Testicular Cancer

By Dr. Loretta Lanphier, ND, CN, HHP, CH

Cancer of the testicles is one of the most common cancers that men may have to deal with, but it is still relatively rare as cancers go. Unfortunately, the number of cases is increasing, and we are hearing more about it in the media as more victims are coming forward. The best tool for fighting testicular cancer is for men to monitor their own bodies for changes so that if cancer does develop, it can be identified as early as possible.

What is Testicular Cancer?

Testicular cancer is an abnormal growth of malignant cells in the male testicles, also known as the gonads or testes, located in a loose bag of skin underneath the base of the penis called the scrotum. The testicles are a pair of oval shaped organs each about the size of a large peanut, located on either side of the scrotum. They are responsible for producing the male sex hormones and sperm cells necessary for reproduction.

Testicular cancer is a relatively rare form of cancer, but it is the most common form of cancer in teen boys and younger men between the ages of 15-34. It is more openly discussed now than in years past, which was mainly due to denial and the reluctance of men to go public about it due to embarrassment. The precise causes of testicular cancer have not been positively identified, but environmental factors that are responsible for many types of cancer are suspected. Statistics tell us that the incidence of testicular cancer has been steadily increasing over the last 40 years, which seems to be corroborating evidence to support the environmental theory. The rate of exposure to toxic chemicals in our culture is also, unfortunately, on the rise.

Testicular cancer, like many other types, often does not have easily discernible symptoms in the early stages. It is much more common in males whose testicle(s) never properly descended into the scrotum, even if surgery was used to correct this. It can also be a very quickly growing cancer, so self-examination of the testicular region is of utmost importance to men so that if cancer does occur, it can be caught as early as possible. The recovery rate for most types of testicular cancer is very high if caught early enough. The testes contain several different types of cells that may succumb to cancer. There are basically two main types of testicular cancer: seminoma and non-seminoma.

What Are the Symptoms of Testicular Cancer?

There are a number of common symptoms that may occur with testicular cancer. These include:

  • Enlargement of either testicle
  • A lump in either testicle
  • Pain in the testicle(s) or scrotal area
  • Dull ache in the abdomen and/or groin
  • Sudden accumulation of fluid in the scrotum
  • Breast tenderness and/or enlargement
  • Unexplained fatigue
  • General malaise (sense of not feeling well)
  • For reasons that are not fully understood, testicular cancer almost always affects only one testicle.

More advanced cases may also experience:

  • Lower back pain
  • Difficulty breathing
  • Difficulty urinating
  • Unexplained cough
  • Heaviness and pain in the testicles

If you are experiencing any of the above symptoms, it is important to get checked out to determine if the problem is indeed cancer. However, testicular cancer is not the only condition that can produce a lump in the testicles or other symptoms. Other maladies that may mimic testicular cancer symptoms include:

  • Benign scrotal masses:  These non-cancerous issues can occur due to various causes. Sometimes physical trauma such as an accident or hernia or inflammation may result in accumulations of solid or liquid material in the scrotal area. Cysts may also form on or near the testicles.
  • Hydrocele:  This happens when a collection of watery fluid causes swelling in the scrotum that is usually painless.
  • Epididymitis:  This can cause pain and discomfort in the scrotal area due to inflammation of the tubes that transport sperm from the testicles.
  • Varicocele:  This condition involves swelling of the veins in the scrotum.
  • Spermatocele:  This is the result of a cyst that forms in a location that blocks the tubes that transport sperm. It can lead to pain and swelling.
  • Orchitis:  A bacterial infection in the scrotum that is often associated with a case of the mumps can cause inflammation and irritation of the testicle(s).

What Are the Different Types of Testicular Cancer?

If testicular cancer is suspected, there are various methods of determining the diagnosis and type of cancer, if it is indeed present. A physical exam whereby the scrotum and testicles are palpitated by your health care provider is the place to begin. There are various imaging techniques for getting a picture of the condition of your testes. The least harmful, in terms of exposure to radiation, is an ultrasound. I would recommend using this first, as it may be the only imaging testing needed.

If it is determined that a biopsy is necessary, be sure your doctor uses the inguinal incision method (via a small incision in the groin) rather than using a needle to access the affected testicle. Use of a needle has been linked to the spread of cancer to other areas beyond the testicle.

