Testicles (testes) are male sex glands that make and store sperm. Testicular malignancies are cancers that start in one of the testicles. About 7500 new cases are diagnosed each year in the United States. Most occur in men between 15 and 40 years old.
The cause is unknown. Men with a greater chance of getting it include those born with an undescended testicle and those who have fathers or brothers with testicular cancer. Testicular cancer isn’t contagious.
The most common first symptom is a painless lump or swelling on or around the testicle. Other symptoms are a feeling of fullness or heaviness in the scrotum (the sac or pouch that holds the testicles), swollen lymph glands (nodes) in the groin or thigh, back pain, and testicular or scrotal pain.
The best way to find testicular cancer is by doing self-examination of the testicles. A health care provider will diagnose testicular cancer by doing a physical examination (including testicles) and ordering an ultrasound scan to find the mass. Ultrasound uses sound waves to see inside testicles; it’s painless and harmless. If ultrasound shows a mass (lump), a urologist will operate to remove the testicle.
Staging is done to find out how far the disease has spread. Staging involves blood tests, computed tomography (CT), and possibly surgery to remove lymph nodes (called retroperitoneal lymph node dissection, or RPLND).
Stage I disease means the cancer is only in the testicle. Stage II disease has spread to nearby lymph nodes. Stage III disease has spread far from the testicles.
Treatment depends on the type of cancer (seminomatous or nonseminomatous) and its stage. Seminomatous tumors without spread are treated with radiation. With distant spread, chemotherapy is used.
Surgery (RPLND) is used for early-stage nonseminomatous tumors. For more advanced disease, chemotherapy is added.
Having one testicle removed shouldn’t affect having sex or children.
Almost 90% of newly diagnosed testicular cancers are curable. Even cancers that spread have very good cure rates of 70% to 80%.
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