Testicular Cancer

Overview

Cancer or tumor that develops in the tissues of the testicles of men is called Testicular Cancer.

Erectile Dysfunction

Symptoms for Testicular Cancer

  • Lump in the testicles: Without pain
  • Swollen testicles or a dense feeling of the testicles: With or without pain
  • On and off sharp pain felt on the testicles
  • Tenderness of male breasts
  • Distinct difference of size of the testicles

If cancer in the testicles has spread to other parts of the body, known as metastatic cancer, a man can experience the following symptoms for testicular cancer:

  • Pain on the lower back
  • Persistent cough
  • Shortness of breath
  • Hemoptysis (coughing with blood)
  • Lump on the neck area
  • Enlargement of male breasts

Testicular Cancer Causes

Some testicular cancer causes:

  • Family history of testicular cancer
  • Previous history of undescended testes (cryptorchidism)
  • Age: Usually affects men ages 15-35 years old
  • Race: Common in white men
  • Abnormal development of testicles: Genetic condition such as Klinefelter syndrome because it affects the growth of testicles, causing testicles to become small

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Types of Testicular Cancer

Germ cell tumors:

are cells responsible for sperm production, and most cancer in the testicles begin in the germ cells. Germ cell tumors (GCT) are classified into two, which are:

  1. Seminomas: It grows slowly, can be treated well with chemotherapy and radiation therapy; most common type of cancer in the testicles; some seminomas causes a rise in HCG (Human Chorionic Gonadotropin) levels in the blood
  2. Non-seminomas: It grows rapidly, increases levels of AFP (Alpha-Fetoprotein) and/ or HCG; treatment includes monitoring (surveillance) of the patient and surgery
    • Embryonal carcinoma: Cancer cells look like very early embryos
    • Yolk sac carcinoma: Cancer cells look like yolk sac of an early embryo, commonly affects children
    • Choriocarcinoma: Very rare type of testicular cancer in adults; grows rapidly
    • Teratoma: Look like a growing embryo with 3 layers; often occurs as a part of mixed germ cell tumors. 3 types of teratoma:
      • Mature teratomas
      • Immature teratomas
      • Teratomas with somatic type malignancy
Carcinoma in situ (CIS) or Intratubular Germ Cell Neoplasia:

Upon microscope visualization, cells appear abnormal but usually do not spread out of the seminiferous tubules; a biopsy is done to diagnose CIS

Stromal Tumors or Gonadal Stromal Tumors:

Develops from stroma, which are tissues that support and produce hormones, of the testicles. Type of stromal tumors:

  1. Leydig cell tumors
  2. Sertoli cell tumors

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Testicular Cancer Staging

Stage 0:

Cancer cells are confined in seminiferous tubules

Stage I:

Cancer cells have spread outside seminiferous tubules and beyond testicles, might have spread to adjacent tissues; no lymph node involvement

  • Stage IA: The tumor is confined in the testicles
  • Stage IB: The tumor has spread outside the testicles and affected adjacent tissues
  • Stage IS: Cancer cells may or may not have grown outside the testicles, and extent cannot be identified for some reason
Stage II:

Cancer cells have reached 1 or more lymph nodes in the abdomen; no involvement of other parts of the body

  • Stage IIA: The tumor has reached at least 1 lymph node with a size of <2cm diameter
  • Stage IIB: The tumor has reached at least 1 lymph node with a size of 2-5 cm diameter
  • Stage IIC: The tumor has reached at least 1 lymph node with a size of >5 cm diameter
Stage III:

Cancer cells may or may not have spread to adjacent lymph nodes; have reached other parts of the body

  • Stage IIIA: The tumor has spread to nearby lymph nodes or to the lungs
  • Stage IIIB: The tumor has spread to 1 or more nearby lymph nodes but has not reached other parts of the body, or no lymph node involvement but has reached other parts of the body or the lungs
  • Stage IIIC: The tumor has spread to 1 or more nearby lymph node and 1 tumor marker is very high or has reached other parts of the body or the lungs and 1 tumor marker is very high

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