Testicular Cancer
Table of Contents
Description
What is cancer of the testicle?
- Stage Explanation
-
Stages of cancer of the testicle
- Stage I
- Stage II
- Stage III
- Recurrent
- Treatment Option Overview
-
How cancer of the testicle is treated
- Treatment by stage
- To Learn More
What is cancer of the testicle?
Cancer of the testicle (also called the testis), a rare kind of cancer in men, is a
disease in which cancer (malignant) cells are found in the tissues of one or both
testicles. Sperm (the male germ cells that can join with a female egg to develop into a
baby) and male hormones are made in the testicles. There are two testicles located inside
of the scrotum (a sac of loose skin that lies directly under the penis). The testicles are
similar to the ovaries in women (the small sacs that hold the female egg cells).
Cancer of the testicle is the most common cancer in men 15 to 35 years old. Men who
have an undescended testicle (a testicle that has never moved down into the scrotum) are
at higher risk of developing cancer of the testicle than other men whose testicles have
moved down into the scrotum. This is true even if surgery has been done to place the
testicle in the appropriate place in the scrotum.
A doctor should be seen if there is any swelling in the scrotum. The doctor will
examine the testicles and feel for any lumps. If the scrotum doesn't feel normal, the
doctor may need to do an ultrasound examination, which uses sound waves to make a picture
of the inside of the testes. The doctor may need to cut out the testicle and look at it
under a microscope to see if there are any cancer cells. It is very important that this be
done correctly.
The chance of recovery (prognosis) and choice of treatment depend on the stage of the
cancer (whether it is just in the testicle or has spread to other places) and the
patient's general state of health.
Stages of cancer of the testicle
Once cancer of the testicle has been found, more tests will be done to find out if the
cancer has spread from the testicle to other parts of the body (staging). A doctor needs
to know the stage of the disease to plan treatment. The following stages are used for
cancer of the testicle:
Stage I
Cancer is found only in the testicle.
Stage II
Cancer has spread to the lymph nodes in the abdomen (lymph nodes are small, bean-shaped
structures that are found throughout the body; they produce and store infection-fighting
cells).
Stage III
Cancer has spread beyond the lymph nodes in the abdomen. There may be cancer in parts
of the body far away from the testicles, such as the lungs and liver.
Recurrent
Recurrent disease means that the cancer has come back (recurred) after it has been
treated. It may come back in the same place or in another part of the body. A patient
should regularly examine the opposite testicle for possible recurrence for many years
after treatment. Patients will probably have check-ups once per month during the first
year after surgery, every other month during the next year, and less frequently after
that.
How cancer of the testicle is treated
There are treatments for all patients with cancer of the testicle, and most patients
can be cured with available treatments. Four kinds of treatment are used:
- surgery (taking out the cancer in an operation)
- radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer
cells)
- chemotherapy (using drugs to kill cancer cells)
- bone marrow transplantation
Surgery is a common treatment of most stages of cancer of the testicle. A doctor may
take out the cancer by removing one or both testicles through an incision (cut) in the
groin. This is called a radical inguinal orchiectomy. Some of the lymph nodes in the
abdomen may also be removed (lymph node dissection).
Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and shrink
tumors. Radiation therapy for testicular cancer usually comes from a machine outside the
body (external-beam radiation).
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it
may be put into the body by a needle in a vein. Chemotherapy is called a systemic
treatment because the drugs enter the bloodstream, travel through the body, and can kill
cancer cells outside the testicle.
Bone marrow transplantation is a newer type of treatment. For autologous bone marrow
transplant, bone marrow is taken from the patient and treated with drugs to kill any
cancer cells. The marrow is then frozen and the patient is then given high-dose
chemotherapy with or without radiation therapy to destroy all of the remaining marrow. The
marrow that was taken out is then thawed and given back to the patient through a needle in
a vein to replace the marrow that was destroyed.
Treatment by stage
Treatment of cancer of the testicle depends on the stage and cell type of the disease,
and the patient's age and overall condition.
Standard treatment may be considered because of its effectiveness in patients in past
studies, or participation in a clinical trial may be considered. Not all patients are
cured with standard therapy and some standard treatments may have more side effects than
are desired. For these reasons, clinical trials are designed to find better ways to treat
cancer patients and are based on the most up-to-date information. Clinical trials are
ongoing in many parts of the country for all stages of cancer of the testicle. To learn
more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER
(1-800-422-6237); TTY at 1-800-332-8615.
Treatment depends on what the cancer cells look like under a microscope (cell type). If
a tumor called a seminoma is found, treatment will probably be surgery to remove the
testis (radical inguinal orchiectomy), followed by external-beam radiation to the lymph
nodes in the abdomen. Clinical trials are also being performed on radical inguinal
orchiectomy alone followed by careful testing to see if the cancer comes back.
