Testicular cancer

Testicular cancer is a malignant tumor that affects the male sex glands. 90% of this type of cancer begins in germ cells. Some neoplasms develop outside the testicle. As the malignant process progresses, it can spread to the lymph nodes in the abdominal cavity, liver, intestines, lungs, and brain.

The incidence of testicular cancer is increasing all over the world, however, in Western countries in recent decades, there has been a decrease in the death rate. This is due to the fact that the field of oncology is developing rapidly. There are new diagnostic methods that allow to detect the disease at an early stage. Effective treatments are being developed.

One of the latest innovations in this area is vaccine therapy. The use of cancer vaccines helps to “tune” the immune system so that it can recognize and destroy cancer cells on its own. Cancer vaccines are used as part of complex therapy to increase its effectiveness and reduce the risk of recurrence of the disease. More information about the new method of cancer treatment can be found in the “Treatment” section.

Cause of testicular cancer

The exact causes of the disease are unknown, but there are factors that increase the risk of developing it. These include:

• Personal history. Patients with previously diagnosed cancer in one testicle are at increased risk of cancer in the other.
• Undescended testicle. Cryptorchidism occurs in 2-5% of male children and, according to studies, increases the risk of developing cancer by almost 4 times compared to men with normal testicles.
• Family history. Testicular cancer in close male relatives increases the likelihood of developing a tumor. However, it is a risk factor for only 2% of affected patients.
• AIDS virus. There is evidence that people infected with HIV are more likely to develop testicular cancer.
• Birth defects. Hypospadias (a developmental anomaly in which the urethra is located on the underside of the penis rather than at its end) and inguinal hernia are proven risk factors.

Having the conditions listed above does not necessarily mean that a person will develop cancer. However, men who are at risk need to be more attentive to their own health and undergo regular oncological examinations.

Symptoms and signs of testicular cancer

Common symptoms of the disease are:

• a lump on the testicle, which often does not hurt, but may cause discomfort or swelling;
• feeling of heaviness in the lower abdomen or scrotum;
• Breast growth and tenderness (some testicular tumors produce high levels of the hCG hormone, which stimulates breast growth);
• lower back pain (a common symptom of advanced testicular cancer);
• shortness of breath, chest pain, cough, sputum with blood (a sign that the malignant process has spread to the lungs and is rapidly progressing).

Some tumors produce androgens (male sex hormones) or estrogens (female sex hormones). Estrogen-producing neoplasms can provoke a decrease in libido. Androgen-producing tumors are not associated with any specific symptoms in men, but in boys they cause facial and body hair to grow at an abnormally early age.

Types of testicular cancer

Germ cell tumors are the most common type of testicular cancer. They are divided into two main types:

• Seminomas. They develop slowly. The tumor usually occurs between the ages of 25 and 45, but can also occur in the elderly.
• Nonseminomas. They progress quickly and are most commonly diagnosed in teenagers and young adults. There are four major subtypes of nonseminoma tumors, including teratoma, choriocarcinoma, yolk sac tumor, and embryonic carcinoma.

Sometimes testicular cancer is mixed, that is, it contains seminoma and non-seminoma cells. In this case, it is treated as if it were nonseminoma cancer.

A small number of testicular tumors begin in the cells that make up the supporting (structural) and hormone-producing tissue of the testicles. They are called stromal. The two main types of stromal tumors are neoplasms arising from Sertoli cells and Leydig cells. They are usually benign and are well treated with surgery. Other types of cancer, such as lymphoma, can also affect the testicles.

Diagnosis of testicular cancer in men

At the first stage, the doctor conducts a physical examination and examines the patient’s history. Further, the specialist prescribes laboratory and instrumental studies:

• blood tests;
• ultrasound of the testicles;
• high-resolution CT of the abdomen and pelvis;
• chest x-ray;
• brain MRI (performed, if a doctor suspects brain metastases after a clinical examination).

Laboratory tests for tumor markers are also carried out:

• alpha-fetoprotein (AFP) – increases with some types of non-seminomas;
• beta-human chorionic gonadotropin (beta-hCG) – increases with some non-seminoma and seminoma tumors;
• lactate dehydrogenase (LDH) is elevated in some nonseminoma and seminoma cancers.

The level of tumor markers is necessary to assess the risk of disease recurrence after surgery. The test results help doctors plan further treatment.

Can testicular cancer be seen on ultrasound?

Ultrasound is the main imaging modality for testicular tumors due to its high sensitivity, low cost, and availability of this diagnostic technique. Ultrasound helps to distinguish cancer from a benign tumor.

A fluid-filled neoplasm is most likely not cancerous. Seminomas usually appear as well-circumscribed, hypoechoic (shaded on the ultrasound screen) masses without cystic areas. Non-seminomas are patchy hyperechoic (bright on ultrasound) with calcifications, cystic areas, and indistinct margins.

