Testicular Cancer

Testicular cancer is a malignant tumor that develops in the tissue of the testicles, specifically in the male reproductive glands. These are responsible for sperm production and testosterone formation. Testicular cancer develops in most cases from germ cells, the precursor cells of sperm, and is therefore often referred to as a germ cell tumor. There are two main types of germ cell tumors: seminomas, which grow slowly and usually remain confined to the testicles, and non-seminomas, which are more aggressive and can spread more quickly. The exact causes of testicular cancer are not fully understood, but genetic factors, an undescended testicle (cryptorchidism), and family history are considered typical risk factors.

Testicular cancer is a relatively rare tumor compared to other cancers. However, it primarily affects young men and is thus the most common type of cancer in men under 40 years of age. In Germany, approximately 4,200 men are newly diagnosed with testicular cancer annually, accounting for about 1.6% of all cancer cases in men.

In Switzerland, around 471 new cases and about 12 deaths from testicular cancer are registered annually. Worldwide, the frequency varies significantly from country to country. Testicular cancer occurs much more frequently in European countries and the USA than in other regions of the world.

Despite its rarity, testicular cancer poses a particular challenge due to the young age at which it occurs. Nevertheless, preventive examinations and awareness of self-examinations provide a good method for early detection and thus the possibility of early treatment.

There are various types of testicular cancer, which differ in their origin and growth patterns. Most tumors develop from germ cells, the precursor cells of sperm, and are classified as germ cell tumors. Depending on the cell type and behavior, two types are distinguished, which progress differently. This differentiation is crucial for diagnosis and the choice of appropriate therapy.

Germ cell tumors represent approximately 95% of testicular cancer cases and develop from the germ cells responsible for sperm production. They are divided into two main groups, seminomas and non-seminomas, which differ significantly in their growth behavior, aggressiveness, and potential treatment approaches.

Seminomas develop more slowly and typically occur in men over 30 years of age. This form of tumor is generally benign in its growth pattern and responds particularly well to treatments such as radiation or chemotherapy. They tend to spread initially to nearby lymph nodes before affecting other organs. Therefore, seminomas are often diagnosable early and highly treatable.

Non-seminomas, on the other hand, are more aggressive and grow significantly faster. They occur more frequently in younger men between 20 and 30 years of age. These tumors can be composed of various cell types, such as embryonal carcinomas, yolk sac tumors, choriocarcinomas, or teratomas.

The distinction between these two main types of germ cell tumors is therefore crucial, as they significantly influence the choice of therapy and chances of recovery. While seminomas can often be treated successfully with radiation alone, treatment of non-seminomas typically requires a combination of surgical procedures and chemotherapy to achieve the best possible results.

Besides the more common germ cell tumors, there are also rarer forms of testicular cancer that develop from the supporting structures of the testicle. These include stromal tumors, such as Leydig cell tumors, which arise from testosterone-producing Leydig cells and can therefore cause hormonal disorders like gynecomastia. Sertoli cell tumors, which develop from the supporting cells for sperm development, are usually benign but can become malignant in rare cases. Other rare tumors also include metastases that can spread to the testicle from tumors in other organs, such as the lungs or intestines.

Early detection of testicular cancer is crucial, as timely diagnosis can significantly improve chances of recovery. One of the first and most common signs is a palpable nodule or lump in the testicle, which often feels hard but is usually painless. Size differences between testicles that weren’t previously present can also indicate changes in the tissue.

Another symptom is a slight pulling sensation or pain in the testicular area, which may be accompanied by a feeling of heaviness in the scrotum. Occasionally, pressure sensations in the lower abdomen or groin area may occur.

Since these symptoms aren’t always clear-cut, it’s important to consult a doctor early, even if there’s only a suspicion. A simple but effective way for early detection is regular self-examination, where the testicles are checked for lumps or other abnormalities.

Testicular cancer can manifest through various symptoms that can be recognized particularly in the early stages. Among the most common signs are pain in the lower abdomen or groin, often experienced as dull or pulling sensations. Sometimes, those affected also feel pain or pulling in the testicle, which particularly intensifies during movement or when pressure is applied to the testicle.

Another common symptom is swelling or enlargement of the testicle. This swelling may be caused by a lump in the scrotum, which can feel hard to the touch. In some cases, the testicle may feel heavier or uncomfortable, which can be caused by fluid accumulation in the scrotum (hydrocele). In rare cases, enlargement of breast tissue (gynecomastia) may occur due to hormonal changes. Also, a visible change in testicle shape, if not previously known, can in some cases indicate a possible illness.

