How do we treat testicular cancer?
Treatment Options for Testicular Cancer, by Type and Stage
- Carcinoma in situ (stage 0) testicular tumors. In this stage, the cancer has not spread outside the testicle, and tumor marker levels (like HCG and AFP) are not elevated.
- Seminomas. These cancers can be cured in nearly all patients. ...
- Non-seminomas. ...
- Stage III seminomas and non-seminomas. ...
- Recurrent testicular cancer. ...
- Sertoli cell and Leydig cell tumors. ...
How rare is testicular cancer?
Testicular cancer is not common: about 1 of every 250 males will develop testicular cancer at some point during their lifetime. The average age at the time of diagnosis of testicular cancer is about 33.
How do testicular tumors usually present?
The majority of testicular cancers start in germ cells. Germ cells in your testicles make sperm. When these cells begin to grow out of control, they form two main types of tumors: seminomas and non-seminomas. They grow and spread at different rates. Most seminoma tumors grow more slowly than non-seminoma tumors.
What causes testicle cancer?
What are the risk factors for testicular cancer?
- Cryptorchidism (an undescended testicle)
- Abnormal testicle development due to Klinefelter syndrome or Down’s syndrome
- Family history of testicular cancer
- Human immunodeficiency syndrome ( HIV) infection
- Infertility
- Previous history of testicular cancer
- Belonging to a certain race/ethnicity
- Age
Which is more common seminoma or nonseminoma?
Nonseminoma: This more common type of testicular cancer tends to grow more quickly than seminomas.
What are the three types of testicular cancer?
Types of testicular cancerGerm cell tumors. Within germ cell tumors are three types of testicular cancers: ... Rare testicular tumors. Stromal tumors are sometimes referred to as gonadal stromal tumors. ... Lymphoma. ... Carcinoma in situ of the testicle. ... Recurrent testicular cancer.
Where is testicular cancer most common?
Worldwide, the risk of developing testis cancer is highest in the United States and Europe and lowest among men living in Africa or Asia.
What is the most common type of testicular cancer found in males around the age of 30?
Classical seminoma: More than 95% of seminomas are classical. These usually occur in men between 25 and 45. Spermatocytic seminoma: This rare type of seminoma tends to occur in older men.
What type of testicular cancer is more aggressive?
Embryonal carcinoma: present in about 40 percent of tumors and among the most rapidly growing and potentially aggressive tumor types. Embryonal carcinoma can secrete HCG or alpha fetoprotein (AFP).
What are the 5 warning signs of testicular cancer?
Signs and symptoms of testicular cancer include:A lump or enlargement in either testicle.A feeling of heaviness in the scrotum.A dull ache in the abdomen or groin.A sudden collection of fluid in the scrotum.Pain or discomfort in a testicle or the scrotum.Enlargement or tenderness of the breasts.Back pain.
What are three 3 risk factors for testicular cancer?
Risk factors for testicular cancer include:Undescended testicles (cryptorchidism) ... Abnormal cells in the testicle (germ cell neoplasia in situ, or GCNIS) ... Family history. ... Previous testicular cancer. ... Abnormality of the penis and urethra (hypospadias) ... HIV or AIDS. ... Ethnic background.
What is the main cause of testicular cancer?
Undescended testicles (cryptorchidism) is the most significant risk factor for testicular cancer. Around 3 to 5% of boys are born with their testicles inside their abdomen. They usually descend into the scrotum during the first year of life, but in some boys the testicles do not descend.
Is Stage 3 testicular cancer curable?
Even though stage III cancers have spread by the time they are found, most of them can still be cured. Both stage III seminomas and non-seminomas are treated with radical inguinal orchiectomy, followed by chemo.
Where is the first place testicular cancer spreads?
Therefore, testis cancer has a very predictable pattern of spread. The first place these cancers typically spread is to the lymph nodes around the kidneys, an area called the retroperitoneum.
What are the chances of dying from testicular cancer?
Because testicular cancer usually can be treated successfully, a man's lifetime risk of dying from this cancer is very low: about 1 in 5,000 . If you would like to know more about survival statistics, see Testicular cancer survival rates.
How quickly does testicular cancer spread?
Many men do not tell their health care provider about these signs. On average, men wait for about five months before saying anything. Since the tumor can spread during that time, it is vital to reach out to a urologist if you notice any of these signs.
What is the survival rate of ball cancer?
5-year relative survival rates for testicular cancerSEER stage5-year relative survival rateLocalized99%Regional96%Distant73%All SEER stages combined95%Mar 1, 2022
What is the main cause of testicular cancer?
