Testicular Cancer

Overview

Types of Testicular Cancer

This cancer strikes mostly young men and even children, making it unusual. Two major types of testicular cancer exist and grow from germ cells, the cells that make sperm:

• Seminomas. These usually occur in men between age 25 and 45 and tend to grow and spread more slowly than non-seminomas.
• Non-seminomas. These types of tumors usually occur in men between their late teens and early 30s. They grow more quickly than seminomas, and can be more difficult to treat.

Symptoms

Symptoms of testicular cancer may include:

• A lump in either testicle
• A swollen testicle
• Pain, swelling or hardness in the testicles
• Heaviness in the scrotum
• Dull ache in the lower abdomen or groin
• Tenderness or swelling in the breast area
• Persistent back pain
• Coughing up blood

Risk Factors for Testicular Cancer

Testicular cancer is not linked currently to any habits or activities. There are some risk factors which increase your chance of getting the disease:

• An undescended testicle: Testicles drop down from the abdomen to the scrotum before you’re born. If you were born with an undescended testicle, you have a greater risk of testicular cancer, even if you’ve had surgery to the fix the issue.
• If you have a first-degree male relative such as a father or brother, your risk of testicular cancer is higher than the general population
• A prior history of testicular cancer in one testicle also places you at a higher risk than the general population to get a second cancer in the other testicle.

How We Can Help

Medical advances have made the overall cure rate for testicular cancer about 95 percent.

Men come from around the world to IU Health for treatment of testicular cancer. IU Health physicians offer a wide range of treatment options. Their multidisciplinary approach provides well-rounded and highly effective treatment.

Your IU Health urologic and medical oncologists will collaborate to treat even advanced testicular cancer that has metastasized (spread) to other organs of the body. Your particular cancer and your preferences play an important role in treatment decisions. Your team will also consist of social workers and counselors who can help you with emotional aspects of cancer.

Treatment

Your physicians will remove the affected testicle as an essential part of treatment. If you catch the cancer at an early stage, you may not require any additional treatment. If your physicians decide you do not need further treatment, they will carefully monitor you. Testicular cancer is categorized into three stages to help guide the appropriate next recommendations in your care:

• Stage I, when the cancer is only in the testicle with no evidence that it has spread
• Stage II, when the cancer has spread to nearby lymph nodes in the abdomen or pelvis
• Stage III, when the cancer has spread to lymph nodes in the chest, lungs, liver, bones, or brain

As a partner with the Indiana University Simon Comprehensive Cancer Center, you will have access to the full spectrum of testicular cancer care in urology, medical oncology, surgery, pathology, radiology and sexual health.

If not caught early enough, testicular cancer can spread (metastasize) upward into your lymph nodes in the abdomen. In this case, your treatment team may recommend a surgery called a retroperitoneal lymph node dissection (RPLND) to remove the affected lymph nodes. This is a surgery that was pioneered at Indiana University in the 1960s. Our center has more experience with this operation than any other facility in the world.

Further metastasis often appears in the lungs and requires more aggressive treatment such as chemotherapy. The chemotherapy used to treat men with larger volume metastatic disease was discovered at IU Health in the 1970s and has been further refined over the past 50 years to limit the side effects as much as possible. Our expert medical oncologists meet with you and determine which regimen is best for you and your specific case.

Depending on the type and stage of your cancer, your treatment may require surgery, chemotherapy and/or radiation.

In treating testicular cancer your physicians will speak with you about cure rates, not just survival rates. Their treatment has become so effective that males commonly do not have any recurrence—they live normal lives.

We understand that treatment for testicular cancer can be difficult in young men. We provide experts in Men’s Sexual and Reproductive Health to help with guidance regarding fertility and sexual health concerns, including how to store sperm prior to treatment if desired.

Follow up care and support

After testicular cancer, surveillance is crucial. Once your treatment is complete, your doctor will likely recommend that you perform self-exams and return for regular checkups.

During these checkups, your doctor will examine the unaffected testicle for any lumps or abnormalities and possibly recommend periodic blood tests to look for tumor markers and order regular chest x-rays or CT scans to detect any tumors.

If traveling from locations outside of Indiana, our physicians can communicate the appropriate surveillance schedules to your local providers as well as keep in touch with you.

Clinical Trials

Lifesaving treatments developed over the last 50 years have made testicular cancer one of the most survivable cancers. Researchers and physicians at IU Health have helped develop innovative treatments through clinical trials for this cancer. They gained an international reputation for their work, and remain on the leading edge of treatment for testicular cancer. These include both surgical and chemotherapy trials.