Q. What is testicular cancer?
A. It’s cancer that forms in tissues of the testis in cells that produce sperm or cells that produce male hormones. The two main types of testicular cancer are seminomas, cancers that grow slowly and are sensitive to radiation therapy, and nonseminomas, different cell types that grow more quickly than seminomas.
Q. How does a man get testicular cancer?
A. The exact causes of testicular cancer are not known. However, studies have shown that several factors increase a man’s chance of developing it, although many men who develop testicular cancer do not have any recognized risk factors.
Risk factors include:
* Undescended testicle (cryptorchidism): Normally, the testicles descend from inside the abdomen into the scrotum before birth. The risk of testicular cancer is increased in males with a testicle that does not move down into the scrotum. This risk does not change even after surgery to move the testicle into the scrotum. The increased risk applies to both testicles.
* Congenital abnormalities: Men born with abnormalities of the testicles, penis, or kidneys, as well as those with inguinal hernia (hernia in the groin area, where the thigh meets the abdomen), might be at increased risk.
* Family history of testicular cancer: The risk for testicular cancer is greater in men whose brother or father has had the disease.
Q. Who gets it?
A. Most commonly, young or middle-aged men.
Q. How is it treated?
A. Surgery to remove the testicle through an incision in the groin, called a radical inguinal orchiectomy, is necessary for diagnosis and is the first step in treatment. In some cases, some of the lymph nodes deep in the abdomen might also be removed, lymph-node dissection.
Radiation therapy aimed at the lymph nodes in the abdomen is often used to treat seminomas.
It is usually given after surgery. Because nonseminomas are less sensitive to radiation, men with this type of cancer usually do not undergo radiation therapy. Chemotherapy is the use of anticancer drugs to kill cancer cells and is most often used for nonseminomas. When chemotherapy is given to testicular cancer patients, it is usually given as adjuvant therapy (after surgery) to destroy cancerous cells that might remain in the body. Chemotherapy might also be the initial treatment if the cancer has spread outside the testicle at the time of the diagnosis.
Q. What are the long-term effects of testicular cancer?
A. It’s one of the most curable types of cancer with a cure rate of more than 90 percent. Patients are at risk for the return of the cancer for several years, and also have a very low risk, 3 percent, of developing an unrelated cancer in the other testicle.
Q. What can men do to lessen the risk of testicular cancer?
A. Cryptorchidism and a family history of the disease are the main known risk factors. None of these factors can be prevented because they are present at birth. Also, many men with testicular cancer have no known risk factors. For these reasons, there is no way to prevent most cases of this disease. But it is wise to correct cryptorchidism before puberty, and knowing that a man has a risk factor, because of a history of cryptorchidism, might cause a young man to be more watchful and to check his testicles, making it more likely that a cancer will be found early.
Q. How often do you see testicular cancer cases in your office?
A. It’s not terribly common. There are only 8,000 to 9,000 new cases annually in U.S. I see a couple of new cases a year.
— By Dr. Kent Hoskins, oncologist at the Center for Cancer Care at OSF Saint Anthony Medical Center
Photos