Undescended testicles (cryptorchidism) is the most significant risk factor for testicular cancer. Around 3 to 5% of boys are born with their testicles inside their abdomen. They usually descend into the scrotum during the first year of life, but in some boys the testicles do not descend.
Where is the first place testicular cancer spreads?
Therefore, testis cancer has a very predictable pattern of spread. The first place these cancers typically spread is to the lymph nodes around the kidneys, an area called the retroperitoneum.
How long does it take for testicular cancer to spread?
Many men do not tell their health care provider about these signs. On average, men wait for about five months before saying anything. Since the tumor can spread during that time, it is vital to reach out to a urologist if you notice any of these signs.
What are the different types of testicular cancer?
Types of Testicular Cancer. Testicular Cancer. The most common type of testis cancer is a germ cell tumor. There are two main types of GCT: seminoma and nonseminomatous germ cell tumors (NSGCT). Both seminoma and NSGCT occur at about the same rate, and men can have seminoma, NSGCT or a combination of both. There are several differences between ...
What percentage of testicle tumors are stromal?
Stromal Tumors. Tumors can also develop from the supportive tissues around the germ cells in the testicle. These tumors are rare, making up less than 5 percent of testis cancers, and have an excellent prognosis if surgically resected. There are two types of stromal tumors:
Which type of seminoma tends to spread more slowly?
Seminomas tend to grow and spread more slowly than NSGCT, although some seminomas can grow very rapidly. Subtypes of seminoma include: Classic seminoma: 95 percent of seminomas are classic. Spermatocytic seminoma: tend to occur in older men and has an excellent prognosis.
What type of tumor is most common in children?
Yolk sac carcinoma: the most common type of tumor in children; responds well to chemotherapy in children and adults. Yolk sac tumors almost always secrete AFP. Choriocarcinoma: very rare and very aggressive form of testis cancer. Can secrete HCG.
Which type of cell makes testosterone?
Leydig cell tumors: Leydig cells make the male hormone testosterone and are most often cured with surgery. Sertoli cell tumors: Sertoli cells support and nourish the developing sperm and are usually benign tumors.
Is teratoma a mixed NSGCT?
Teratoma: most often appear as a mixed NSGCT; usually grow locally but can appear in retroperitoneal lymph nodes. Teratoma is chemotherapy- and radiation-resistant and best treated with surgical removal.
Can a seminoma be treated with chemotherapy?
If seminoma spreads from the testicle, it is most often and best treated with chemotherapy and/or radiation. Surgery can be performed in some cases.
Where do testicular tumors start?
Tumors can also start in the supportive and hormone-producing tissues, or stroma, of the testicles. These tumors are known as gonadal stromal tumors. They make up less than 5% of adult testicular tumors, but up to 20% of childhood testicular tumors. The main types are Leydig cell tumors and Sertoli cell tumors.
What is it called when you have cancer in your testicles?
Cancer that starts in the testicles is called testicular cancer. To understand this cancer, it helps to know about the normal structure and function of the testicles.
What percentage of testicular tumors are embryonal?
Embryonal carcinoma: These cells are found in about 40% of testicular tumors, but pure embryonal carcinomas occur only 3% to 4% of the time.
Why are testicular tumors treated as non-seminomas?
These mixed germ cell tumors are treated as non-seminomas because they grow and spread like non-seminomas.
What is the protein in a seminoma?
Some seminomas can increase blood levels of a protein called human chorionic gonadotropin (HCG). HCG can be checked with a simple blood test and is considered a tumor marker for certain types of testicular cancer. It can be used for diagnosis and to check how the patient is responding to treatment.
How to diagnose testicular CIS?
The only way to diagnose testicular CIS is to have a biopsy . (This is a procedure to take out a tiny bit of tissue so it can be checked under a microscope.) Sometimes CIS is found incidentally (by accident) when a testicular biopsy is done for another reason, such as infertility.
How do you know if you have testicular cancer?
Doctors can tell what type of testicular cancer you have by looking at the cells under a microscope.
What are the different types of testicular tumors?
Within germ cell tumors are three types of testicular cancers: 1 Seminomas may be slightly more common, accounting for about 55 percent of all testicular germ cell tumors in the United States, according to a 2014 study in Andrology . 2 Non-seminomas account for about 44 percent of testicular germ cell tumors, according to the same study. 3 The remaining 1 percent are spermatocytic seminomas, according to a 2011 study in BMC Research Notes. These are extremely rare, generally not aggressive, and affect older men.
What type of cancer is found in the testicles?
Determining which treatments to use for testicular cancer may depend on the kind of cells involved. Many types of cells are found in the testicles, all of which can become cancerous. However, two main types of tumors account for most testicular cancers: Seminoma: Of the two sub-types of seminomas, the classical ...
