Testicular Cancer

Testicular cancer is a disease in which malignant (cancer) cells form in tissues of the testis (one of two egg-shaped glands inside the scrotum that make sperm and male hormones). Testicular cancer usually occurs in young or middle-aged men. Two main types of testicular cancer are seminomas (cancers that grow slowly and are sensitive to radiation therapy) and nonseminomas (different cell types that grow more quickly than seminomas).

Estimated new cases and deaths from testicular cancer in the United States in 2007:

• New cases: 7,920
• Deaths: 380

Symptoms and Diagnosis

These and other symptoms may be caused by testicular cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:

• A painless lump or swelling in either testicle.
• A change in how the testicle feels.
• A dull ache in the lower abdomen or the groin.
• A sudden build-up of fluid in the scrotum.
• Pain or discomfort in a testicle or in the scrotum.

The following tests and procedures may be used to diagnose testicular cancer:

• Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. The testicles will be examined to check for lumps, swelling, or pain. A history of the patient's health habits and past illnesses and treatments will also be taken.
• Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
• Serum tumor marker test: A procedure in which a sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumor markers. The following 3 tumor markers are used to detect testicular cancer:
  
  • Alpha-fetoprotein (AFP).
  • Beta-human chorionic gonadotropin (ß-hCG).
  • Lactate dehydrogenase (LDH).
  Tumor marker levels are measured before radical inguinal orchiectomy and biopsy, to help diagnose testicular cancer.
• Radical inguinal orchiectomy and biopsy: A procedure to remove the entire testicle through an incision in the groin. A tissue sample from the testicle is then viewed under a microscope to check for cancer cells. (The surgeon does not cut through the scrotum into the testicle to remove a sample of tissue for biopsy, because if cancer is present, this procedure could cause it to spread into the scrotum and lymph nodes.) If cancer is found, the cell type (seminoma or nonseminoma) is determined in order to help plan treatment.

Causes

All cancers are caused by dysfunctions of proteins involved in cell division, apoptosis, or DNA repair (see general characteristics). Dysfunctional proteins may arise from gene mutations or protein interactions with environments. The following factors may increase the risk of developing testicular cancer:

• Having had an undescended testicle.
• Having had abnormal development of the testicles.
• Having a personal or family history of testicular cancer.
• Having Klinefelter's syndrome.
• Being white.

Reference:

National Cancer Institute, USA.