Chest
  • Determines if cancer has spread to lymph nodes or lungs.
• MRI or PET-CT (when necessary)
  • Used in select cases to evaluate metastasis or residual disease.
• Surgical Exploration (Orchiectomy)
  • If cancer is suspected, the affected testicle is removed and examined to confirm diagnosis.

Treatment Options for Testicular Cancer

Testicular cancer is one of the most curable cancers, even in cases where it has spread. Treatment options include:

1. Surgery (Orchiectomy)

• Primary treatment involves removal of the affected testicle.
• Further lymph node dissection may be done in non-seminomas.

2. Radiation Therapy

• Mainly used for seminoma-type testicular cancer.
• Targets cancer cells in lymph nodes after surgery.

3. Chemotherapy

• Used for both seminomas and non-seminomas, especially in advanced or metastatic stages.
• Drugs like cisplatin, etoposide, and bleomycin are commonly used.

4. Surveillance

• Active monitoring after surgery in low-risk cases.
• Includes regular blood tests and imaging.

5. High-Dose Chemotherapy with Stem Cell Transplant

• Used in recurrent or resistant cases.
• Helps restore bone marrow function after intensive treatment.

Conclusion

Testicular cancer, though rare, is one of the most treatable forms of cancer, especially when detected early. Most cases are diagnosed in younger men and can be cured with timely medical intervention. Key to this is self-awareness, routine testicular self-examination, and consulting a doctor upon noticing any unusual symptoms. Modern diagnostic tools, such as testicular ultrasound and tumor marker blood tests, allow for early detection and accurate staging. Treatment options such as surgery, radiation, and chemotherapy are highly effective. Advances in nuclear imaging and PET-CT scans also assist in evaluating the spread and planning therapy in complex cases. A proactive approach to symptoms and regular follow-up with your healthcare provider ensures the best possible outcome and long-term survival.