Testicular Cancer. This reference summary will help you better understand what testicular cancer is and what treatment options are available.

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1 Testicular Cancer Introduction Testicles, or testes, make male hormones and sperm. The testicles are two egg-shaped organs inside the scrotum, the loose sac of skin behind the penis. You can get cancer in one or both testicles. Testicular cancer mainly affects men between the ages of 20 and 39. Treatment is available, but it can affect fertility. This reference summary will help you better understand what testicular cancer is and what treatment options are available. The Male Reproductive System The male reproductive organs include: The testicles. The duct system, made up of the epididymis and the vas deferens. The accessory glands, which include the seminal vesicles and prostate gland. The penis. Male reproductive organs are located both inside and outside the pelvis. The testicles are egg-shaped glands that sit in a soft pouch outside the pelvis called the scrotum. Testicle 1

2 The testicles have 2 main functions: The production of sperm, which are the male reproductive cells. The production of hormones, including testosterone. Testosterone is a hormone. During puberty, testosterone causes boys to develop deeper voices, bigger muscles and body and facial hair. It also stimulates the production of sperm. The epididymis and the vas deferens make up the duct system. They are located alongside the testicles. The epididymis is a set of two tubes. Each tube connects a testicle to the vas deferens. This system is located in the scrotum. The vas deferens is a tube of muscle that transports the sperm to the seminal vesicles. The accessory glands are the seminal vesicles and the prostate gland. These glands keep sperm healthy. They also make semen. The urethra is the channel that carries semen to the outside of the body through the penis. It also carries urine from the bladder to the outside of the body. The penis is made up of two parts: the shaft and the glans. The main part of the penis is called the shaft. The tip of the penis is called the glans, or the head. At the end of the glans is an opening. Semen and urine exit the body through this opening after traveling through the urethra. Testicular Cancer The body is made up of very small cells. Normal cells in the body grow and die in a controlled way. Sometimes cells keep dividing and growing in an uncontrolled way. This causes an abnormal growth called a tumor. Normal Cell Growth Abnormal Cell Growth (Tumor) If the tumor does not invade nearby tissues and body parts, it is called a benign tumor. A benign tumor is a non-cancerous growth. Benign tumors are usually not life threatening. 2

3 If the tumor invades nearby tissues and body parts, it is called a malignant tumor or cancer. Cancer cells spread to different parts of the body through blood vessels and lymph channels. Lymph is a clear fluid produced by the body that drains waste from cells. It travels through special vessels and bean-shaped structures called lymph nodes. Cancers in the body are given names, depending on where the cancer started. Cancer that begins in the testicles will always be called testicular cancer, even if it spreads to other places. Cancer that moves from one tissue to other body parts is known as metastatic cancer. Testicular cancer may develop in one or both of the testicles. Compared with other types of cancer, testicular cancer is rare. But it is one of the most common cancers diagnosed in young men. Almost all testicular cancers start in the germ cells. Germ cells are Lymph Channels cells that make sperm. The two main types of testicular germ cell tumors are seminomas and nonseminomas. Nonseminomas tend to grow and spread more quickly than seminomas. Seminomas are more sensitive to radiation. A testicular tumor that contains both seminoma and nonseminoma cells is treated as a nonseminoma. Risk Factors It is usually impossible to specify the cause of cancer in an individual patient. But we do know what causes cancer in general. Health care providers also know factors that can increase the chances of getting cancer. These are known as risk factors. Testicular cancer mainly affects young men between the ages of 20 and 39. It is also more common in men who: Have had abnormal testicle development. Have had an undescended testicle. Men who have had a personal or family history of testicular cancer are also at an increased risk. This is especially true if the father or brother has had testicular cancer. Not everybody who has risk factors for cancer gets it. Some people who have no risk factors for cancer can still get cancer. 3

4 Symptoms Common symptoms of testicular cancer include: A change in how the testicle feels. A dull ache in the lower abdomen or the groin. A painless lump or swelling in either testicle. Pain or discomfort in a testicle or in the scrotum. Testicular cancer can also cause: A feeling of heaviness in the scrotum. A sudden build-up of fluid in the scrotum. Breast growth or enlargement. Tenderness of the breasts. These symptoms may not be caused by testicular cancer. Make sure to see a health care provider to find out what is causing your symptoms. Diagnosis Your health care provider will ask about your personal and family medical history. A physical exam will be performed. The testicles will be examined to check for lumps, swelling or pain. Tests that can help diagnose testicular cancer include: Ultrasound exam. Serum tumor marker test. During an ultrasound exam, high-energy sound waves are bounced off internal tissues or organs and make echoes. The echoes form a picture of structures inside the body. For a serum tumor marker test, a blood sample is tested to measure the amounts of certain substances. Some substances are linked to specific types of cancer when found in increased levels in the blood. Sometimes testicular cancer is not diagnosed until after surgery. During a radical inguinal orchiectomy and biopsy, the entire testicle is removed through an incision in the groin. A tissue sample from the testicle is then viewed under a microscope to check for cancer cells. 4

5 Staging If you have testicular cancer, your health care provider will determine the stage of the cancer. Staging is an attempt to find out if the cancer has spread and, if so, to which parts of the body. Testicular cancer is usually described using the numbers 1-4. A lower number indicates an earlier stage. The stage of cancer is determined based on: The size of the tumor. Whether the cancer has spread to lymph nodes. Whether the cancer has spread to other parts of the body and, if so, where. Tests used to diagnose testicular cancer are also used to stage the cancer. Sometimes staging is not complete until after surgery to remove the tumor and nearby lymph nodes. Treatment and Supportive Care The type of treatment for testicular cancer depends on the size and location of the tumor, the stage of the disease and the health of the patient. Treatment for testicular cancer may include: Surgery. Radiation therapy. Chemotherapy. Stem cell transplant. Some combination of these treatments may be used. Surgery is the most common treatment of testicular cancer. It involves removing the cancer and some of the healthy tissue around it. Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. 5

6 Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be given in the blood stream through an IV or taken by mouth. It can also be placed in a specific area of the body. The type used depends on the type and stage of the cancer being treated. With a stem cell transplant, high-dose chemotherapy is first given to destroy cancer cells. Stem cells are immature blood cells. They are removed from the blood or bone marrow of the patient or a donor. They are then frozen and stored. Aft er the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These stem cells grow into and restore the body s blood cells. Cancer and its treatment can lead to other health problems. It is important to have supportive care before, during and after cancer treatment. Supportive care is treatment to control symptoms. Supportive care also deals with the pain associated with cancer and its treatments. Your health care provider or a pain control specialist can suggest ways to relieve or reduce pain. Treatments may cause infertility. If you may want children later on, you should consider sperm banking before treatment. Summary Testicles, or testes, make male hormones and sperm. The testicles are two eggshaped organs inside the scrotum. You can get cancer in one or both testicles. Testicular cancer mainly affects young men between the ages of 20 and 39. Common symptoms of testicular cancer include: A change in how the testicle feels. A dull ache in the lower abdomen or the groin. A painless lump or swelling in either testicle. Pain or discomfort in a testicle or in the scrotum. 6

7 Many tests can help diagnose and stage testicular cancer. Sometimes diagnosis and staging is not complete until after surgery to remove the tumor and nearby lymph nodes. Treatment options for testicular cancer usually involve surgery, radiation therapy, chemotherapy or a stem cell transplant. Often cancer is most treatable in its early stages. Research already has led to advances that have helped people with cancer live longer. Research continues to find better ways to care for people with cancer. 7

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