What is Testicular Cancer?
What is Testicular Cancer?Testicular cancer is cancer that starts in a testicle. It is a rare cancer that often begins in germ cells, the cells that make sperm, and typically affects men ages 15 to 35. Testicular cancer is treatable, even when cancer has spread, and has a high survivorship rate with the potential for reoccurrence later in life." The treatment for testicular cancer depends on the type and stage of cancer. Treatment options may affect fertility. For this reason, NewYork-Presbyterian recommends discussing fertility options before treatment.
Types of Testicular Cancer
TypesMost testicular cancers develop from germ cells. These are called seminomas and non-seminomas.
- Seminomas grow and spread more slowly than non-seminomas. Two sub-types of seminoma cancers are classical and spermatocytic seminomas.
- Classical seminoma (also called typical) is the most common type and usually affects men between the ages of 25 and 45
- Spermatocytic seminoma is a rare type of seminoma that occurs in older men (average age of 65). Spermatocytic tumors develop more slowly than classical seminoma tumors and are less likely to spread to other body parts.
- Non-seminomas are tumors that occur in patients in their late teens and early 30s. The four types of non-seminoma tumors are embryonal carcinoma, yolk sac carcinoma, choriocarcinoma, and teratoma. Non-seminoma tumors often include a mix of different types of non-seminomas and can also include seminoma cancer cells.
- Embryonal carcinoma tumors grow fast and might spread to other body parts
- Yolk sac carcinoma is a type of testicular cancer found in children and infants. Yolk sac carcinoma tumors without other types of non-seminoma cells are rare in adults. Chemotherapy is an effective treatment for yolk sac carcinoma, especially in children, even when the cancer has spread.
- Choriocarcinoma is a rare type of testicular cancer in adults. Choriocarcinoma cells are often mixed with other types of non-seminoma cells in germ cell tumors. Mixed tumors tend to be more treatable than pure choriocarcinomas, which grow fast and often spread to other parts of the body.
- Teratoma cancer cells are often mixed with other germ cell types of cancer cells. Pure teratoma tumors of the testicles are rare. There are three main types of teratomas:
- Mature teratomas, which rarely spread and can often be cured with surgery
- Immature teratomas are more likely than mature teratomas to grow and spread to other parts of the body and recur (come back) after treatment
- Teratomas with somatic type malignancy, which are rare
Stages of Testicular Cancer
StagesStaging is the process of finding out if and how your testicular cancer has spread. Knowing the stage of cancer helps your healthcare team develop a treatment plan that’s right for you. The earliest stage of testicular cancer is stage 0 (also called germ cell neoplasia in situ). The other stage groupings range from stage I (1) to stage III (3). Substages A, B, and so on provide more specific staging information.
- Stage 0 - There are abnormal cells in the testicle, only in the seminiferous tubules (small tubes inside each testicle), which have not grown into other parts of the testicle or nearby lymph nodes
- Stage I - The tumor is only in the testicle and has not spread to lymph nodes or other body parts
- Stage IA - The tumor has grown only within the testicle, and tumor markers are normal
- Stage IB - The tumor has grown outside the testicle to nearby structures but has not spread to lymph nodes. Tumor markers are normal.
- Stage IS - The tumor has grown outside the testicle, and at least one tumor marker level is above average
- Stage II - The tumor has spread to at least one close lymph node but has not spread to distant lymph nodes or other body parts. Tumor markers are normal or slightly elevated.
- Stage IIA - The tumor has spread to between one and five nearby lymph nodes, and the size of the lymph nodes is up to 2 cm
- Stage IIB - The tumor has spread to:
- Up to 5 close lymph nodes, which are between 2 cm and 5 cm, or
- More than five close lymph nodes, which are all smaller than 5 cm, or
- It has grown outside of a close lymph node
- Stage IIC - The tumor has spread to at least one close lymph node larger than 5 cm
- Stage III - The cancer has spread to distant lymph nodes or other body parts
- Stage IIIA - The tumor has spread to distant lymph nodes or the lungs. The level of at least one tumor marker is higher than normal.
- Stage IIIB - The tumor has spread to distant lymph nodes or the lungs, or the tumor marker levels are higher than average
- Stage IIIC - Cancer has spread to distant lymph nodes or the lungs, and the level of at least one tumor marker is very high, or the tumor has spread to other parts of the body such as the liver or the brain
Signs & Symptoms of Testicular Cancer
SymptomsPatients with testicular cancer may not have symptoms even when the cancer has spread to other body parts. Signs and symptoms of testicular cancer include:
- Lump in a testicle
- Swollen testicle
- Pain or discomfort in a testicle or the scrotum
- Dull pain in the abdomen or groin
- Collection of fluid in the scrotum
- Lower back pain
- Enlargement or tenderness of the breasts
What Causes Testicular Cancer?
CausesThe cause of testicular cancer is not known. Most testicular cancers start in germ cells that change and become cancerous.
Risk Factors for Testicular Cancer
Risk FactorsMost people who develop testicular cancer do not have a known risk factor, and those who have risk factors may not develop testicular cancer. Factors that may increase your risk of testicular cancer include:
- Undescended testicle (cryptorchidism) - A testicle that did not descend from the abdominal area into the scrotum before birth, unlike in normal male development
- Irregular testicle development - Klinefelter syndrome and other conditions that cause irregular testicle development
- Age - Testicular cancer affects teens and younger men between ages 15 and 35, but can affect males at any age
- Family history - Having family members who have had testicular cancer may increase the risk due to inherited genes
- Race and ethnicity - White men are at a higher risk of developing testicular cancer than other groups
Trust NewYork-Presbyterian for Testicular Cancer Care
At NewYork-Presbyterian, our cancer specialists are highly experienced in diagnosing and treating testicular cancers. Learn more about available treatment options for testicular cancer.