Testicular cancer self examination

Definition

Testicular cancer is a cancerous growth occurring in the male gonads, or testes. The testes are located outside the body cavity, in the scrotum.

Description

Although testicular cancer is a rare type of cancer, it often grows very quickly. It is the most common type of cancer to occur in young males, with most cases occurring in men under the age of 30 years. Recent advances in treatment, however, have made testicular cancer very manageable and curable. Testicular cancer is more prevalent in males whose testes have not descended into the scrotum. There are several cell types present in the testes, any of which can be involved in cancer. The two basic subtypes of testicular cancer are the seminomas and the non-seminomas. Although the incidence of testicular cancer has been increasing for the past 40 years, its cause is unknown.

Causes & symptoms

Testicular cancer usually shows no early symptoms. It is suspected when a mass is felt in the testes, although a testicular mass does not necessarily mean cancer. It is important for men to perform periodic examinations of their testes in order to detect any mass at an early stage. In advanced cases, or metastatic testicular cancer, symptoms include lower back pain and discomfort, difficulty in urinating, a cough, and breathing difficulties. A feeling of heaviness in the testes is also common and there is sometimes pain.

No cause for testicular cancer has been identified. Exposure of the fetus to certain chemicals or an individual's exposure to environmental estrogens may cause changes in cells that could lead to testicular cancer. As of yet, however, there is no conclusive evidence to name a cause. Higher rates of testicular cancer occur in men with HIV infection, suggesting that the two may also be related. Studies examining the relationship of testicular trauma, such as may occur with bike riding, and the occurrence of testicular cancer found that trauma does not contribute to testicular cancer.

Diagnosis

Once a mass is identified in the testes, the abdomen and other areas of the body are felt (palpated) to check for additional masses. A computed tomography scan (CT scan) of the abdomen and pelvis, as well as chest x rays, are performed to determine if the cancer has spread to other areas of the body. Sometimes the lymphatic vessels are also examined by x ray (lymphangiogram). There are some blood tests that are also helpful, including serum alpha-fetoprotein (AFP) and beta-subunit human chorionic gonadotropin (beta-hCG). These tests will allow the oncologist to stage the tumor, or determine the type, extent, and severity of the cancer. These blood tests can also be used to monitor the progress of treatment and check for recurrences of testicular cancer. A tissue sample (biopsy) will also be taken to confirm the diagnosis of cancer.

Treatment

Treatment for testicular cancer depends upon the stage of the cancer. However, the first line of treatment is usually surgery to remove the mass. If the cancer has spread to other parts of the body, surgery is followed by chemotherapy, using anti-cancer drugs such cisplatin, bleomycin, vincristine, etoposide, and methotrexate. Radiation therapy may also be used to treat testicular cancer.

Alternative treatment

No alternative treatments are known for testicular cancer. However, alternative therapies may be helpful to support the person undergoing conventional treatment for testicular cancer. Dietary modifications emphasizing whole foods and healthy fats, nutritional supplementation, acupuncture, Chinese and western botanical medicine, and homeopathy can strengthen the person and assist with recovery from surgery, chemotherapy, or radiation.

Prognosis

The cure rate for testicular cancer that hasn't spread (non-metastatic) is 95%. This high cure rate for testicular cancer that is caught early makes self-examination extremely important. The most common type of testicular cancer, seminoma, has an overall five-year survival rate of 80-90%. Choriocarcinomas, a non-seminomatous type, are rare but have a poorer prognosis. Patients cured of testicular cancer, however, need to be seen frequently because they are at a greater risk for developing additional cancers later in life, especially leukemias. This may be due to treatment procedures.

Prevention

Since the causes of testicular cancer are unknown, it is difficult to give specific measures to prevent it. One theory is that testicular cancer is related to exposure to environmental estrogens, such as insecticides and byproducts of the plastics industry. It is possible that avoidance of these products may decrease the risk of this type of cancer. Many types of cancers are associated with smoking. Stopping or cutting back on smoking decreases the risk of many cancers, and may also decrease the risk of testicular cancer. Other suspected causes for testicular cancer occur prenatally; one of these is smoking during pregnancy. Long term studies are underway to investigate this possibility.

Key Terms

Cisplatin

A metal-based drug used to treat cancer.

Environmental estrogen

Compounds found in pesticides and industrial chemicals that have an estrogen-like effect in the body. It is suspected by some scientists that these compounds may cause some cancers.

HIV

The virus that is associated with AIDS, or acquired immunodeficiency syndrome.

Metastatic testicular cancer

Testicular cancer that has spread to other parts of the body.

Further Reading

For Your Information

Books

• Garnick, M.B., et al. "Cancer of the Testis." In Cancer Manual. 9th ed. Boston, MA: American Cancer Society, 1996.
• Kassabian, V.S., and S.D. Graham. "Urologic and Male Genital Cancers." In Clinical Oncology, 2nd ed. Atlanta, GA: American Cancer Society, 1995.

  Periodicals

• Ginsburg, J. "Unanswered Questions in Carcinoma of the Testis." The Lancet 349 (June 21, 1997): 1785-1786.
• "Metastatic Testicular Cancer." Clinical Reference Systems (December 1994): 1052.
• Parker, L. "Causes of Testicular Cancer." The Lancet 350 (September 20, 1997): 827-829.
• "Presence May Indicate Need for HIV Screening." AIDS Weekly Plus (June 3, 1996): 21.
• "Secondary Cancers Afflict Men Treated for Testicular Cancer." Cancer Weekly Plus (October 20, 1997): 14.

  Organizations

• National Cancer Institute. Cancer Information Service. (800) 4-CANCER.

  Other

• Quackwatch: Questionable Cancer Therapies. http://www.quackwatch.com.
• Cancer Care News. http://www.cancercarinc.org.

Gale Encyclopedia of Medicine. Gale Research, 1999.