Testicular cancer is one of the most curable forms of cancer, particularly when it is diagnosed early. Testicular cancer is the uncontrolled growth of cells in the testes, the male sex organs that make and store sperm and produce testosterone. While testicular cancer is generally rare, it is also the most common form of cancer in young men.
The research community has not yet determined a single cause for testicular cancer, but we do know that certain conditions are often correlated with it. These include an undescended testicle, Klinefelter syndrome, or genetic factors. But many men who are diagnosed with testicular cancer don’t have any associated risk factors whatsoever.
The majority of cases of testicular cancer start in the male’s germ cells – these are the cells that produce sperm. Testicular cancers that occur in the germ cells are categorized as either seminomas or non-seminomas. Seminomas develop and spread more slowly than non-seminomas, and the former usually respond very well to radiation therapy. Non-seminomas are themselves categorized into several different subtypes. Testicular cancers may also occur in cells other than the germ cells; these are less common and include tumours that affect other cells, such as Sertoli-Leydig cell tumours.
The symptoms of possible testicular cancer may vary from person to person, but in general they include:
- Swelling or lumps in the scrotum that may be tender or painful
- A feeling of weightiness in the scrotum
- Pressure or dull pain in the groin or below the stomach
It’s most common to find symptoms of testicular cancer during a self-exam or during a routine physical check-up.
There are other conditions that present with conditions similar to those of testicular cancer. Because of this, your GP will likely order tests to rule out these conditions. They may order blood tests that look for tumour markers called alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG). These tumour markers suggest the presence of a testicular tumour. Imaging tests such as testicular ultrasound and CT scans can also detect abnormalities in the testicles. If these tests return a diagnosis of testicular cancer, surgery to remove the testicle is almost always the first step in treatment. Surgery allows the oncologist to determine whether a patient definitely has testicular cancer as well as whether it is a seminoma, a non-seminoma, or another kind of cancer.
SIGNS AND SYMPTOMS OF TESTICULAR CANCER
Testicular cancer can present with a variety of different signs and symptoms. Occasionally, testicular cancer can be diagnosed in men who do not have any of these signs and symptoms, and in other cases, these symptoms can be due to a condition other than testicular cancer. Enlargement of the testicle, or a small hard lump on the testicle, are typically the initial symptoms of testicular cancer. But these symptoms can also by caused by conditions that are not related to testicular cancer. It’s also common for one testicle to normally be slightly larger than the other, and unless you notice a change in the size of either testicle, it’s not cause for alarm by itself.
Conditions that are NOT testicular cancer, but present similar symptoms, include:
- Variocele: an enlargement of the blood vessels that surround the testicle.
- Hydrocele: a build-up of fluid in the outer membrane of the testicle.
- Hernia: this is a tear in the abdominal muscle above the groin.
An Epididymal Cyst is the condition that is perhaps most commonly mistaken for a testicular tumour. An epididymal cyst is a benign, fluid filled structure that develops on the epididymis, the coiled structure that transports sperm away from the testicle. Also called a spermatocele, an epididymal cyst feels like a smooth, firm lump near the top of the testicle. Symptoms of an epididymal cyst can include pain or swelling of the scrotum and pressure at the base of the penis. If your doctor suspects an epididymal cyst is present, it can be confirmed by shining a light behind the testicle to see if light passes through it. Because epididymal cysts are filled with fluid, light will pass through them. Your doctor may also order an ultrasound to confirm that it is in fact an epididymal cyst. Epididymal cysts are benign and usually do not require treatment, but may be removed if they are causing pain or growing larger.
Some symptoms of testicular cancer may not be noticed until after the cancer has metastasized and spread to other parts of the body – at which point it is much more difficult to successfully treat. That’s why it is so important to perform self-examinations at least once a month in order to detect symptoms of cancer while it is still early and has a high chance of being treated successfully.
While you’re performing your self-examination, pay attention to any of the following signs and symptoms, which may indicate the possibility of testicular cancer:
- Any lumps or swelling in either testicle. They may or may not be painful – regardless, it’s important to get any lumps or swelling checked out by a doctor immediately. When a tumour in the testes is detected early, it may only be as large as a pea, but if left untreated it can grow much larger.
- Pain, tenderness or discomfort in either testicle or in the scrotum. It may or may not be accompanied with swelling or lumps – and can often be a symptom of a number of non-cancerous conditions, including infections, injury to the groin or scrotum, or a testicle that is twisted or otherwise out of place. Infections of the testicle or epididymis, called orchitis and epididymitis respectively, can be treated with a course of antibiotics.
- Any changes at all in how the testicles or scrotum feel. This may include the scrotum feeling heavier than it has in the past; one testicle feeling firmer than the other; or any change in the size (larger or smaller) of the testicle.
- A dull ache in the groin or lower abdomen can be caused by a number of different conditions, and testicular cancer is just one of many. Even so, because of the risk, this condition should be checked out by a doctor if it persists for more than a day or two.
- A sudden build-up of fluid in the scrotum, which can be caused by conditions other than testicular cancer; any of these conditions require medical attention, however. Fluid can be detected in the scrotum with a self-exam.
- Tenderness in the chest or enlarged pectorals. Some rare testicular cancers can produce oestrogen and other hormones that cause tenderness in the breast region and occasionally lead to a condition called gynecomastia, or the growth of breast tissue in males.
- Low back pain, chest pain, difficulty breathing, and blood in the sputum or phlegm are symptoms of a wide variety of conditions, and do not necessarily indicate cancer. But they are also all potential symptoms of late-stage cancer, when the tumour has metastasized and is spreading through the body.
- Developing a blood clot that results in shortness of breath or swollen legs can sometimes be the first symptom of testicular cancer they notice. A blood clot that leads to shortness of breath is a pulmonary embolism, while a blood clot that causes swelling in the leg is called deep venous thrombosis. These are both potential symptoms for a wide range of conditions, but all of them require medical attention.
FINDING TESTICULAR CANCER EARLY
It can’t be stressed enough that testicular cancer responds very well to treatment if it is detected early, and because of that performing monthly self-examinations is extremely important. Testicular cancer can often be detected while it still in its early stages. Testicular cancers are often detected by men themselves during a self-examination. Men between the ages of fifteen and 55 should perform self-examinations on a monthly basis. If you do notice any swelling, lumps, hardness, tenderness, pain, or changes in either or both testicles should immediately contact their doctor to schedule an examination.
At the same time, symptoms may not always present, and some symptoms may not be detected even with monthly self-examinations. Routine physical examinations can catch other symptoms, particularly if blood tests and other diagnostic tests are performed as part of an examination.
If you feel you are at-risk for testicular cancer, or have noticed any signs of swelling, lumps, or other symptoms during your monthly self-exam, contact us today to schedule a testicular ultrasound. Don’t wait: catching testicular cancer early is the best way to survive it. Find out how we can help you today.
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