If a tumor called a nonseminoma is found, treatment may be one of the following:
- 1. Radical inguinal orchiectomy and removal of some of the lymph nodes in the abdomen
(lymph node dissection). Patients may undergo surgery that will preserve fertility. Blood
tests and chest x-rays must be done once each month for the first year following the
operation and at least every 2 months during the second year. A CT scan, a special kind of
x-ray, may also be done. If results of the tests don't look normal and the cancer has
recurred (come back), the doctor will give the patient systemic chemotherapy as soon as
possible.
2. Radical inguinal orchiectomy alone followed by careful testing to see if the cancer
comes back. The doctor must check the patient and do blood tests and x-rays every month
for 2 years. This option is chosen only if the tumor has certain special features.
Treatment depends on what the cancer cells look like under a microscope (cell type). If
a tumor called a seminoma is found and the tumor is nonbulky (no lymph nodes can be felt
in the abdomen, and no lymph nodes block the ureters [the tubes that carry urine from the
kidney to the bladder]), treatment will probably be surgery to remove the testis (radical
inguinal orchiectomy). External-beam radiation is then given to the lymph nodes in the
abdomen.
If a tumor called a seminoma is found and the tumor is bulky (lymph nodes can be felt
in the abdomen and/or the lymph nodes block the ureters, or if a CT scan shows them to be
large), treatment will probably be a radical inguinal orchiectomy followed by systemic
chemotherapy or external-beam radiation therapy.
If a tumor called a nonseminoma is found, treatment will probably be one of the
following:
- 1. Radical inguinal orchiectomy and removal of the lymph nodes in the abdomen (lymph
node dissection). The doctor will check the patient each month and do blood tests, chest
x-rays, and CT scans. If the test results are not normal, patients will probably receive
systemic chemotherapy.
2. Radical inguinal orchiectomy and lymph node dissection, followed by systemic
chemotherapy. Blood tests and chest x-rays must be done once each month for the first year
after the operation. CT scans are also done regularly.
3. Radical inguinal orchiectomy followed by systemic chemotherapy. If x-rays following
chemotherapy show that cancer remains, surgery may be done to remove the cancer. After the
operation, the doctor will check the patient each month and do blood tests, chest x-rays,
and CT scans. In some cases, chemotherapy may be given before the radical inguinal
orchiectomy.
4. Clinical trials of systemic chemotherapy instead of lymph node dissection (in selected
patients).
Treatment depends on what the cancer cells look like under a microscope (cell type). If
a tumor called a seminoma is found, treatment will probably be surgery to remove the
testis (radical inguinal orchiectomy), followed by systemic chemotherapy. Clinical trials
are testing radical inguinal orchiectomy followed by systemic chemotherapy. If a tumor
called a nonseminoma is found, treatment will probably be one of the following:
- 1. Systemic chemotherapy. Clinical trials are testing new chemotherapy drugs.
2. Systemic chemotherapy, followed by surgery to take out any masses that remain to see if
there are any cancer cells left. If cancer cells remain, patients will probably receive
more systemic chemotherapy.
3. Clinical trials of systemic chemotherapy.
4. Clinical trials of high-dose systemic chemotherapy with autologous bone marrow
transplantation (in some patients).
Treatment depends on what the cancer cells look like under a microscope, where the
cancer recurred (came back), and other factors. Treatment options include systemic
chemotherapy, high-dose systemic chemotherapy with autologous bone marrow transplantation,
surgery, and clinical trials testing new chemotherapy drugs.
TO LEARN MORE..... CALL 1-800-4-CANCER
To learn more about cancer of the testicle, call the National Cancer Institute's Cancer
Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. By dialing
this toll-free number, you can speak with a trained information specialist who can answer
your questions.
The Cancer Information Service also has booklets about cancer that are available to the
public and can be sent on request. The following booklets about cancer of the testicle may
be helpful:
- What You Need To Know About Testicular Cancer
Testicular Self-Examination
The following general booklets on questions related to cancer may also be helpful:
- What You Need To Know About Cancer
Taking Time: Support for People with Cancer and the People Who Care About
- Them
What Are Clinical Trials All About?
Chemotherapy and You: A Guide to Self-Help During Treatment
Radiation Therapy and You: A Guide to Self-Help During Treatment
Eating Hints for Cancer Patients
Advanced Cancer: Living Each Day
When Cancer Recurs: Meeting the Challenge Again
There are many other places where people can get material and information about cancer
treatment and services. The social service office at a hospital can be checked for local
and national agencies that help with getting information about finances, getting to and
from treatment, getting care at home, and dealing with problems.
For more information from the National Cancer Institute, please write to this address:
- National Cancer Institute
Office of Cancer Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580
Date Last Modified: 07/98
If you want to know more about cancer and how it is treated, or if you wish to know
about clinical trials for your type of cancer, you can call the NCI's Cancer Information
Service at 1-800-422-6237, toll free. A trained information specialist can talk
with you and answer your questions.
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