Due to its low discriminative power, ultrasound is not suitable for tumor staging, so CT is used for this purpose. The final diagnosis is made not on the basis of the results of imaging studies, but after a histological analysis of the removed tumor.

Testicular cancer (tumor) treatment

Before starting treatment, a urologist and oncologist should discuss the treatment regimen with the patient. The choice of therapeutic tactics will be based on the stage of cancer, its location, age and personal preferences of the man. Patients should be aware that anticancer therapy may adversely affect their fertility. Therefore, men who wish to have children in the future may freeze their sperm.

Testicular cancer surgery

Surgery is the main method of treatment. The removal of the testicle is called an orchiectomy. Most often, the operation is performed through a small incision in the groin. A tumor sample is sent for histological analysis. According to its results, further treatment is prescribed. For men who are concerned about the appearance of the genitals, a testicular prosthesis is installed.

With spreading cancer, a dissection of the retroperitoneal lymph nodes is performed. This surgery is usually recommended for men with non-seminomas that are prone to recurrence.

Radiotherapy

Radiation therapy is used to kill cancer cells that may have remained after surgery or migrated to the lymph nodes. This treatment is only used for seminomas because some non-seminomas are resistant to radiotherapy. Radiation therapy is also given to patients with brain metastases.

Chemotherapy

It is used for cancer that has spread beyond the testicle or with an increased level of tumor markers after surgery. Chemotherapy drugs are also prescribed to reduce the risk of cancer coming back after surgery.

Cancer vaccines

Vaccine therapy is a new method of treating malignant tumors, the main principle of which is to activate the immune system to fight cancer cells. Currently, there is an active development of antitumor vaccines for the treatment of various cancers. MedTour is committed to making innovative cancer therapies more accessible to its patients. We currently offer treatment with two types of Cancerax vaccine:

• Autovaccine. It is made from tumor material after surgery to remove the neoplasm. When ingested, the vaccine “trains” the immune system to recognize and attack cancer cells. The treatment is suitable for patients who have recently had an orchiectomy and wish to improve their outcome.
• Xenovaccine. It has the same operating principle. The difference lies in the fact that the composition of this vaccine includes embryonic proteins of animal origin. They are structurally very similar to tumor antigens. The immune system recognizes these proteins and begins to fight the tumor on its own. The treatment is suitable for patients who do not have a sample of tumor material. Vaccines help reduce the chance of cancer coming back. It can also be used prophylactically in patients at high risk of developing testicular cancer.

Vaccine therapy is an innovative method of anticancer therapy. However, it cannot be perceived as a panacea in the treatment of cancer. Vaccines are used as an adjunct to standard treatment to improve outcomes and reduce the risk of relapse.

To learn more about testicular cancer vaccine therapy, call or fill out the feedback form. Our medical coordinator will answer all your questions in detail and help you organize your treatment.

Testicular cancer – forecasts

The prognosis depends on the stage of the disease:

• A good prognosis is determined, as a rule, in cases where the tumor has not spread beyond the testicle, and the level of all tumor markers is slightly higher than normal.
• The intermediate prognosis differs for seminomas and nonseminomas. With non-seminomas, the tumor should not spread to other organs except the lungs. The level of tumor markers is slightly higher than normal. In seminomas, the tumor can spread to organs other than the lungs. The AFP level should be normal. The levels of beta-hCG and LDH can be anything.
• An unfavorable prognosis for non-seminoma is determined if there are metastases in the mediastinum, the tumor has spread to organs other than the lungs, and also with a high level of all tumor markers. There is no poor prognosis for testicular seminoma.

Early detection and timely initiation of qualified therapy are the keys to successful treatment of testicular cancer.

How many years can a person live with testicular cancer?

Testicular cancer is highly curable even in patients with metastases at the time of diagnosis. The overall 5-year survival rate is 95.2%. The prognosis varies depending on the histological type of cancer (seminoma or nonseminoma), stage, level of tumor markers, presence and location of metastases. Depending on the stage, the 5-year survival rate is:

• with a localized tumor – 99.2%;
• with metastases to regional lymph nodes – 96%;
• with distant metastases – 73.4%.

With early detection and quality treatment, a patient can live as long as people without cancer.

The best clinics for the treatment of testicular cancer

The MedTour platform cooperates with the world’s leading cancer centers specializing in the treatment of testicular cancer. We will select a clinic that has modern equipment and has access to innovative methods of anticancer therapy. Our coordinators will help resolve all issues related to the organization of treatment. Contact the medical coordinator of MedTour to get a free consultation.

The best doctors for the treatment of testicular cancer

The MedTour platform contains information about leading oncologists who specialize in the treatment of testicular cancer and have been able to achieve significant results in this area. Contact our medical coordinator in any way convenient for you to find the best available specialist for you, taking into account your personal needs and wishes.

Published: 08.08.2023

Updated: 10.08.2023

Medical author, Medical editor:

Olena Kursabaieva

Medical author, Medical editor:

Natalia Segen