Definition
Testicular cancer is a disease in which malignant (cancer) cells form in the tissues of one or both testicles. It occurs in the testicles (testes), which are located inside the scrotum, a loose bag of skin underneath the penis.
Testicular cancer
Epidemiology
Studies of testicular cancer in selected global populations from 1973-2007 have shown a clear trend toward an increased incidence in most populations evaluated. In recent years, however, rates have plateaued in some areas and even decreased in a few.
Rates are highest in Northern Europe and in men descended from European populations—Northern European populations in particular. The incidence varies even in Northern Europe, however, with rates notably higher in Norway and Denmark than in Sweden and Finland. In recent years, rates in Eastern European countries have risen rapidly, approaching those in Northern European countries. Rates are lowest in Asia and Africa and intermediate in Central and South America.
Epidemiologic observations have suggested that environmental factors are instrumental in determining risk for testicular cancers. However, epidemiologic evidence does not consistently support any specific risk factor.
Types of Testicular Cancer
The different types are classified by the type of cells cancer begins in. The most common type of testicular cancer is “germ cell testicular cancer”, which accounts for around 95% of all cases. Germ cells are a type of cell that the body uses to create sperm.
There are two main subtypes of germ cell testicular cancer. They are:
- Seminomas – which have become more common in the last 20 years and now account for 50-55% of testicular cancers
- Non-seminomas – which account for most of the rest and include teratomas, embryonal carcinomas, choriocarcinomas, and yolk sac tumors
- Both types tend to respond well to chemotherapy. Less common types of testicular cancer include:
- Leydig cell tumors – which account for around 1-3% of cases
- Sertoli cell tumors – which account for around 1% of cases
- Lymphoma – which accounts for around 4% of cases
Risk factors of Testicular Cancer
Factors that may increase your risk include:
An undescended testicle (cryptorchidism). The testes form in the abdominal area during fetal development and usually descend into the scrotum before birth. Men who have a testicle that never descended are at greater risk of testicular cancer than are men whose testicles descended normally. The risk remains elevated even if the testicle has been surgically relocated to the scrotum.
Still, the majority of men who develop testicular cancer don’t have a history of undescended testicles.
Abnormal testicle development. Conditions that cause testicles to develop abnormally, such as Klinefelter syndrome, may increase your risk of testicular cancer.
Family history. If family members have had testicular cancer, you may have an increased risk.
Age. Testicular cancer affects teens and younger men, particularly those between ages 15 and 35. However, it can occur at any age.
Race. Testicular cancer is more common in white men than in black men.
Causes
It’s not clear what causes it in most cases.
Doctors know that testicular cancer occurs when healthy cells in a testicle become altered. Healthy cells grow and divide in an orderly way to keep your body functioning normally. But sometimes some cells develop abnormalities, causing this growth to get out of control — these cancer cells continue dividing even when new cells aren’t needed. The accumulating cells form a mass in the testicle.
Nearly all testicular cancers begin in the germ cells — the cells in the testicles that produce immature sperm. What causes germ cells to become abnormal and develop into cancer isn’t known.
Symptoms
The lump or swelling can be about the size of a pea but may be larger. Most lumps or swellings in the scrotum aren’t in the testicle and aren’t a sign of cancer. But they should never be ignored. Visit your GP as soon as you notice a lump or swelling in your scrotum.
Associated symptoms
Testicular cancer can also cause other symptoms, including a:
- dull ache or sharp pain in your testicles or scrotum, which may come and go
- feeling of heaviness in your scrotum
- change in the texture or increase in firmness of a testicle
- difference between one testicle and the other
Diagnosis and test
To determine whether a lump is testicular cancer, your doctor may recommend:
Ultrasound. A testicular ultrasound test uses sound waves to create an image of the scrotum and testicles. During an ultrasound, you lie on your back with your legs spread. Your doctor then applies a clear gel to your scrotum. A hand-held probe is moved over your scrotum to make the ultrasound image.
An ultrasound test can help your doctor determine the nature of any testicular lumps, such as whether the lumps are solid or fluid-filled. An ultrasound also tells your doctor whether lumps are inside or outside of the testicle.
Blood tests. Your doctor may order tests to determine the levels of tumor markers in your blood. Tumor markers are substances that occur normally in your blood, but the levels of these substances may be elevated in certain situations, including testicular cancer. A high level of a tumor marker in your blood doesn’t mean you have cancer, but it may help your doctor in determining your diagnosis.
Surgery to remove a testicle (radical inguinal orchiectomy). If it’s determined that the lump on your testicle may be cancerous, surgery to remove the testicle may be recommended. Your removed testicle will be analyzed to determine if the lump is cancerous and, if so, what type of cancer.
Staging the cancer
Once your doctor confirms your diagnosis, the next step is to determine the extent (stage) of cancer. To determine whether cancer has spread outside of your testicle, you may undergo:
Computerized tomography (CT) scan: CT scans take a series of X-ray images of your abdomen, chest, and pelvis. Your doctor uses CT scans to look for signs that cancer has spread.
Blood tests: Blood tests to look for elevated tumor markers can help your doctor understand whether cancer likely remains in your body after your testicle is removed.