What type of cells are in a non-seminoma tumor?
They may be teratoma cells, yolk sac cells, choriocarcinoma cells, embryonal carcinoma cells or even seminoma cells. No matter what mix of cells the tumor contains, treatment is usually similar for all non-seminoma testicular cancers.
How common are seminomas?
Seminomas may be slightly more common, accounting for about 55 percent of all testicular germ cell tumors in the United States, according to a 2014 study in Andrology .
What is stromal tumor?
Stromal tumors are sometimes referred to as gonadal stromal tumors. This is a rare form of testicular cancer, accounting for only about 5 percent of cases. In addition to producing sperm for reproduction, the testicles, or male gonads, are also a component of the endocrine system, a series of hormone-producing glands.
What type of tumor starts in a testicular cell?
Nearly all testicular cancers are germ cell tumors, meaning that they start in a particular type of cell called a germ cell.
How to tell if a tumor is a seminoma or a non-seminom?
Blood tests are one of the ways to determine the type of testicular tumor. Different types of tumors produce high levels of specific proteins, and testing the blood for those proteins indicates which type of tumor is present. Non-seminomas usually produce high levels of proteins such as alpha-fetoprotein (AFP). Seminomas never cause an increase in AFP levels, so if there’s too much AFP in the blood, this is a good indication that the tumor is a non-seminoma type.
How many men get testicular cancer each year?
Testicular Cancer Statistics. It is estimated that 8,000 to 10,000 men will develop testis cancer each year. The chance of developing testis cancer is about one in 270. Fortunately, the cure rate is excellent (greater than 95 percent for all men with testis cancer).
How old is the average person with testicular cancer?
Testis cancer is most common in men in their late 20s and early 30s, with an average age of diagnosis of 33 years old. In fact, testis cancer is the most common malignancy among men 20 to 40 years old.
How old is the testis?
However, testis cancer can occur at any age: It is the second most common malignancy in young men 15 to 19 years old (leukemia is No. 1), with approximately 6 percent of cases occurring in children and teens, and about 7 percent occurring in men over the age of 55. In the United States, testis cancer is most common in white (Caucasian) ...
Is testis cancer more common in black men?
In the United States, testis cancer is most common in white (Caucasian) men and less common in black (African-American), Hispanic and Latino and Asian-American men. In fact, white men are four to five times more likely to have testis cancer than black men and three times more likely than Asian-American men.
How common is testicular cancer?
Testicular cancer is the most common malignancy in men aged 15 to 45 years and represents one of the most common curable malignancies when identified promptly and treated with a multimodal approach. It represents 1% of male tumors and 5% of urological malignancies.[1] The incidence of testicular cancer has been increasing over recent years, gaining increased significance due to the long impact both the disease and its treatment can have over the course of a patient's life. Testicular cancer incidence has doubled over the past 40 years.[2]
Where is the highest incidence of testicular cancer?
The highest incidence of testicular cancer is observed in Western and Northern Europe (8.7 and 7.2 per 100,000 men, respectively).[1] The highest mortality rates are reported in western Asia, with most countries showing a decrease in mortality, likely due to the combined impact of earlier detection through self-examination and integration of multimodal treatments. [1]
What are the genetic factors that cause testicular cancer?
Genetic risk factors: Multiple genetic changes have been described in the etiology of testicular cancer. The isochromosome of the short arm of chromosome 12 – (i12p) – is pathognomonic of all types of adult germ cell tumors (GCTs), as well as GCNIS. Alterations in p53 have been observed in about 66% of cases of GCNIS. [18][19]Genetic polymorphisms in the PTEN tumor suppressor gene and the risk of testicular cancer (TC) have also been described.[20] Dysregulation in the pluripotent program of fetal germ cells (identified by markers, M2A, C-KIT, and OCT4/NANOG) is thought to be responsible for the development of GCNIS and germ cell neoplasia. Along with this, genome-wide association studies (GWAS) showed evidence of several single nucleotide polymorphisms (SNPs) markers known to have an association with an increased risk of developing testicular cancer, in particular at 15q21.3. [21]
What is the primary imaging modality to identify testicular cancer when suspected on physical examination?
Testicular imaging with trans-scrotal ultrasound is the primary imaging modality to identify testicular cancer when suspected on physical examination. [39][40][41] Ultrasound imaging, when combined with a physical examination, provides nearly 100% sensitivity in the diagnosis of testicular cancer.[42] Testicular cancer is suspected when an ultrasound reveals a hypoechoic, solid, vascularized intratesticular lesion, and different testicular cancer types show subtle morphologic differences in imaging.[43] Further evaluation should include serum tumor markers (AFP, HCG, and LDH) before any intervention, including orchiectomy. Adequate counseling should be given regarding the possibility of infertility and placement of the testicular prosthesis if desired. Sperm banking should be considered in patients with bilateral testicular pathology. [39][40]
What CT scan is used for testicular tumors?
