Testicular cancer
- Overview Of PDQ
- Description
- Stage Explanation
- Treatment Option Overview
- Stage I Testicular Cancer
- Stage II Testicular Cancer
- Stage III Testicular Cancer
- Recurrent Testicular Cancer
- To Learn More
CancerNet from the National Cancer Institute
Information from PDQ for Patients
PDQ is a computer system that gives up-to-date information on cancer and its
prevention, detection, treatment, and supportive care. It is a service of the
National Cancer Institute (NCI) for people with cancer and their families and
for doctors, nurses, and other health care professionals.
To ensure that it remains current, the information in PDQ is reviewed and
updated each month by experts in the fields of cancer treatment, prevention,
screening, and supportive care. PDQ also provides information about research
on new treatments (clinical trials), doctors who treat cancer, and hospitals
with cancer programs. The treatment information in this summary is based on
information in the PDQ summary for health professionals on this cancer.
PDQ can be used to learn more about current treatment of different kinds of
cancer. You may find it helpful to discuss this information with your doctor,
who knows you and has the facts about your disease. PDQ can also provide the
names of additional health care professionals who specialize in treating
patients with cancer.
Before you start treatment, you also may want to think about taking part in
a clinical trial. PDQ can be used to learn more about these trials. A clinical
trial is a research study that attempts to improve current treatments or finds
information on new treatments for patients with cancer. Clinical trials are
based on past studies and information discovered in the laboratory. Each trial
answers certain scientific questions in order to find new and better ways to
help patients with cancer. Information is collected about new treatments,
their risks, and how well they do or do not work. When clinical trials show
that a new treatment is better than the treatment currently used as
"standard" treatment, the new treatment may become the standard
treatment. Listings of current clinical trials are available on PDQ. Many
cancer doctors who take part in clinical trials are listed in PDQ.
To learn more about cancer and how it is treated, or to learn more about
clinical trials for your kind of cancer, call the National Cancer Institute's
Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237); TTY
at 1-800-332-8615. The call is free and a trained information specialist will
be available to answer cancer-related questions.
PDQ is updated whenever there is new information. Check with the Cancer
Information Service to be sure that you have the most up-to-date information.
Cancer of the testicle (also called the testis), a rare kind of cancer in men,
is a disease in which cancer (malignant) cells are found in the tissues of one
or both testicles. Sperm (the male germ cells that can join with a female egg
to develop into a baby) and male hormones are made in the testicles. There are
two testicles located inside of the scrotum (a sac of loose skin that lies
directly under the penis). The testicles are similar to the ovaries in women
(the small sacs that hold the female egg cells).
Cancer of the testicle is the most common cancer in men 15 to 35 years old.
Men who have an undescended testicle (a testicle that has never moved down
into the scrotum) are at higher risk of developing cancer of the testicle than
other men whose testicles have moved down into the scrotum. This is true even
if surgery has been done to place the testicle in the appropriate place in the
scrotum.
A doctor should be seen if there is any swelling in the scrotum. The doctor
will examine the testicles and feel for any lumps. If the scrotum doesn't feel
normal, the doctor may need to do an ultrasound examination, which uses sound
waves to make a picture of the inside of the testes. The doctor may need to
cut out the testicle and look at it under a microscope to see if there are any
cancer cells. It is very important that this be done correctly.
The chance of recovery (prognosis) and choice of treatment depend on the
stage of the cancer (whether it is just in the testicle or has spread to other
places) and the patient's general state of health.
Once cancer of the testicle has been found, more tests will be done to find
out if the cancer has spread from the testicle to other parts of the body
(staging). A doctor needs to know the stage of the disease to plan treatment.
The following stages are used for cancer of the testicle:
Cancer is found only in the testicle.
Cancer has spread to the lymph nodes in the abdomen (lymph nodes are small,
bean-shaped structures that are found throughout the body; they produce and
store infection-fighting cells).
Cancer has spread beyond the lymph nodes in the abdomen. There may be cancer
in parts of the body far away from the testicles, such as the lungs and liver.
Recurrent disease means that the cancer has come back (recurred) after it has
been treated. It may come back in the same place or in another part of the
body. A patient should regularly examine the opposite testicle for possible
recurrence for many years after treatment. Patients will probably have
check-ups once per month during the first year after surgery, every other
month during the next year, and less frequently after that.
There are treatments for all patients with cancer of the testicle, and most
patients can be cured with available treatments. Four kinds of treatment are
used:
- surgery (taking out the cancer in an operation)
- radiation therapy (using high-dose x-rays or other high-energy rays to
kill cancer cells)
- chemotherapy (using drugs to kill cancer cells)
- bone marrow transplantation
Surgery is a common treatment of most stages of cancer of the testicle. A
doctor may take out the cancer by removing one or both testicles through an
incision (cut) in the groin. This is called a radical inguinal orchiectomy.
Some of the lymph nodes in the abdomen may also be removed (lymph node
dissection).
Radiation therapy uses x-rays or other high-energy rays to kill cancer
cells and shrink tumors. Radiation therapy for testicular cancer usually comes
from a machine outside the body (external-beam radiation).
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by
pill, or it may be put into the body by a needle in a vein. Chemotherapy is
called a systemic treatment because the drugs enter the bloodstream, travel
through the body, and can kill cancer cells outside the testicle.
