Testicular cancer is a malignant tumor that occurs in one of the two testicles. Men between the ages of 25 and 45 are particularly affected; for the vast majority of them, the cancer can be cured. How can you recognize testicular cancer and what treatment helps?
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Quick overview
Definition: Testicular cancer is a malignant cell growth that usually only occurs in one of the two testicles and primarily affects men between 25 and 45.
Symptoms: Testicular cancer is initially characterized by painless swelling or hardening in one of the two testicles. Later, a feeling of heaviness or pulling pain often occurs.
Cause: The causes of testicular cancer are not clearly understood. However, there are factors that increase the risk of developing testicular cancer – including congenital undescended testicles or a family history.
Diagnosis: In the urological practice, a palpation examination is carried out. The blood is also examined. The size and location of the testicular tumor can be determined using ultrasound, CT and/or MRI.
Treatment: The affected testicle is surgically removed. Chemotherapy and/or radiation therapy may then be carried out afterwards.
Article content at a glance:
Where testicular pain comes from
What is testicular cancer?
Testicular cancer – also called testicular tumor or testicular carcinoma – is a malignant cell growth that arises from the testicular tissue in men. Depending on which cell type the tumor arises from, experts differentiate between two types of cancer:
- Seminoma: Germ cell tumors of the testicle from spermatogonia (germ tissue)
- Non-seminoma: Testicular tumors from other tissue, for example teratoma or stromal tumors
In 95 percent of cases, only one testicle is affected; However, if the tumor is not treated in time, it can spread to the other testicle, the epididymis or the vas deferens.
Testicular cancer is one of the rare cancers. Men between the ages of 25 and 45 are particularly often affected – in this age group, testicular cancer accounts for a quarter of all cancers, making it the most common type of cancer in young men. In Germany, around 4,000 men develop testicular cancer every year.
Symptoms of testicular cancer
Typical of testicular cancer is an initially painless swelling or hardening of a testicle (“lump”). Many patients also complain of a feeling of heaviness in the testicles or describe pulling pain.
As the disease progresses, the testicle becomes increasingly enlarged and sometimes back pain occurs, which is caused by an enlargement of the lymph nodes in the back of the abdomen.
Because some testicular tumors release female hormones, in some cases the mammary gland becomes enlarged (gynecomastia).
Therapy: How is testicular cancer treated?
The aim of any treatment for testicular carcinoma is to completely remove the affected tissue. That’s why treatment always begins with the surgical removal of the affected testicle (orchiectomy) and any affected lymph nodes. If the patient wishes, a testicular implant can be inserted during this operation.
Depending on the type (seminoma or non-seminoma) and stage of the tumor disease, various treatment options are available:
Chemotherapy: If the cancer has already spread to other parts of the body (metastases), chemotherapy with medication is carried out. Sometimes chemotherapy is also given as a precaution to kill any remaining but not yet visible cancer cells.
Irradiation: Radiation therapy can also be used both as a precaution and to combat metastases. The tumor tissue is prevented from further cell division by high-energy ionizing radiation.
controlled waiting: If you are afraid of the side effects of chemotherapy and/or radiation therapy and do not have metastases, you can simply wait and see whether a relapse occurs. However, this strategy requires regular and careful check-ups in order to be able to react quickly if the cancer recurs.
Prevention: How can testicular cancer be prevented?
Since the causes of testicular cancer are not clearly understood, there are no concrete measures to prevent testicular cancer – apart from a healthy lifestyle.
However, as part of early detection, men can help ensure that changes in the testicles are detected and treated early with regular palpation examinations of the testicles. This improves the prognosis significantly. Anyone who belongs to one of the risk groups due to family history or other factors should have regular check-ups with a doctor from the age of 27.
Prognosis and chance of survival for testicular cancer
Testicular cancer is one of the most treatable cancers: depending on the type and stage of the tumor, 96 out of 100 people affected survive. Even if metastases have already formed, survival rates are 50 to 90 percent.
The earlier diagnosis and treatment occurs, the greater the chances of recovery. Most recurrences (relapses) occur within the first two years after treatment, which is why regular check-ups are recommended.
Since radiation and chemotherapy can have an impact on fertility and sperm quality, if you want to have children, it is recommended to freeze sperm before starting treatment.
Causes and risk factors of testicular cancer
The causes for the development of testicular cancer have not yet been clearly clarified. However, there are some risk factors that have been proven to increase the likelihood of developing testicular cancer:
Undescended testicles: If the testicle does not descend into the scrotum during the embryonic period, but remains in the abdominal cavity or groin, the risk of later developing testicular cancer is increased tenfold. This also applies if the undescended testicles are corrected surgically.
genetic predisposition: If the father or brother has testicular cancer, there is an increased risk of also developing a testicular tumor.
previous cancer: Three to five out of 100 patients who have already had a testicular tumor also develop testicular cancer on the other side.
Infertility: Testicular cancer is 20 times more common in men with fertility problems than in normally fertile men.
Congenital malformation of the urethral meatus: If the opening of the urethra is on the underside of the glans (hypospadias), the risk of developing testicular cancer increases.
Diagnosis when testicular cancer is suspected
Most testicular tumors are recognized by those affected in their early stages. Young men are therefore recommended to examine their testicles once a month for enlargements or hardening – this is best done while standing in the shower or after a warm bath. If changes are discovered, you should see a doctor as quickly as possible.
To diagnose testicular cancer, a detailed discussion (anamnesis) is first carried out. The specific complaints, the medical history and any existing risk factors are asked. This is followed by a physical examination in which the testicles, mammary glands and abdominal area are palpated.
If testicular cancer is suspected, a blood test is carried out for tumor markers: These are substances that are produced by tumor cells and indicate cancer. The size and location of the tumor can be determined using an ultrasound examination (sonography). CT (computed tomography) and/or MRI (magnetic resonance therapy) of the abdomen and pelvis are used to check whether the disease has already spread to other areas of the body.
If all of these examinations confirm the suspicion of testicular cancer, the affected testicle is surgically exposed in the next step. The tumor can usually be seen with the naked eye, and a tissue sample is taken and examined for changes. If it is actually cancer, the affected testicle is removed directly in the same operation.
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