Testicular Cancer Symptoms and Treatment

Testicular cancer is a form of urologic cancer that occurs within the tissues of one or both testicles, which are part of the male reproductive system. The testicles, which are also known as testes, are external organs that are responsible for producing sperm and testosterone, a hormone that aids in the development of masculine features and characteristics.

Testicular cancer occurs when healthy testicle cells change and grow out of control, forming a mass known as a tumor. Non-cancerous tumors are referred to as benign, while cancerous tumors are referred to as malignant.

Learn more about testicular cancer types, causes, symptoms, diagnosis and treatment.

Why Choose Us for Testicular Cancer Care

State-of-the-Art Testicular Cancer Treatment In New Jersey

RWJBarnabas Health, in partnership with Rutgers Cancer Institute of New Jersey, the state’s only National Cancer Institute-designated Comprehensive Cancer Center, meets the highest standards in testicular cancer research, treatment, prevention and education. We offer access to the full spectrum of therapeutic procedures and advanced testicular treatment options including clinical trials, radiation therapy techniques and complex surgical procedures.

New Jersey’s Largest Network of Cancer Specialists

Our integrated care model for testicular cancer treatment includes the state’s largest network of cancer specialists, working together to ensure the greatest patient outcomes. The team includes:

• medical oncologists
• radiation oncologists
• Urologic oncologists
• Urologists
• Advanced practice nurses and certified technicians with enhanced credentials in cancer specialty care
• Nurse navigators
• Nutrition experts
• Oncology support professionals

Oncology Nurse Navigators Guide You Through Your Cancer Journey

Our oncology nurse navigators help patients through their testicular cancer journeys, from securing initial appointments to coordinating follow-up visits related to treatments and procedures, all the way through aspects of survivorship. Oncology nurse navigators also can refer you to social workers or financial counselors for matters about health insurance, financial concerns and other challenges.

Types of Testicular Cancer

The majority of testicular cancers develop in the germ cells, which are the sperm-producing cells in the body. Despite being a cancer related to the testicles, germ cell tumors can originate in several different locations of the body, including:

• The testicles
• The lower spine
• The retroperitoneum, which is the back of the abdomen near the spine
• The mediastinum, which is the central portion of the chest
• Very rarely, the pineal gland, which is located in the brain

As the most common type of testicular cancer, germ cell tumors can be broken down into two categories:

• Seminoma. This term is only applied if the testicular cancer does not include any attributes of any other type of tumor.
• Non-seminoma. Testicular cancer is labeled as non-seminoma when it contains one or more of the following types of tumor:
  • Choriocarcinoma
  • Embryonal carcinoma
  • Yolk sac tumor
  • Teratoma

Other forms of testicular cancer that occur less frequently are as follows:

• Carcinoma of the rete testis, which is a part of the testicles
• Testicular lymphoma
• Leydig cell tumor
• Sertoli cell tumor

Testicular Cancer Causes

Scientists continue to learn through research every day, specifically, how DNA can cause a cell to become cancerous. There are, however, some known risk factors of testicular cancer, including hereditary traits, health conditions and other factors. They include:

• Age. The average age of those diagnosed with testicular cancer is between age 20 and 45, however, a male of any age can develop the disease.
• Hereditary traits. Someone with a close relative with testicular cancer has an increased chance of developing testicular cancer.
• Personal history. Those who have had cancer in one testicle have an increased likelihood of developing testicular cancer in the other.
• Ethnicity. Males of any race or ethnicity can develop testicular cancer, however, Caucasians are more likely than those of other races to be diagnosed with testicular cancer. While testicular cancer is rare among people of African descent, those who are diagnosed tend to be associated with lower testicular cancer survival rates particularly if the cancer has spread to the lymph nodes or other parts of the body.
• Cryptorchidism. Commonly known as an undescended testicle, this refers to the condition when one or more testicles are not moved down to the scrotum at birth. Despite being one of the potential testicular cancer causes, the risk may be reduced if it is surgically corrected prior to puberty. Many parents opt to have their child’s undescended testicles surgically corrected between the ages of 6 and 15 months to reduce the child’s risk of infertility.
• Human immunodeficiency virus (HIV). Another one of the potential testicular cancer causes, individuals with HIV or Acquired Immune Deficiency Syndrome (AIDS) caused by HIV have a slightly higher risk of developing seminoma, a form of testicular cancer.

Testicular Cancer Symptoms

Testicular cancer symptoms may vary from patient to patient and may depend on your cancer stage. Not all symptoms are unique to testicular cancer. Some common testicular cancer symptoms could indicate noncancerous conditions such as a hernia, a buildup of fluid, a cyst, an injury, or other health conditions which should also be addressed by a doctor. Common signs of testicular cancer include:

• Lump or swelling in the testicle. When first detected, a testicular tumor may be roughly the size of a pea or a marble, but if not managed, may grow much larger.
• Pain or numbness in the testicle. Discomfort, loss of feeling, or swelling in this area can be associated with testicular cancer.
• Heaviness in the scrotum. Another sign of testicular cancer may involve a change in the density or weight of the scrotum, which contributes to a feeling of heaviness. Testicular cancer can also cause one testicle to grow bigger or smaller than the other.
• Fluid retention. A sudden buildup of fluid in the scrotum could be a potential sign of testicular cancer.
• Dull ache. Testicular cancer can impact other areas in the body, including producing a dull ache in the lower abdomen or groin.
• Swelling of the legs. Other signs of testicular cancer include swelling of the extremities combined with shortness of breath. This can result from a blood clot caused by cancer. Developing a blood clot may be one of the first signs of testicular cancer for young to middle-aged individuals.
• Other bodily symptoms. Testicular cancer causes lower back pain, shortness of breath, chest pain and bloody sputum or phlegm in the later stages of the disease.

