Symptoms, Risk and Diagnosis of Testicular Cancer

Testicular cancer forms in the cells of the testicles, glands that produce semen and sperm and are found just below the penis in the scrotum. It is the most common cancer in men 20 to 35 years old. The main goal at the Siteman Cancer Center is to get a correct diagnosis of your condition and decide what treatment is needed. Specialists here excel in using the technology and experience to make an accurate diagnosis, often down to the genetic level so the best treatment options may be identified.

Symptoms of Testicular Cancer

• A painless lump or swelling in either testicle
• A change in how the testicle feels
• A dull ache in the lower abdomen or the groin
• A sudden build-up of fluid in the scrotum
• Pain or discomfort in a testicle or in the scrotum

Risk Factors

• Having had an undescended testicle
• Having had abnormal development of the testicles
• Having a personal history of testicular cancer
• Having a family history of testicular cancer (especially in a father or brother)
• Being Caucasian

Diagnosis

Diagnosing testicular cancer requires more than one approach.

The following tests and procedures may be used:

1. Physical exam and history: The doctor reviews and examines the patient’s past illnesses and treatments and any signs of disease, lumps or tenderness in the testicle or other abnormalities.
2. Ultrasound exam of the testicles: This painless procedure can show dense areas that may indicate a tumor.
3. Serum tumor marker test: A sample of blood is examined to measure any increased amounts of certain substances called tumor markers that are released into the blood. Tumor markers used to detect testicular cancer include alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (β-hCG), and lactate dehydrogenase (LDH).
4. Inguinal orchiectomy: This surgical procedure removes the entire testicle through an incision in the groin. A tissue sample from the testicle is then viewed under a microscope to check for cancer cells. That’s because if the surgeon were to cut through the scrotum into the testicle to remove a sample of tissue for biopsy, and cancer is present, it could cause the cancer to spread into the scrotum and lymph nodes

Staging of Testicular Cancer

Staging is ranked 0 through 3 and recurrent, meaning the cancer comes back after treatment, either in the other testicle or another part of the body. Because stage is an important factor in treatment options, additional testing to determine stage may include:

CT-PET Scan: This shows detailed pictures of organs to reveal cancer within the testicles if it is present and glucose uptake activity of tumor cells, which locates involvement with other organs or lymph nodes.

Abdominal lymph node dissection: This surgical procedure removes lymph nodes in the abdomen to obtain a sample of tissue to check under a microscope for signs of cancer. This procedure is also called lymphadenectomy. For patients with nonseminoma, removing the lymph nodes may help stop the spread of disease. Cancer cells in the lymph nodes of seminoma patients can be treated with radiation therapy.

Tumor marker levels are measured again after surgery in order to determine the stage of the cancer. It helps to show if all of the cancer has been removed or if more treatment is needed.