Overview
Cancer of the testis is a relatively rare form of cancer, which accounts for approximately one percent of all male tumors with more than 5,000 new cases detected annually. Testicular tumors occur mainly between the ages of 20 and 40 years, but there are specific tumors of childhood and elderly men as well. However, the majority of testicular and scrotal lesions identified by patients are benign in nature.
The testicles are responsible for producing sperm and the male hormone testosterone. There are certain risk factors for the development of testicular cancer. Caucasian men have a higher incidence than other ethnic groups. Men with a history of an undescended testicle (usually located in the groin or abdomen) which is not brought back into the scrotum in childhood are at increased risk of cancer and need to be followed carefully even after the testicle is placed into the scrotum.
Evaluation
The most common physical finding is a hard lump in the testicle. It is very important for men to examine both of their testicles on a monthly basis in order to detect tumors early. There is usually no pain in the testicle although at times the breasts may be tender due to production of substances by the tumor that cause tender enlargement of the breast tissue. Men are often embarrassed at the prospect of having a doctor examine their genitals, but early detection is very important in successful treatment.
The doctor will examine the testicles carefully and decide if there is a problem within the testicle, or possibly a structure close to the testicle. An ultrasound may be performed to help determine the relevant anatomy of the testicle and lesion.
Treatment
If a testicle tumor is identified, then the testicle will need to be removed surgically. Pre-operative chest X-rays and blood tests will be performed. The most important determinant of future treatment is dependent on the exact pathologic diagnosis and staging by X-rays. Radiation therapy, chemotherapy and surveillance are options, depending on the data accumulated. Some patients will need to undergo a surgical removal of the abdominal lymph nodes to rule out involvement of these areas. The good news is that greater than 95 percent of men will have their disease successfully eradicated.