Monthly Testicular Self-Exams

Early detection of any signs of testicular cancer is key. Monthly self-exams are one way to stay on top of your testicular health, as testicular cancer survival rates are most favorable when caught in an early stage. Self-exams can be performed after bathing, when the scrotum is relaxed.

• Holding your penis out of the way, examine each testicle separately with your hands.
• One at a time, roll the testicle gently between your thumbs and fingers.
• Feel for lumps, masses, changes in size, appearance, texture or consistency.

The epididymis is part of the testicle. It is a small, coiled tube that may feel like a bump on the upper outside of the testicle. Being able to feel the epididymis is normal. Also, bear in mind that one testicle may be slightly smaller than the other or hang slightly higher than the other, so these traits do not necessarily relate to testicular cancer.

Be mindful of any other abnormalities or changes, which could be potential signs of testicular cancer or other health issues. In many cases, testicular cancer symptoms do not appear until the later stages, so self-exams and regular screenings are important. Be sure to schedule an appointment with your doctor if you have any concerns.

Testicular Cancer Staging

Testicular cancer is staged by a tool known as the TNM Staging System. It classifies your testicular cancer stage with numbers and abbreviations that characterize the details of your condition. These details help to provide insight and inform your path of testicular cancer treatment.

Testicular cancer is categorized into stages 0 through III, with 0 being the earliest signs of testicular cancer and stage III as the stage in which cancer has spread to organs outside the testes. As with other cancers, earlier stages are associated with better outcomes.

Testicular Cancer Screening

Although there are no standard screening recommendations for testicular cancer, screening can allow a physician to detect the disease in its early stages, before testicular cancer symptoms or signs of testicular cancer appear. Some of the tools used identify and diagnose testicular cancer may include:

• Physical exam. A physician may perform an exam to check for signs of testicular cancer.
• Laboratory tests. These tests can reveal abnormalities such as the presence of testicular tumor markers including alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) in the urine or blood.
• Imaging tests. High definition images from ultrasounds, computed tomography (CT) and magnetic resonance imaging (MRI) are used to identify the presence of tumors, masses and testicular cancer.
• Genetic tests. These screen for inherited traits that may increase a person’s risk of developing testicular cancer.
• Bone scan. This test determines whether testicular cancer has spread to the bones.
• Biopsy. A biopsy is not often recommended to diagnose testicular cancer, as it may encourage the tumor to spread. In some cases, a biopsy may be performed prior to surgery to obtain a tissue sample for confirmation of the tumor type, however.

Testicular Cancer Treatment

Testicular cancer is highly treatable in its early stages, so early detection is crucial to achieving the best patient outcome. Learn about testicular cancer causes, risk factors and symptoms. Depending on the stage, the testicular cancer treatment may be managed by a urologist, a radiation oncologist or a medical oncologist. One or more therapies may be used.

Surgery

Surgery is the most common testicular cancer treatment for the early stages of the cancer. Depending on your condition, it may be performed alongside other therapies. There are a few different types of testicular cancer surgery, which include:

• Laparoscopic surgery. Generally used in earlier stages of testicular cancer, this detailed procedure involves several small incisions to remove the tumor and affected lymph nodes, if necessary.
• Radical inguinal orchiectomy. This procedure involves the removal of the testicle, vas deferens, blood and lymph vessels that are affected by or likely to spread testicular cancer.
• Retroperitoneal lymph node dissection (RPLND). This complex procedure is sometimes necessary for more advanced cases of testicular cancer. involves the total removal of the lymph nodes through a large incision.

Nonsurgical Testicular Cancer Treatments

Aside from surgery, common treatments for testicular cancer include:

• Radiation therapy
• Immunotherapy
• Chemotherapy
• High-dose chemotherapy is made possible through stem cell transplant

Clinical trials testing promising new therapies or combinations of existing therapies may also be an option.

There are benefits as well as risk factors and side effects associated with any testicular cancer treatment option, so it is important to discuss your concerns with your doctor.

Leading Cancer Treatment in New Jersey

As part of the largest health network in New Jersey, RWJBarnabas Health is led by a team of highly knowledgeable urologic oncologists, medical oncologists, radiation oncologists, urologists, advanced practice nurses and certified technicians who provide superior testicular cancer care to our patients.

To schedule an appointment with one of New Jersey’s testicular cancer specialists, call 844-CANCERNJ or 844-226-2376.