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Testicular cancer is a malignancy that grows within a man's testicle.

What is going on in the body?

Testicular cancer is uncommon. It is responsible for only half of one percent of all male cancer deaths. As rare as it is overall, it is still the most common cancer in men between the ages of 29 and 35. It occurs most often in white men.

Testicular cancer occurs in two major types: seminoma, which is the more common, and nonseminoma germ cell tumors. Usually testicular cancer occurs only in one testicle.

What are the signs and symptoms of the disease?

A painless swelling of the testicle is the most common symptom. Sometimes a man will notice this swelling after he has had an injury to the scrotum. The injury is not responsible for the cancer.

What are the causes and risks of the disease?

In most cases, the cause of testicular cancer is unknown. Men who have an undescended testicle are at greater risk for the disease. The male children of women who took hormones while pregnant may also be at greater risk.

What can be done to prevent the disease?

Nothing can be done to prevent this kind of cancer. Any lump in the testicle should be reported promptly to a healthcare provider. Early detection is critical to successful treatment. It is important that every man perform testicular self-examination routinely.

How is the disease diagnosed?

Certain body chemicals such as alpha fetoprotein and beta human chorionic gonadotrophin are produced by some testicular cancers. These are called tumor markers. A small amount of blood will be drawn to look for these. The only sure way to determine if cancer is present, however, is to remove the testicle.

What are the long-term effects of the disease?

This cancer is fatal if not treated. With treatment, however, over 70% of men are long-term survivors.

What are the risks to others?

Testicular cancer cannot be spread to other people, even intimate partners.

What are the treatments for the disease?

Testicular cancer treatment is extremely effective. The cancer can be cured even if the disease has spread to other parts of the body.

In addition to removal of the affected testicle, treatment may include:

• additional surgery. During surgery, lymphatic tissue in the abdomen is removed for testing. If lymph nodes are still suspected of harboring cancer after treatment, these may be removed as well.
• radiation therapy to the lymph nodes in the abdomen. This therapy is given to men with seminomas, especially in the early stages. In some cases, chemotherapy will be given in addition to radiation therapy.
• chemotherapy. This treatment is given to men with nonseminomas or seminomas that are large or have spread. Chemotherapy is often used when other treatments have not been effective. Cisplatin (i.e., Platinol AQ), bleomycin, and etoposide are the medications most commonly used, often in combination.

What are the side effects of the treatments?

Side effects can vary widely. Specific side effects depend on the particular treatment.

Orchiectomy, or removal of the testicle, may cause the man distress. However, removal of the testicle does not cause erectile dysfunction.

Lymph node removal can cause a reduction in ejaculate, the amount of fluid ejected with orgasm. Radiation therapy can cause:

• fatigue that goes away after treatment is completed
• inflammation of tissue that has been exposed to radiation.

• nausea and vomiting
• immune system suppression, which makes the man more susceptible to infection.
• infertility, which may be temporary or permanent
• hair loss, known as alopecia

What happens after treatment for the disease?

The man will recover from side effects of treatment within a few months. He will able to resume his normal activities at that time.

How is the disease monitored?

After therapy, the man will be watched for signs that the cancer has come back. The frequency of monitoring will decrease over time. This monitoring may be done with CT scans of the abdomen, or monitoring the blood tumor markers if they were initially elevated.