Even if you think you know everything there is to know about testicular cancer, you may be surprised by some of the facts. For starters, the American Cancer Society says it’s important to understand the structure and function of the testicles in order to grasp how the cancer affects a man. They perform two very important jobs: producing androgens, male hormones, and making sperm, which (of course) is needed to fertilize a female egg.
Needless to say, there’s a lot at stake when these important organs are in jeopardy, which is why we’re breaking down the ins and outs of it all.
1. Testicular cancer most commonly develops in germ cells
Germ cells are the cells that make sperm. According to the ACS, more than 90% of testicular cancer cases develop in these cells, which are broken down into two main types: seminomas and non-seminomas. Seminomas can further be separated into classical and spermatocytic subtypes, with the former accounting for 95% of all seminomas. Similarly, non-seminomas can also be broken down into different types: embryonal carcinoma, yolk sac carcinoma, choriocarcinoma, and teratoma.
There are also mixed germ cell tumors, which contain both types of cells. This type of tumor is common in many testicular cancer cases.
2. Abnormal germ cells don’ts always progress into invasive cancer
Before we leave the topic of germ cells, it’s important to mention testicular cancer sometimes begins as a non-invasive form of the disease called carcinoma in situ (CIS). While the cells appear abnormal, they haven’t spread from where they formed. According to the ACS, detecting CIS before it becomes an invasive cancer is difficult since there are often no symptoms. If CIS does become invasive, the cancer cells can spread to the lymph nodes through lymphatic channels or through the blood.
Since there’s no medical consensus on the best treatment for CIS, anyone diagnosed needs to have a thorough discussion with their doctor. It’s also worth considering a second opinion.
3. Testicular cancer can also develop in other cells
The stromal cells in the testicles are responsible for producing male sex hormones, and they can also be the starting point for testicular cancer. The Cancer Treatment Centers of America explains these tumors account for only about 5% of testicular cancer cases. Furthermore, many tumors that form in the stromal cells are benign. The downside is these types of tumors can be very difficult to treat with conventional methods should they spread elsewhere.
4. Other types of cancer can spread to the testicles
Secondary testicular cancers occur when another type of cancer spreads from a different organ to the testicles. The most common is lymphoma, according to the Testicular Cancer Society, but cancers of the prostate, lung, skin, and more can be the source. Often, the prognosis is not good for such diagnoses because it means the cancer has already spread from where it began. The further the disease has progressed, the harder it is to treat.
5. There are early signs of testicular cancer
Some signs of testicular cancer are relatively obvious: a lump or pain in the testicle. Others, though, are less expected. The ACS says some men may experience enlarged or sore breasts. This is the result of increased levels of a type of hormone that stimulates breast development.
While detecting any disease early on is always better, a man may not recognize any signs of testicular cancer until it has already spread. If he does have symptoms at that point, they can include low back pain, shortness of breath, headaches, and even stomach pain. All of these signal the cancer has spread to other organs.
6. There are several ways to diagnose and treat testicular cancer
Although it can sometimes be hard to detect, there are a handful of ways a doctor can diagnose testicular cancer. The first test is often an ultrasound, which can detect a tumor. There are also blood tests that can find high levels of certain proteins associated testicular cancer. In some cases, a biopsy will be performed, but more often than not, surgery to simply remove the entire tumor is recommended.
As for other treatment options, the ACS says surgery, radiation therapy, chemotherapy, and high-dose chemo coupled with a stem cell transplant are common.
7. It’s still possible to father a child after treatment of testicular cancer
A man may still be fertile after he’s had testicular cancer. But because there’s no way to know for sure whether his sperm will be able to fertilize an egg, it’s important to discuss all post-treatment possibilities before treatment begins. For instance, freezing sperm is an option for men who definitely want to have children of their own some day.
It’s also worth noting treatment can affect the ability to reproduce just as much as the actual cancer. In cases where only one testicle has to be removed, which is common, the ACS says “fertility typically returns about two years after chemotherapy stops.” But it’s worth noting fertility isn’t the only thing that can change. Livestrong.com points out a number of ways cancer and treatment can impact sexual function, including erectile dysfunction and difficulty climaxing.
Despite the scary reality that comes along with any cancer diagnosis, testicular cancer often has a relatively hopeful prognosis. The ACS says the chance of death is only about one in 5,000. Regardless, it’s always helpful to have your facts straight.