After these tests, your testicular cancer is assigned a stage. The stage helps determine what treatments are best for you. The stages of testicular cancer are:
Stage I: Cancer is limited to the testicle.
Stage II: Cancer has spread to the lymph nodes in the abdomen.
Stage III: Cancer has spread to other parts of the body. Testicular cancer most commonly spreads to the lungs and liver.
Treatment and medications
Testicular cancer treatment has a success rate of about 95 percent – in other words, 95 percent of all testicular cancer patients who receive treatment make a full recovery. The sooner a patient is diagnosed and treated the better his prognosis is.
Treatment may involve surgery, radiotherapy, chemotherapy, or a combination.
Testicular cancer surgery
Orchiectomy
- Orchiectomy is usually the first line of treatment. The testicle is surgically removed to prevent the tumor from spreading. If the patient is diagnosed and treated in stage 1, surgery may be the only treatment needed.
- An orchiectomy is a straightforward operation. The patient receives a general anesthetic. A small incision is made in the groin, and the testicle is removed through the incision. The patient remains in the hospital for a few days.
If the man still has one testicle after the operation, his sex life and chances of reproducing should not be affected.
Fertility
- If after the operation, the patient has no testicles, he will be infertile. He will not be able to produce sperm.
- Males who wish to have children one day should consider banking their sperm before the operation – some sperm is kept in a sperm-bank before the testicle or testicles are removed.
- Other testicular cancer therapies, including radiotherapy and chemotherapy, can also affect a cancer patient’s long-term fertility.
Lymph node surgery
If cancer has reached the lymph nodes, they will need to be surgically removed. This usually involves the lymph nodes in the abdomen and chest. Sometimes lymph node surgery can result in infertility.
Radiation therapy (radiotherapy)
Radiotherapy involves the use of beams of high-energy X-rays or particles (radiation) to destroy cancer cells. Radiotherapy works by damaging the DNA inside the tumor cells, destroying their ability to reproduce.
Patients with seminoma testicular cancer will typically require radiotherapy as well as surgery. The radiotherapy is used to prevent cancer recurrence.
Patients whose cancer has spread to their lymph nodes will need radiation therapy. Radiation therapy may cause the following temporary side effects:
- Tiredness
- Rashes
- Muscle stiffness
- Joint stiffness
- Loss of appetite
- Nausea
Chemotherapy
Chemotherapy is the use of chemicals (medication) to destroy cancer cells. Cytotoxic medication prevents cancer cells from dividing and growing.
Chemotherapy is usually given to patients with advanced testicular cancer – cancer that has spread to other parts of the body. Treatment is administered either orally (tablets by mouth) or injection. As chemotherapy attacks healthy cells as well as cancerous ones, the patient may experience the following temporary side effects:
- Nausea
- Vomiting
- Hair loss
- Mouth sores
- Tiredness
- Malaise
Most people immediately link chemotherapy with uncomfortable side effects. However, side-effect management has improved considerably over the last 20 years.
Natural Remedies for Testicular Cancer
Testicular cancer natural remedies include:
- Garlic – Garlic has natural anti-inflammatory and anti-cancer properties that work through the immune system. Garlic can be eaten raw or commonly added while cooking food when used in testicular cancer natural remedies.
- Curcumin – Curcumin is the ingredient in turmeric that is so effective in treating many ailments, including certain forms of cancer. Curcumin can prevent testicular cancer and keep an existing tumor controlled from spreading.
- Cannabis – Research is proving that cannabis products are effective in fighting testicular cancer symptoms and relieving chronic pain. Cannabis can be smoked or eaten with foods.
- Grape Seed Extract – Grape seed extract is a natural home treatment that contains a powerful antioxidant that is high in proanthocyanidins that help fight testicular cancer cells.
- Turmeric – Turmeric contains the active compound curcumin that is a natural anti-cancer and anti-inflammatory agent used to treat testicular symptoms and other cancers.
- Cat’s Claw – Cat’s claw is a natural herb that’s been used in indigenous medicine for thousands of years. Alkaloids are the chemical compounds in cat’s claw that have been found to be effective treatments for testicular cancer.
Prevention
Because there is little or nothing men can do to change most of the above risk factors, it is often thought that it is not possible to prevent testicular cancer. However, as with all cancers, there are definite steps one can take to help prevent cancer of the testes. Such steps include:
Reducing exposure to chemical toxins: One possible cause of testicular cancer is phthalates and other endocrine-disrupting compounds (hormone-mimicking chemicals) used routinely in many different household items like carpets, plastics, toiletries, pesticides, pharmaceutical drugs, and in-car upholstery. These chemicals are thought to be particularly harmful to male reproductive health, causing infertility, deformation of the penis, undescended testicles, and testicular cancer.
Other ways to prevent testicular cancer include general healthful measures like:
- Building up your immune system
- Eating a cancer-fighting diet
- Taking nutritional supplements such as turmeric, medicinal mushrooms, and Boswellia.
- Engaging in regular exercise
- Reducing stress
- Detoxifying and protecting your liver, the body’s most important cancer-fighting organ
In sum, we recommend healthful lifestyle approaches to help to build up the body nutritionally and immunologically and to make it as inhospitable to cancer as possible.