Testicular Cancer

What is testicular cancer?

Testicular cancer refers to cancer that develops within one or both of the testicles. Testicular cancer most commonly forms in germ cells, which are cells that produce sperm. As such, germ cell tumours form 95% of testicular cancers.

There are two main types of testicular germ cell cancer. They are split equally into seminoma and non-seminoma.

  • Seminoma testicular cancer – the tumour does not include any subtypes. This typically grows more slowly compared to non-seminoma testicular cancer
  • Non-seminoma testicular cancer –where the tumour contains at least one of the following subtypes: teratoma, choriocarcinoma, yolk sac tumour and embryonal carcinoma, and develops more quickly than seminoma cancers

Testicular cancer is an uncommon cancer, with 850 Australian men diagnosed with testicular cancer in 2016. However, it is most prevalent in men aged between 30 and 34 years.

Stages of testicular cancer

Testicular cancer can be described in stages depending on how early or advanced the cancer is.

The way to stage the cancer is by undergoing a CT-scan (computer tomography) of the chest, abdomen and pelvis. Sometimes a CT-scan of the brain or other scans may be clinically indicated as per your doctor.

The TNM system is used to stage testicular cancer and helps doctors understand what your cancer looks like. TNM stands for:

  • Tumour – the degree to which the tumour has affected other tissue.
  • Node – is a measure of whether lymph nodes have been affected.
  • Metastasis – the degree to which the cancer has spread to other organs of the body.

The TNM information, along with other tests helps determine the stage of your testicular cancer.

  • Stage IA – the cancer is confined to the testicle and has not grown into the epididymis, hilar soft tissue, or lymphatic/blood vessels. The tumour may have grown into the inner membrane surrounding the testicle (tunica albuginea), but not the outer membrane (tunica vaginalis). If the tumour is seminoma cancer, it is smaller than 3 cm. Tumour markers are normal.
  • Stage IB – the cancer has grown into the epididymis, hilar soft tissue, outer membrane (tunica vaginalis), lymphatic/blood vessels, spermatic cord or scrotum. Tumour markers are normal.
  • Stage IS – the cancer is confined to the testicle. However, one (or more) tumour markers levels are elevated. This often means that the cancer cells may have spread outside the testicle but have not spread to lymph nodes or distant areas of the body (that could be detected on scans).
  • Stage IIA – the cancer has spread to no more than five nearby lymph nodes and none are larger than 2 cm. Tumour markers are normal or slightly elevated.
  • Stage IIB – the cancer has spread to nearby lymph nodes and is between 2 cm and 5 cm in size. Tumour markers are normal or slightly high.
  • Stage IIC – the cancer has spread to nearby lymph nodes and is larger than 5 cm. Tumour markers are normal or slightly high.
  • Stage IIIA – the cancer has spread to distant lymph nodes and/or the lungs. Tumour markers are normal or slightly high.
  • Stage IIIB – the cancer has spread to distant lymph nodes and/or the lungs but not to other organs. At least one tumour marker is substantially higher than normal.
  • Stage IIIC – the cancer has spread to distant lymph nodes and/or the lungs and at least one tumour marker is very high. Alternatively, the cancer has spread to distant areas of the body other than the lymph nodes or lungs.

Signs and symptoms of testicular cancer

In some people, testicular cancer causes no symptoms. However, symptoms may include:

A painless swelling or lump

in testicle

Changes to the size or shape

of a testicle

A feeling of heaviness

in the scrotum

A dull ache, pain or discomfort

in the lower abdomen, testicle or scrotum

Back pain

Breast growth or tenderness

Treatment for testicular cancer

Frequently asked questions

What are the risk factors for testicular cancer?

While the exact causes of testicular cancer are unknown, factors known to increase the risk of developing testicular cancer include:

  • An undescended testicle
  • Having a personal or family history of testicular cancer
  • Pre-existing medical conditions such as HIV infection
  • Ethnicity/race – the risk for Caucasian men is significantly higher than other ethnicities
  • Body size/height
How is testicular cancer diagnosed?

There are many different tests that are used to diagnose testicular cancer, alongside a physical examination. This may include an ultrasound to confirm the presence of a mass or a blood test to look at your general health and any tumour markers. Further tests may include CT, PET or MRI scans to detect if the cancer has spread. However, the only way to definitively diagnose testicular cancer is through the surgical removal of the affected testicle.

References

For a full list of references, click here.
  1. Cancer Australia. (2020). Testicular cancer. Retrieved on 9 April 2021 at https://www.canceraustralia.gov.au/affected-cancer/cancer-types/testicular-cancer/testicular-cancer-australia-statistics
  2. Cancer Council Australia. (2020). Testicular cancer. Retrieved on 9 April 2021 at https://www.cancer.org.au/cancer-information/types-of-cancer/testicular-cancer
  3. American Cancer Society. (2020). Testicular cancer. Retrieved on 9 April 2021 at https://www.cancer.org/cancer/testicular-cancer/
  4. American Society of Clinical Oncology. (2020). Testicular Cancer. Retrieved on 9 April 2021 at https://www.cancer.net/cancer-types/testicular-cancer/
  5. Department of Health, State Government of Victoria. (2015). Testicular cancer. Retrieved on 9 April 2021 at https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/testicular-cancer
  6. Mayo Clinic. (2020). Testicular cancer. Retrieved on 9 April 2021 at https://www.mayoclinic.org/diseases-conditions/testicular-cancer-care/symptoms-causes/syc-20352986

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