Testicular Cancer definition. Testicular cancer forms in tissues of one or both testicles. Testicular cancer is most common in young or middle-aged men. Most testicular cancers begin in germ cells (cells that make sperm) and are called testicular germ cell tumors. It is rare and is most frequently diagnosed in men 20-34 years old. Most testicular cancers can be cured, even if diagnosed at an advanced stage. Source: https://www.cancer.gov/types/testicular .
Testicular Cancer diagnosis. In some cases men discover testicular cancer themselves, either unintentionally or while doing a testicular self-examination to check for lumps. In other cases, your doctor may detect a lump during a routine physical exam.
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.
Determining the type of cancerYour extracted testicle will be analyzed to determine the type of testicular cancer. The type of testicular cancer you have determines your treatment and your prognosis. In general, there are two types of testicular cancer:Seminoma. Seminoma tumors occur in all age groups, but if an older man develops testicular cancer, it is more likely to be seminoma. Seminomas, in general, aren't as aggressive as nonseminomas.Nonseminoma. Nonseminoma tumors tend to develop earlier in life and grow and spread rapidly. Several different types of nonseminoma tumors exist, including choriocarcinoma, embryonal carcinoma, teratoma and yolk sac tumor.Source: https://www.mayoclinic.org/diseases-conditions/testicular-cancer-care/diagnosis-treatment/drc-20352991 .
Testicular Cancer Biopsy. Most types of cancer are diagnosed by removing a small piece of the tumor and looking at it under a microscope for cancer cells. This is known as a biopsy. But a biopsy is rarely done for a testicular tumor because it might risk spreading the cancer. Source: https://www.dana-farber.org/testicular-cancer/diagnosis/.
Testicular Cancer Treatment. There are different types of treatment for patients with testicular cancer. Testicular tumors are divided into 3 groups, based on how well the tumors are expected to respond to treatment. Good Prognosis. For nonseminoma, all of the following must be true: The tumor is found only in the testicle or in the retroperitoneum (area outside or behind the abdominal wall); and The tumor has not spread to organs other than the lungs; and The levels of all the tumor markers are slightly above normal. For seminoma, all of the following must be true: The tumor has not spread to organs other than the lungs; and The level of alpha-fetoprotein (AFP) is normal. Beta-human chorionic gonadotropin (β-hCG) and lactate dehydrogenase (LDH) may be at any level.
Intermediate Prognosis. For nonseminoma, all of the following must be true:The tumor is found in one testicle only or in the retroperitoneum (area outside or behind the abdominal wall); and The tumor has not spread to organs other than the lungs; and The level of any one of the tumor markers is more than slightly above normal. For seminoma, all of the following must be true:The tumor has spread to organs other than the lungs; andThe level of AFP is normal. β-hCG and LDH may be at any level.
Poor Prognosis. For nonseminoma, at least one of the following must be true:The tumor is in the center of the chest between the lungs; orThe tumor has spread to organs other than the lungs; orThe level of any one of the tumor markers is high.There is no poor prognosis grouping for seminoma testicular tumors.
Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment.Follow-up tests may be needed.
After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy: External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is used to treat testicular cancer. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. See Drugs Approved for Testicular Cancer for more information.
Surveillance Surveillance is closely following a patient's condition without giving any treatment unless there are changes in test results. It is used to find early signs that the cancer has recurred (come back). In surveillance, patients are given certain exams and tests on a regular schedule. High-dose chemotherapy with stem cell transplant High doses of chemotherapy are given to kill cancer cells. Healthy cells, including blood-forming cells, are also destroyed by the cancer treatment. Stem cell transplant is a treatment to replace the blood-forming cells. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the patient completes chemotherapy, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells. See Drugs Approved for Testicular Cancer for more information.
Stem cell transplant. (Step 1): Blood is taken from a vein in the arm of the donor. The patient or another person may be the donor. The blood flows through a machine that removes the stem cells. Then the blood is returned to the donor through a vein in the other arm. (Step 2): The patient receives chemotherapy to kill blood-forming cells. The patient may receive radiation therapy (not shown). (Step 3): The patient receives stem cells through a catheter placed into a blood vessel in the chest.New types of treatment are being tested in clinical trials.Information about clinical trials is available from the NCI website.
Treatment for testicular cancer may cause side effects.For information about side effects caused by treatment for cancer, see our Side Effects page.
Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.Follow-up tests may be needed.Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Men who have had testicular cancer have an increased risk of developing cancer in the other testicle. A patient is advised to regularly check the other testicle and report any unusual symptoms to a doctor right away.
Long-term clinical exams are very important. The patient will probably have check-ups frequently during the first year after surgery and less often after that.
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