Certain blood tests can also be helpful. The most commonly used ones are the serum alpha-fetaprotein (AFP) and the beta-subunit human chorionic gonadotropin (beta-hCG). These tests are used to help diagnose testicular cancer, and are sometimes used to track the progress of treatment or check for a recurrence of the disease.

As with any cancer, the earlier it is discovered, the greater the chance of beating the disease. As with most cancers, the development of the malignancy is rated according to the following scale:

  • Stage I:  Cancer confined to the testicle.
  • Stage II:  The cancer has spread to lymph nodes in the abdominal area.
  • Stage III:  The cancer has metastasized (spread) into other areas of the body, such as the liver or lungs.

The two major types of testicular cancer are:

  • Seminoma:  This is the least critical form of testicular cancer, and the prognosis for recovery from this type is very good if discovered early. Seminoma is most commonly found in men between their late 30s and early 50s.
  • Nonseminoma:  This classification covers a number of different testicular cancer types including teratoma, yolk sac tumors, embryonal carcinoma, and choriocarcinoma. Nonseminomas generally occur in younger men between their late teens and early 40s.

What Causes Testicular Cancer?

No exact cause(s) has been pinpointed, but several possibilities have been identified:

  • Fetal exposure to toxins:  Some studies have found that unborn boys whose mothers have been exposed to certain chemicals containing estrogen, such as insecticides and pesticides, or other chemicals related to the plastics industry, have a higher rate of testicular cancer than the general population.
  • Undescended testicle(s):  In normal fetal development, the testes first form in the abdominal area, and then drop down into the scrotum later. If this does not happen to one or both testicles, a man’s risk for testicular cancer later in life is increased. The risk remains the same even if the condition is surgically corrected. However, the majority of men who develop cancer of the testicles did not have a problem with undescended testicles.
  • HIV/AIDS infections:  For reasons not yet well understood, men with this type of infection also have an increased risk for testicular cancer.
  • Race:  Again for unknown reasons, Caucasian American men have a higher incidence of testicular cancer than African American men.
  • Studies have also shown something that does not appear to be linked to cancer of the testicles: ongoing trauma, such as spending an excessive amount of time riding a bicycle. At one point, this type of chronic trauma was suspected, but research has disproved that theory. However, major trauma causing injury to the testicles can still be a factor.

How is Testicular Cancer Treated?

The big three tools of mainstream medicine to treat testicular cancer are:

  • Surgery:  This usually involves removal of only the affected testicle, if caught early enough, or both testicles and sometimes surrounding lymph tissue as well. It can usually be done through a small incision in the groin.
  • Radiation therapy:  This is typically used for seminomas, and not for nonseminomas.
  • Chemotherapy, the use of drugs to kill cancerous cells, is also sometimes used, often in conjunction with surgery and/or radiation.
  • Bone marrow transplant:  This rather new therapy involves the use of bone marrow that is taken from the patient, treated with chemotherapy to kill any cancerous cells, and then frozen. After chemotherapy and/or radiation, the bone marrow is then thawed and reintroduced back into the patient’s body via intravenous injections.

As is well documented, treatments such as those above can have considerable risks and side effects. If, after thoroughly researching the specifics of your own situation, you decide to go with any of these, be sure to work with a naturopath or MD that is open to and knowledgeable about alternative treatments that can act as a support system to help lessen the bad effects of the other therapies and help your body to heal itself as well.

How Should a Self-Examination Be Performed?

Proper and regular self-examinations of the scrotal area are essential to catching cancer of the testicles as early as possible if it were to occur. Here is how they should be done:

  • Testicular Self-Examination (TSE) should be conducted once a month. The best time to do it is after a hot bath or shower, as the skin of the scrotum is more relaxed and any abnormalities are easier to feel.
  • Use a mirror:  Stand in front of it and first look for any swelling or new changes in the appearance of your scrotum.
  • Feel each testicle, using both hands:  Roll the testicles around in your fingers, feeling for any lumps, bumps, or abnormalities, especially if they are new. It is normal for one testicle to be larger than the other, so don’t be concerned about that. Each man’s body is different, so regular TSEs will help you to become familiar with what is normal for your testicles.

Making healthy lifestyle choices and avoiding obvious toxins is the best way to prevent cancer of all kinds, as well as most other diseases. However, if you do come down with testicular cancer and it can be stopped before it has metastasized, the prognosis for total recovery is excellent. Most men who have one testicle removed can have a completely normal and functional sex life, which is good news and even more impetus to do everything you can to live well and monitor yourself so that intervention can be made as early in the disease process as possible.

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