With such symptoms, it’s typically important to seek medical attention promptly to obtain an accurate diagnosis and discuss possible treatment options early on.

Testicular cancer can be diagnosed through a combination of physical examination, imaging procedures, and laboratory tests. Initially, visible changes in the testicle such as swelling, enlargement, or hardening can provide first indications of a possible illness. A central role in diagnosis is therefore the palpation of the testicle, where a doctor can detect lumps or abnormalities. Additionally, ultrasound is used to create detailed images of the tissue and distinguish between benign and malignant changes. Furthermore, blood tests are conducted to determine tumor markers such as AFP (Alpha-Fetoprotein), HCG (Human Chorionic Gonadotropin), or LDH (Lactate Dehydrogenase), which may be elevated in testicular cancer. In advanced cases, a CT scan is often performed to determine if the cancer has spread to other areas of the body.

Therefore, self-examination is of great importance to detect and investigate changes in testicular tissue early on.

Testicular cancer develops when cells in the testicle grow and multiply uncontrollably. The exact causes of these cellular changes are not yet fully understood, however, various risk factors increase the likelihood of developing testicular cancer.

One of the most common risk factors is typically undescended testicles (cryptorchidism), where one or both testicles haven’t descended into the scrotum during development. Family history of testicular cancer can also increase the likelihood of developing the disease. Awareness of these risks and early examination of changes are therefore crucial to diagnose and successfully treat the disease in a timely manner.

Genetic factors play a very significant role in the development of testicular cancer. A family history of testicular cancer can significantly increase the risk, especially if a close relative such as a father or brother is also affected. Studies show that men with a family history develop the disease significantly more often. Additionally, men who have already had testicular cancer have an increased risk of developing a tumor in the other testicle. This risk is particularly elevated in the first years after initial diagnosis and requires well-controlled follow-up care.

Furthermore, specific genetic changes have been identified that can influence the risk of testicular cancer. For example, an association has been found with mutations in the KITLG gene, which is normally involved in cell division and development. Specific chromosomal changes, particularly on chromosome 12, are also frequently found in patients with testicular cancer.

Moreover, age represents another factor, as testicular cancer occurs particularly frequently in young men between 15 and 40 years of age. The exact cause for this age preference is not yet fully understood but could be related to hormonal or developmental factors.

Lifestyle and health factors can also influence the risk of developing testicular cancer. A significant factor is cryptorchidism, also known as undescended testicles. In this congenital malformation, the testicle remains either in the abdominal cavity or in the inguinal canal during early development, instead of descending into the scrotum. Men with cryptorchidism therefore have up to a tenfold increased risk of developing testicular cancer, particularly if the malposition was corrected late in childhood or not at all.

Additionally, hormonal changes or disorders can affect the development of testicular cancer. For example, it is suspected that an unbalanced hormonal environment during fetal development or adolescence can increase the risk of testicular cancer. This includes conditions that lead to reduced fertility or impaired testicular function.

Furthermore, there is evidence that environmental factors and general lifestyle, such as exposure to certain chemicals or pollutants, can also influence the risk.

Testicular cancer can also affect a man’s fertility. Both the disease itself and treatment measures such as surgeries, chemotherapy, or radiation can impair sperm production. Therefore, early education and appropriate measures are crucial to maintain the possibility of future family planning.

Testicular cancer and its treatments can significantly influence a man’s fertility. The disease itself can restrict sperm production, especially if the tumor affects the healthy tissue of the testicle. Additionally, chemotherapy and radiation therapy can impact germ cells, as these are particularly sensitive to such treatments. This can lead to temporary or even permanent infertility.
The surgical removal of a testicle (orchiectomy) usually only affects fertility if the remaining testicle is no longer fully functional.

The disease and treatment of testicular cancer can reduce sperm production, especially if the tumor is already advanced. Additionally, chemotherapy and radiation therapy can damage germ cells, leading to temporary or permanent infertility. Therefore, it is important to consider measures such as sperm cryopreservation before starting treatment to secure the possibility of later fatherhood. Fertility can be more accurately checked after treatments through tests to assess long-term effects.

The treatment of testicular cancer mainly depends on the type of tumor, the stage of the disease, and the patient’s general health condition. Usually, cancer is treated in a multidisciplinary approach, which includes surgery, chemotherapy, and radiation therapy. The choice of treatment is based on a specific diagnosis and can also be individually adjusted to achieve the best possible results.

