Understanding Testicular Cancer - the Basics

What Is Testicular Cancer?

Testicular cancer is a rare type of cancer that begins within the testicles. The cancer cells no longer follow normal growth patterns, multiplying uncontrollably. If untreated, the cancer can spread and result in death.

This type of cancer starts within the cells of a testicle. The two testicles, or testes, are glands that produce male hormones and sperm. They hang beneath and behind a man's penis in a pouch of skin called the scrotum. The spermatic cord, composed of the sperm duct, nerves, and blood vessels, connects each testicle to the body.

Although testicular cancer is rare, it is the most common type of cancer in men aged 15 to 35. It is much more common in Caucasians than in African Americans and usually is diagnosed when a man is in his teens to mid-30s.

Testicular cancers begin in the testicles themselves. Testicular cancer may spread slowly or rapidly through the lymphatics or blood vessels, depending on its type, but the path is consistent: Once cancer cells are free to spread to nearby lymph or blood vessels, they could be carried to the lungs, then to the liver, bones, and possibly the brain.

Thanks to advances in diagnosis and treatment, testicular cancer is among the most curable of cancers, even in an advanced stage, and it is rarely fatal. Over 90% of patients are diagnosed with small, localized cancers that are highly treatable. Improved detection and treatment techniques have raised the overall five-year survival rate above 95% for most of these cancers. Even if cancer has spread to nearby organs at diagnosis, patients have an excellent chance of long term survival.

What Causes Testicular Cancer?

Doctors don't know why a man develops testicular cancer. However, doctors have found links between testicular cancer and other factors. These are described here.

10% of testicular cancers occur in men who also had a condition called an undescended testicle (cryptorchidism.) The testicles normally develop within the abdominal/pelvic cavity and in most cases they migrate to the groin and scrotum prior to birth. With cryptorchidism, an abnormality within the testicle itself keeps the testicle from making its way into the scrotum. The undescended testicle then remains somewhere along the normal path, within the abdomen or groin. Surgically bringing the testicle into a normal position in the scrotum does not reduce a man's risk for developing cancer. The normal position simply allows for better and closer examination.

Testicular cancer may also run in families.

Men with fertility problems are more likely to be diagnosed with testicular cancer All men with fertility problems should be checked for cancer of the testicle.

Other suspected, but unproven, risk factors include a sedentary lifestyle, early puberty, previous mumps, testicular injury, and overexposure to pesticides or radiation. Others suggest prenatal conditions with the man's mother during pregnancy could be a contributor as well, including abnormal bleeding, estrogen therapy, or taking diethylstilbestrol (DES) during pregnancy. DES was once given to pregnant women to prevent miscarriage but is no longer marketed in the U.S.

Noncancerous growths in the testicle are rare, so all masses should be assumed to be a cancer until proven otherwise.