Testicular (tes-TIK-yoo-lar) cancer occurs when cells in the testicle (TES-ti-kul), one of the two male sex glands located in the scrotum * below the penis, divide without control or order, forming a tumor. Over time, these cancer cells can spread to other parts of the body.
for searching the Internet and other reference sources
A Skater's Story
In February of 1997, while on tour with his professional ice skating show, former Olympic champion Scott Hamilton started experiencing sharp, shooting pains in his abdomen * and lower back. Assuming that he had pulled a muscle, he continued along with the tour. Several weeks later, though, the pain became unbearable, and Hamilton underwent testing at a nearby hospital. Doctors found a grapefruit-sized tumor in his abdomen, which they soon discovered had originated in his testicle. At that point, the skater left the tour and returned home to be treated for cancer * .
For the next 3 to 4 months, Hamilton underwent chemotherapy * in the hope that it would shrink his tumor. Fortunately it worked, and over time the tumor became considerably smaller. That made it much easier for doctors to remove. However, the course of treatment was difficult and weakened Hamilton physically. It took time for him to get back to the level of stamina and flexibility that figure skating requires. Showing the same drive that propelled him to an Olympic gold medal in 1984, Hamilton worked hard and was able to return to the ice within the year.
* scrotum (SKRO-tum) is the pouch on a male body that contains the testicles.
* tumor (TOO-mor) usually refers to an abnormal growth of body tissue that has no known cause or physiologic purpose and is not an inflammation.
* abdomen (AB-do-men), commonly called the belly, is the portion of the body between the chest or thorax (THOR-aks) and the pelvis.
* cancer is any tumorous (TOO-morus) condition, the natural (untreated) course of which is often fatal.
* chemotherapy (kee-mo-THER-a-pee) is the treatment of cancer with powerful drugs that kill cancer cells.
What Is Testicular Cancer?
The testicles, also called the testes or male gonads, are the male sex glands located below the penis in a pouch of skin called the scrotum. The testicles are the body's main source of male hormones * , which control the development of the reproductive organs and male sex characteristics such as body and facial hair, low voice, and muscular arms. They also produce and store sperm, the tiny, tadpole-like cells that fertilize the female egg.
Testicular cancer usually begins when cells begin to divide without control or order, forming a tumor. Cells can break away from the tumor and enter the blood or the lymph, an almost colorless fluid produced by tissues all over the body. The fluid passes through lymph (LIMF) nodes * , the bean-shaped organs that filter the lymph, fight infection, and produce certain kinds of blood cells. When testicular cancer spreads, cancer cells usually are found in the nearby lymph nodes, the liver * , or the lungs.
The Importance of Early Detection
Like most types of cancer, testicular cancer can be treated most easily when it is found early. That is why doctors encourage all teenage boys and men to perform monthly testicular self-examination (TSE), which involves rolling each testicle between the fingers and thumb. The testicles are smooth, oval-shaped, and rather firm, and men who examine themselves regularly become familiar with the way their testicles feel. If any change occurs, it should be reported to a doctor. For most men, it takes time to get comfortable with doing TSE, but it is the best way to find a lump early. This usually is the first sign of testicular cancer.
Other possible symptoms of testicular cancer include:
- Any enlargement of a testicle
- A feeling of heaviness in the scrotum
- A dull persistent ache in the lower abdomen or the groin
- A sudden collection of fluid in the scrotum
- Pain or discomfort in a testicle or in the scrotum.
It is important for all men to be aware of these symptoms, because doctors cannot predict who will get testicular cancer and who will not. They have not been able to identify what causes it. They do know that boys who are born with undescended testicles (located in the lower abdomen, rather than in the scrotum) have a higher risk of developing testicular cancer later in life. However, it usually develops for no apparent reason.
How Is Testicular Cancer Diagnosed?
Doctors begin by examining the scrotum and testes carefully and ordering urine and blood tests. These tests can help determine whether an infection or some other disorder might be causing the symptoms. Also, if a tumor is present, certain substances in the blood may be found at higher levels. These substances are called tumor markers, because they often are found in abnormal amounts in patients with some types of cancer. The doctor may also order tests that create images of the inside of the body, such as a CT scan * or an ultrasound * .
* hormones are chemicals that are produced by different glands in the body. Hormones are like the body's ambassadors: they are created in one place but are sent through the body to have specific regulatory effects in different places.
* lymph nodes are round masses of tissue that contain immune cells that filter out harmful microorganisms,
* liver is a large organ located in the upper abdomen that has many functions, including storage and filtration of blood, secretion of bile, and participation in various metabolic (met-a-BOLL-ik) processes.
* CT scan or CAT scan are the shortened names for computerized axial tomography (to-MOG-ra-fee), which uses x-rays and computers to view structures inside the body.
* ultrasound is a painless procedure in which sound waves passing through the body create images on a computer screen.
After all of these tests, the doctor can be reasonably certain about the diagnosis. However, the only sure way to determine whether cancer is present is to examine a sample of tissue under a microscope. In an operation, surgeons remove the affected testicle.
Once cancer is diagnosed, doctors need to figure out whether it has spread to other parts of the body and formed metastases * . They may perform other tests to look for cancer elsewhere. Because the cancer frequently spreads through the lymph nodes in the abdomen, these may be removed and then checked for cancer cells.
How Is Testicular Cancer Treated?
The removal of the testicle, which is necessary to diagnose the cancer, is also the first step in treating it. In addition, tumors that have spread to other parts of the body may be removed partly or entirely by surgery. In most cases, surgery will be followed by radiation therapy, which focuses high-energy rays on the remaining tumor to kill cancer cells and stop their growth.
In some cases, chemotherapy may be used either before or after surgery. During chemotherapy, anticancer drugs are given by mouth or by injection into a muscle or vein.
Life after Testicular Cancer
Fortunately, this disease responds well to treatment, even when it has spread from the testicle to other parts of the body. Men who have had testicular cancer need to see their doctors for regular follow-up appointments to make sure that the cancer has not recurred.
A man with one healthy testicle can still have sex and father children. Radiation therapy and chemotherapy may cause a temporary drop in sperm production, but it usually returns to normal within a few months. Patients who are concerned about how they look can also have an artificial testicle, called a testicular prosthesis * , placed in the scrotum. It looks and feels just like a normal testicle.
* metastases (me-TAS-ta-seez) are new tumors formed when cancer cells from a tumor spread to other parts of the body.
* prosthesis (pros-THEE-sis) is an artificial substitute for a missing body part. It can be used for appearance only or to replace the function of the missing part (as with a prosthetic leg).
The National Cancer Institute (NCI), part of the U.S. National
Institutes of Health (NIH), posts information about testicular cancer on
its website. From the Publication Index, follow the links Types of
Cancer, "What You Need To Know About Cancer" Series, and
The American Cancer Society's website features a section devoted
to testicular cancer.