A common first step is the removal of the affected testicle (orchiectomy) to eliminate the tumor. For non-seminomatous tumors and advanced cancer, additional chemotherapy or radiation therapy may be necessary to completely destroy remaining cancer cells.

The surgical treatment of testicular cancer mainly involves orchiectomy, the removal of the affected testicle. This is usually the first step of therapy to remove the tumor tissue from the body and prevent further spread. In most cases, the procedure is performed minimally invasively, significantly shortening the healing time. In more advanced cases, i.e., where the cancer has spread to lymph nodes, additional lymph node removal may be necessary. This is often also performed through surgery. Orchiectomy is a very successful therapy for the treatment of testicular cancer, and in most cases, the patient can return to a normal life after the procedure with appropriate follow-up care. Nevertheless, further treatments such as chemotherapy or radiation therapy are often necessary, especially if the cancer has spread beyond the testicle.

Chemo- and radiation therapy are mainly used in advanced stages of testicular cancer or after surgical removal of the affected testicle if cancer cells could still remain in the body.

Chemotherapy is particularly effective when the cancer has already spread to other parts of the body. It aims to destroy cancer cells or prevent their growth. The medications are usually administered intravenously and can cause typical side effects such as nausea, hair loss, and fatigue.

On the other hand, radiation therapy is often used, especially from the point where the cancer has spread to the lymph nodes. This form of therapy can also cause side effects such as skin irritations and exhaustion, but it is a valuable support to prevent relapse.

In addition to conventional treatment approaches such as surgical removal, chemotherapy, and radiation therapy, holistic therapies can also provide valuable support in the treatment of testicular cancer. These complementary methods focus particularly on strengthening the immune system, alleviating side effects of treatment, and promoting general well-being.

An example is hyperthermia, which can be used during or after chemotherapy. In hyperthermia, body tissue is specifically heated to weaken cancer cells and improve their response to therapy. There is the possibility of local hyperthermia and whole-body hyperthermia, depending on the affected area of the body.

Mistletoe therapy is another alternative method often used as an accompanying treatment for cancer. It aims to strengthen the immune system and support the healing process by mobilizing the body’s own defense forces.

It is also believed that mistletoe therapy could reduce the toxicity of chemotherapeutic agents.
Another approach is offered by ozone therapy, which promotes cell regeneration by increasing the body’s oxygen supply. This form of therapy also helps to strengthen the immune system and can accelerate the healing process.

Acupuncture has proven helpful in alleviating pain and nausea, which occur especially during chemotherapy. It can therefore improve the quality of life during treatment and contribute to pain management.

These holistic approaches should not be viewed as a direct replacement for conventional treatment, but rather as valuable complementary measures that can improve well-being and promote physical and mental regeneration.

Prevention of testicular cancer is crucial, as the disease is very treatable in early stages. Regular self-examinations and medical check-ups are therefore important measures to detect possible signs early.

Regular self-examination of the testicles is a simple and particularly effective prevention of testicular cancer. Each testicle should be carefully palpated with the fingers to notice lumps, hardening, or other changes in size or shape early. The examination is best done after showering or bathing when the testicles are relaxed. It can be helpful to use a flashlight to better illuminate the testicle. It is important to have noticeable changes checked by a doctor, even if no pain occurs.

There are various early detection examinations that can be performed, for example, by a urologist to detect testicular cancer. Common examinations include palpation of the testicles. Additionally, an ultrasound of the testicle can be used to obtain more detailed information about abnormalities or hardening. In some cases, a blood test for tumor markers may also be performed, especially if a risk of disease is already known. These preventive measures are significant for early diagnosis and allow increasing the chances of recovery.

After treatment for testicular cancer, regular check-ups are important to detect a relapse early and continue to monitor healing very closely. This follow-up care often includes blood tests for tumor markers, ultrasound examinations, and further medical consultations to ensure that the cancer does not return. In many cases, those affected also benefit from rehabilitation measures that contribute to physical and psychological recovery. In advanced stages or permanent limitations, there may be the possibility to apply for a disability card to receive additional support in everyday life.

In the following, we aim to answer your most common questions about testicular cancer to provide you with a more comprehensive picture of the symptoms, development, and treatment.

The information listed contains relevant topics and serves to improve understanding.