Testicular Cancer: Symptoms, Causes, Diagnosis, Treatment

Testicular cancer begins in the testicles and is commonly found in males between the ages of 15 and 40. However, it is possible for men to get testicular cancer at any age. Testicular cancer usually occurs when cancer cells develop in the tissues of a testicle. These cells grow uncontrollably and can spread all around the body.

According to Malaysia's National Cancer Registry Report (2012 – 2016), testicular cancer accounted for 1.2% of cancers in Malaysian males. Testicular cancer is very rare and affects approximately 1 in 250 men in their lifetimes.

Types of testicular cancer

The testicle is comprised of many different cells which can develop into different types of cancer. There are several types of testicular cancer:

Germ cell tumours

More than 90% of testicular cancers begin in germ cells which are the cells that produce sperm. The two main types of germ cell tumours are seminomas and non-seminomas:

• Seminomas grow and spread more slowly and occur later in life
• Non-seminomas grow and spread rapidly and develop earlier in life

Stromal cell tumours

Cancer begins in the stroma which are hormone-producing tissues. This cancer is found in up to 20% of childhood testicular cancers, but less than 5% of adult testicular cancer cases.

Risk factors of testicular cancer

People who are at risk for being diagnosed with testicular cancer include:

• Family history of testicular cancer
• Having an undescended testicle (cryptorchidism)
• Abnormal testicle development through conditions like Klinefelter syndrome
• Personal history of testicular cancer

Signs and symptoms of testicular cancer

The following are symptoms that can be attributed to testicular cancer:

• A lump in either the scrotum or testicle
• A sudden or abrupt build-up of fluid in the scrotum
• Swelling of the scrotum or testicle
• A feeling of sudden heaviness in the scrotum
• Pain in the scrotum or testicle
• A shrinking testicle
• Dull aches in the groin area or lower abdomen
• Tenderness in the breast tissue
• A difference in appearance between the testicles

Stages of testicular cancer

The stage of testicular cancer helps to determine how serious and how far the cancer has spread in the body.

The earliest stage of testicular cancer is Stage 0. The other stages range from I (1) to III (3) and each stage may be split to cover specific details using capital letters (e.g. A, B, C). A lower the number indicates the cancer is limited to the affected area, but a higher number indicates the cancer has spread. Within stages, an earlier letter means a lower stage.

Diagnosis of testicular cancer

Testicular cancer is usually diagnosed once a lump or an abnormal change in a testicle is found during self-examination or unintentionally.

Some common techniques that your doctor may use to diagnose testicular cancer include:

• Physical exam
• Ultrasound
• Serum tumour marker test
• Inguinal orchiectomy (surgery to remove the testicle)
• Biopsy
• Imaging tests such as computed tomography (CT) scans, X-rays, and magnetic resonance imaging (MRI) scans
• Blood tests

Learn more about the different types of screening and diagnostic procedures performed to diagnose testicular cancer.

Treatment options for testicular cancer

Treatment options depend on your health, preferences, cancer stage and type.

Some of the treatment for testicular cancer include:

1. Surgery:
• Radical inguinal orchiectomy is the treatment for both seminomas and non-seminomas. In this process, the testicle with the tumour is removed.
• Retroperitoneal lymph node dissection (RPLND) is another form of surgery, where the lymph nodes and large blood vessels in the back area of the abdomen may be removed.
2. Radiation therapy: High doses of X-rays are utilised to destroy the cancer cells.
3. Chemotherapy: Certain drugs, like cisplatin, bleomycin, and etoposide, are used to destroy the cancer cells. Chemotherapy is beneficial for seminomas and non-seminomas.

Learn more about the different types of treatment technologies to treat testicular cancer.

Prevention of testicular cancer

There is no way to completely prevent testicular cancer. However, it is recommended that you perform regular testicular self-examinations at least once a month.

Self-examination for testicular cancer

It is best to perform a testicular self-examination after a bath as the skin of the scrotum is relaxed, which makes it easy to identify any abnormalities.

Begin by using both hands and fingers to examine each testicle. Roll the testicle between your fingers and thumbs. Feel around for any lumps, which may range in size. Having any lumps or bumps is not normal and should be checked with a doctor.

There will be a cord-like structure on top and at the back of the testicle. However, this is just the epididymis and should not be confused with a lump.

Detect to Protect!

Testicular cancer is very treatable, and the number of individuals who recover from it is high. Yearly physical exams and regular self-examinations can help identify any changes that may be indicative of testicular cancer.

Discuss with your doctor to understand if you would benefit from screening for testicular cancer.

Make an appointment at Gleneagles Hospitals

If you are experiencing any of the symptoms of testicular cancer, get in touch with us to find out more about our Oncology Services at your nearest Gleneagles Hospital.

Gleneagles Hospital works with oncologists to assist patients through cancer treatment. The caring and multidisciplinary team of healthcare professionals are available for consultation and to provide the best care.