Regional Cancer Center ~ Erie, PA

What is Testicular Cancer?

Apr 21, 2015 | Posted in News

Testicular cancer is a disease in which cancer develops in one or both of the testicles. It occurs when germ cells experience abnormal growth. Germ cells, like stem cells, have the potential to form any cell in the body. Normally these cells lie dormant until sperm fertilizes an egg. If germ cells (a sexual reproductive cell) become cancerous, they multiply, forming a mass of cells called tumors that begin to invade normal tissue. When this happens these cells have the potential to form a variety of embryonic like features including but not limited to; hair, nails, teeth etc.

testicular-cancer-awareness

Testicular cancer can metastasize, meaning that it can spread to other parts of the body. During this time cells leave the original tumor from the testicle and migrate to other parts of the body through blood and lymph vessels forming new tumors. Testicular cancer spreads most often to the abdomen, liver, lungs, bones, and brain. Testicular cancer can spread rapidly and is deadly if left untreated.

Testicular cancer has a very fast onset. If not detected early, the cancerous tumors can grow rapidly with the ability to double in size in just 10 - 30 days.

Testicular cancer is on the rise and can affect any male from infancy to the elderly. An estimated 8,500 new cases are diagnosed annually and 1 out of 270 young men will be diagnosed. The highest rate of diagnoses are males between the ages of 15 to 35. Largely due to the lack of awareness & early detection more than 370 deaths will occur in 2013. That's 370 too many.

Different types of Testicular Cancer

  • Seminoma Germ Cell Tumors
  • Nonseminoma Germ Cell Tumors
  • Stromal Tumors

Germ cell tumors make up over 90% of testicular cancer diagnoses. There are two main types of germ cell tumors: seminoma and nonseminoma. They each occur about half of the time. Some cancers include both seminomas and nonseminomas, in this case they are treated as nonseminoma, as they grow and spread like nonseminomas.

Seminomas arise from sperm producing germ cells of the testicles. Seminomas are most likely to occur in men aged 30 to 50. Fortunately, seminomas are very treatable by surgery and respond well to chemotherapy and radiation, if these treatments are needed.

Germ cells can also give rise to nonseminoma tumors which often show characteristics of embryonic tissues or of the embryonal yolk sac. Nonseminoma tumors usually develop earlier in life, normally in men in their 20's. These nonseminoma tumor types include:

  • Embryonal carcinoma
  • Yolk sac carcinoma
  • Choriocarcinoma
  • Teratoma

These tumor types are determined after biopsy or removal of the testicle. Nonseminoma tumors have a slightly less favorable prognosis than seminomas but are still very treatable by chemotherapy and radiation.

Stromal Tumors: Tumors can also arise in the supportive and hormone-producing areas of the testicles. Such tumors are known as gonadal stromal tumors. They account for about 4% of adult testicle tumors and 20% or childhood testicle tumors. The two main types are Leydig and Sertoli cell tumors.

Leydig cells tumors develop from normal Leydig cells of the testicle. These are the cells that normally produce androgens (male sex hormones). Leydig cell tumors are more common in adults (75% of cases). They often produce androgens, but sometimes produce estrogens. Although most Leydig cell tumors do not spread beyond the testicle and are cured by surgical removal, a small number metastasize. Metastatic Leydig cell tumors have a poor prognosis, as they do not respond well to chemotherapy and radiation.

Sertoli cells act as supportive, stromal cells of the testicles that nourish sperm producing cells. The American Cancer Society explains that like Leydig cell tumors, Sertoli cell tumors are usually benign, but are quite dangerous if they are metastatic.

If you find something abnormal with your testicle, it may not be cancer, but you definitely need to go to your doctor for testing, to rule out cancer.

The following are benign causes of testicular abnormalities:

Hydrocele

A hydrocele feels like a small fluid-filled balloon inside the scrotum. It is smooth, and is mainly in front of the testis. Hydroceles vary greatly in size. Hydroceles are normally painless and harmless. Large hydroceles cause discomfort because of their size. As the fluid of a hydrocele is transparent, light shone through a hydrocelic region will be visible from the other side. This phenomenon is called transillumination.

Symptoms of a hydrocele can easily be distinguished from testicular cancer, as a hydrocele is soft and fluidy, where a testicular cancer feels hard and rough.

Through diagnostic ultrasound the accumulation of fluids can be diagnosed correctly.

Varicocele

Varicocele is an abnormal enlargement of the pampiniform venous plexus in the scrotum. This plexus of veins drains the testicles. The testicular blood vessels originate in the abdomen and course down through the inguinal canal as part of the spermatic cord on their way to the testis. Upward flow of blood in the veins is ensured by small one-way valves that prevent backflow. Defective valves, or compression of the vein by a nearby structure, can cause dilatation of the testicular veins near the testis, leading to the formation of a varicocele.

Varicocele can be harmless, but in many cases it can cause infertility and pain. Although there are studies showing improvement in sperm quality in 57%, there are also studies showing that the regular surgery has no significant effect on infertility. Thus the surgery may not improve fertility and the patient will need to undergo a non-invasive treatment.

Symptoms of a varicocele may include:

  • Dragging-like or aching pain within scrotum.
  • Feeling of heaviness in the testicle(s)
  • Atrophy (shrinking) of the testicle(s)
  • Low testosterone.
  • Visible or palpable (able to be felt) enlarged vein

Spermatocele

Spermatoceles can be discovered as incidental scrotal masses found on physical examination by a physician. They may also be discovered by self-inspection of the scrotum and testicles.

Finding a painless, cystic mass at the head of the epididymis, that transilluminates and can be clearly differentiated from the testicle, is generally sufficient. If uncertainty exists, ultrasonography of the scrotum can confirm if it is spermatocele.

If an individual finds what they suspect to be a spermatocele, they are advised to consult a urologist.

Epididymitis

Epididymitis is a medical condition characterized by discomfort or pain in of the epididymis, a curved structure at the back of the testicle in which sperm matures and is stored. Epididymitis is usually characterized as either acute or chronic: if acute, the onset of testicular pain is often accompanied by inflammation, redness, and warmth in the scrotum; if chronic, pain may be the only symptom. In either form, testicular pain in one or both testes can vary from mild to severe, and one or both epididymides may noticeably swell and/ or harden. The pain is often cyclical and may last from less than an hour to several days.

Source: Testicular Cancer Awareness Foundation

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