All patients with testicular germ cell tumors should undergo abdominopelvic imaging with computed tomography (CT). Patients with elevated serum tumor markers (AFP, α-fetoprotein; β-hCG, β-subunit of human chorionic gonadotropin; LDH, lactate dehydrogenase) should be evaluated further with computed tomography (CT) of the chest, abdomen, and pelvis for staging.[39] If testicular tumor markers are within the normal range, the rate of metastasis almost outside of the retroperitoneum is very low; therefore, the addition of a chest CT-scan to cross-sectional imaging of the abdomen and pelvis is highly unlikely to alter the treatment plan, and a chest radiograph suffices when combined with abdominopelvic CT imaging. Choriocarcinoma has been shown to spread via hematogenous routes, and patients with high levels of β-hCG should undergo cross-sectional imaging of the brain to identify metastatic lesions due to choriocarcinoma hematogenously spreading to the brain.
What is the prognosis for testicular cancer?
With effective management, the prognosis is excellent with >90% cure rate and >95% five-year survival rate. [3][4] Complex environmental and genetic factors are involved in the development of testicular cancer; common risk factors include cryptorchidism, family history of testicular cancer, personal history of testicular cancer in the contralateral testis, age, and ethnicity. Initial evaluation includes history and physical examination, tumor marker assessment, and scrotal ultrasound. Once a solid intratesticular tumor is identified, radical inguinal orchiectomy is performed both for diagnostic and therapeutic purposes. Tumor staging guides further management with options including active surveillance, chemotherapy, retroperitoneal lymph node dissection, and radiation therapy.
Where do testicular germ cells spread?
Testicular germ cell tumors spread along well-described and predictable lymphatic channels. [45][46] For tumors arising in the right testis, the primary landing zone is the infrarenal inter-aortocaval lymph nodes, followed by paracaval lymph nodes and para-aortic lymph nodes. Tumors arising from the left testis spread primarily to the para-aortic lymph nodes, followed by inter-aortocaval lymph nodes. Retroperitoneal spread from the right side to the left side can be seen in tumors arising from the right testis, but left-to-right spread within the retroperitoneum is rarely seen unless it is associated with bulky lymph node disease.[47] Abdominopelvic cross-sectional imaging is important to identify retroperitoneal lymph node disease arising from primary testis cancer and to inform multimodal treatment.
How old is the average testicular cancer patient?
The average age of a testicular cancer patient is 33 years old. While testicular cancer is not a commonly diagnosed disease—one in every 250 men will be diagnosed during their lifetime—it is one of the most prevalent cancers for younger men. It rarely affects boys under the age of 20 (an estimated 6% of cases) or men over the age of 55 ...
What are the risk factors for testicular cancer?
There are a variety of factors that can raise someone’s risk of testicular cancer, other than his age. These include: A family history of testicular cancer. The race of the individual, as testicular cancer is more common for white men. An HIV diagnosis.
How common is testicular cancer?
Testicular cancer is the most common cancer affecting men. The fact is that it is one of the rarest forms of cancer accounting for just around 1 % of all cancers in men in the Unites States. Around 8000 men are diagnosed with it annually, of which about 390 men succumb to the disease. 2. Testicular cancer is usually fatal.
What age do you get testicular cancer?
Testicular cancer is a rare form of cancer which mostly affects young men between the ages of 15 and 40.
How is the testis removed?
In case of suspicion of a testicular malignancy because of altered levels of tumor marker in the blood or as seen by ultrasound, the entire testis is removed through an incision in the groin, a procedure named as radical inguinal orchiectomy.
What is the condition where the testes fail to descend into the scrotal sac and remain trapped in the?
Cryptorchidism is the condition when the testes fail to descend into the scrotal sac and remain trapped in the abdomen. It is a known risk factor for testicular cancer. However testicular cancer is in itself a very rare disease and moreover it is found in only 2% of the patients having undescended testicles.
How many times more chances of developing tumor on the contralateral side?
There are 8 to 10 times more chances of developing tumor on the contra-lateral side if one testicle has been involved earlier. According to the National Cancer Institute, a doctor's opinion should be sought in case any of the following are noticed by the patient: Any painless growth in either testis.
What is a testis change?
Any change in the size or texture of the testis
What is the procedure called when testicle cancer is removed?
For testicular cancer, the entire affected testicle is removed in a procedure called as orchiectomy. 8.
