Out of all the health issues that affect men annually, cancer is in the top ten. Prostate cancer is the most common cancer in American men, and almost 200,000 new cases are diagnosed annually and more than 30,000 men die from it each year. Annual physicals screen for this type of cancer so it can be detected and treated quickly—however, the number of cases continue to rise.
Men have a little more to be worried about, however. Another cancer that is gaining traction with men is testicular cancer. While it’s not too common yet (only 1 out of every 250 men will develop testicular cancer at some point in their lifetime,) it can have profound effects on quality of life and fertility. While prostate cancer tends to present in older men (55 and above,) the average age of men at the time of a testicular cancer diagnosis is about 33. Younger men and teens can also develop the disease, but only a handful of senior men develop testicular cancer beyond middle age.
What is Testicular Cancer?
Testicles are a part of the male reproductive system. Their two main functions are to make male hormones such as testosterone, and to make sperm, the male cells needed to fertilize a female egg cell. Sperm cells are made inside the testicles in tubes called seminiferous tubules. These tubules are then stored in the epididymis, a small coiled structure behind the testicle. This is where they mature, a process that takes approximately three months.
During ejaculation, sperm cells are carried from this structure through another tube to mix with other fluids in the body that make up semen. The semen then exits the body through the urethra, a tube that runs through the center of the penis.
A high school health class has likely taught you the basics of both the male and female reproductive systems—but very little about how cancer cells may affect the function of these systems. Simply put, cancer starts when normal cells in our body begin to mutate or grow outside of their normal rate—they grow out of control. Because cells multiply in our bodies, the longer we go without discovering them, the more the cells have a chance to reproduce, causing cancer to spread. Nearly any cell in the body can develop cancer, and because cells in our body move around it constantly, cancer spreads in this way.
The Many Types of Testicular Cancer
The many parts of our bodies are made up of many different types of cells, and each type of cell has the ability to develop into a type of cancer. Each type of cancer is treated differently, and physicians can typically tell what type of cancer exists by doing a few basic tests. Because testicles are made up of many types of cells, many different types of cancers can grow within them:
Germ cell tumors
Most testicular cancer begins in cells that make sperm—known as germ cells. The main types of germ cell tumors are called seminomas and non-seminomas. These tumors occur in patients at the same rate, as many cancers contain both types of cells. The main difference between seminomas and non-seminomas are the speed at which they grow and what the cell looks like under a microscope. Seminomas mainly occur in men between the ages of 25 and 45 and can raise levels of a protein called human chorionic gonadotrophin (HCG)—the same protein that rises in a woman when she is pregnant. This level can be tested with a simple blood test.
Non-seminomas typically occur in men ages 18-30. The tissues of non-seminomas look remarkably similar to the tissues of very early embryos or very early yolk sacs seen in pregnancy. Non-seminomas are the most common form of testicular cancer found in children, and rare in adults.
Carcinoma in situ (CIS)
Carcinoma in situ (CIS) cancers doesn’t usually become an invasive form of cancer, meaning that it’s unlikely to spread to other parts of the body. CIS cells look abnormal under a microscope, but are contained within the tubules that store sperm. CIS cells can spread to other parts of the body, but it is rare.
Stromal tumors
Stromal tumors are responsible for less than 5% of adult testicular cancer cases, but 20% of childhood testicular cancer diagnosis. They are cancer cells that grow in the tissues of the testicles. They can cause the testicles to produce estrogen instead of testosterone, and certain types of these tumors can be particularly resistant to treatment.
Lymphoma and leukemia
Testicular lymphoma is actually a cancer that is born in another part of the body and metastasizes to the testicles. It is known as a secondary testicular cancer. Secondary testicular cancers are much more common in men over 50.
Signs, Symptoms and Survival Rates
Just how do you know if something’s wrong with your testicles? The American Cancer Society recommends a monthly testicular self-exam, just as women are advised to perform a monthly self-breast exam. Typically though, the first symptom of testicular cancer is a lump on the testicle, or the testicle becoming swollen or larger than normal. It’s normal for one teste to be larger than the other, but any abnormal changes should be brought to the attention of a doctor. Some cancer cells can cause early puberty in boys, and cause breast pain or growth. Advanced testicular cancer can present as lower back pain, shortness of breath, belly pain or headaches—these are often signs that the cancer has spread to other areas of the body.
A physician will perform an examination, blood test, or ultrasound to determine the presence and type of testicular cancer and the stage of the cancer. Treatments typically include chemotherapy, radiation, or surgery.
Future Family and Quality of Life
One of the biggest questions young men have after being diagnosed with testicular cancer is how the cancer may affect their future chances of starting a family. Because testicular cancer occurs so close to where sperm is stored for maturation, cancer cells may have an effect on male fertility.
The good news is that most men develop cancer in only one testicle. The remaining testicle usually makes enough testosterone to keep fertility functioning normally. If not, hormone replacement therapy is available to ensure that hormone levels are kept steady. Testicular cancer and treatment for testicular cancer can cause infertility, so some men choose to store sperm and freeze it for later use. In some cases, male infertility due to testicular cancer treatment is temporary—fertility usually returns about two years after stopping chemotherapy treatments.
Life with one testicle is not so different than life with two if hormone levels are regulated and your body is functioning as it should. Always talk with your doctor if you have any concerns about symptoms, treatments or potential effects of testicular cancer.
Disclaimer: The contents of this article, including text and images, are for informational purposes only and do not constitute a medical service. Always seek the advice of a physician or other qualified health professional for medical advice, diagnosis, and treatment.