Bone marrow transplantation is a newer type of treatment. For autologous
bone marrow transplant, bone marrow is taken from the patient and treated with
drugs to kill any cancer cells. The marrow is then frozen and the patient is
then given high-dose chemotherapy with or without radiation therapy to destroy
all of the remaining marrow. The marrow that was taken out is then thawed and
given back to the patient through a needle in a vein to replace the marrow
that was destroyed.
Treatment of cancer of the testicle depends on the stage and cell type of the
disease, and the patient's age and overall condition.
Standard treatment may be considered because of its effectiveness in
patients in past studies, or participation in a clinical trial may be
considered. Not all patients are cured with standard therapy and some standard
treatments may have more side effects than are desired. For these reasons,
clinical trials are designed to find better ways to treat cancer patients and
are based on the most up-to-date information. Clinical trials are ongoing in
many parts of the country for all stages of cancer of the testicle. To learn
more about clinical trials, call the Cancer Information Service at
1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
Treatment depends on what the cancer cells look like under a microscope (cell
type). If a tumor called a seminoma is found, treatment will probably be
surgery to remove the testis (radical inguinal orchiectomy), followed by
external-beam radiation to the lymph nodes in the abdomen. Clinical trials are
also being performed on radical inguinal orchiectomy alone followed by careful
testing to see if the cancer comes back.
If a tumor called a nonseminoma is found, treatment may be one of the
following:
- 1. Radical inguinal orchiectomy and removal of some of the lymph
nodes in the abdomen (lymph node dissection). Patients may undergo surgery
that will preserve fertility. Blood tests and chest x-rays must be done
once each month for the first year following the operation and at least
every 2 months during the second year. A CT scan, a special kind of x-ray,
may also be done. If results of the tests don't look normal and the cancer
has recurred (come back), the doctor will give the patient systemic
chemotherapy as soon as possible.
2. Radical inguinal orchiectomy alone followed by careful testing
to see if the cancer comes back. The doctor must check the patient and do
blood tests and x-rays every month for 2 years. This option is chosen only
if the tumor has certain special features.
Treatment depends on what the cancer cells look like under a microscope (cell
type). If a tumor called a seminoma is found and the tumor is nonbulky (no
lymph nodes can be felt in the abdomen, and no lymph nodes block the ureters
[the tubes that carry urine from the kidney to the bladder]), treatment will
probably be surgery to remove the testis (radical inguinal orchiectomy).
External-beam radiation is then given to the lymph nodes in the abdomen.
If a tumor called a seminoma is found and the tumor is bulky (lymph nodes
can be felt in the abdomen and/or the lymph nodes block the ureters, or if a
CT scan shows them to be large), treatment will probably be a radical inguinal
orchiectomy followed by systemic chemotherapy or external-beam radiation
therapy.
If a tumor called a nonseminoma is found, treatment will probably be one of
the following:
- 1. Radical inguinal orchiectomy and removal of the lymph nodes in
the abdomen (lymph node dissection). The doctor will check the patient
each month and do blood tests, chest x-rays, and CT scans. If the test
results are not normal, patients will probably receive systemic
chemotherapy.
2. Radical inguinal orchiectomy and lymph node dissection, followed
by systemic chemotherapy. Blood tests and chest x-rays must be done once
each month for the first year after the operation. CT scans are also done
regularly.
3. Radical inguinal orchiectomy followed by systemic chemotherapy.
If x-rays following chemotherapy show that cancer remains, surgery may be
done to remove the cancer. After the operation, the doctor will check the
patient each month and do blood tests, chest x-rays, and CT scans. In some
cases, chemotherapy may be given before the radical inguinal orchiectomy.
4. Clinical trials of systemic chemotherapy instead of lymph node
dissection (in selected patients).
Treatment depends on what the cancer cells look like under a microscope (cell
type). If a tumor called a seminoma is found, treatment will probably be
surgery to remove the testis (radical inguinal orchiectomy), followed by
systemic chemotherapy. Clinical trials are testing radical inguinal
orchiectomy followed by systemic chemotherapy. If a tumor called a nonseminoma
is found, treatment will probably be one of the following:
- 1. Systemic chemotherapy. Clinical trials are testing new
chemotherapy drugs.
2. Systemic chemotherapy, followed by surgery to take out any
masses that remain to see if there are any cancer cells left. If cancer
cells remain, patients will probably receive more systemic chemotherapy.
3. Clinical trials of systemic chemotherapy.
4. Clinical trials of high-dose systemic chemotherapy with
autologous bone marrow transplantation (in some patients).
Treatment depends on what the cancer cells look like under a microscope, where
the cancer recurred (came back), and other factors. Treatment options include
systemic chemotherapy, high-dose systemic chemotherapy with autologous bone
marrow transplantation, surgery, and clinical trials testing new chemotherapy
drugs.
TO LEARN MORE..... CALL 1-800-4-CANCER
To learn more about cancer of the testicle, call the National Cancer
Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY
at 1-800-332-8615. By dialing this toll-free number, you can speak with a
trained information specialist who can answer your questions.
The Cancer Information Service also has booklets about cancer that are
available to the public and can be sent on request. The following booklets
about cancer of the testicle may be helpful:
- What You Need To Know About Testicular Cancer
Testicular Self-Examination
The following general booklets on questions related to cancer may also be
helpful:
- What You Need To Know About Cancer
Taking Time: Support for People with Cancer and the People Who Care About
Them
What Are Clinical Trials All About?
Chemotherapy and You: A Guide to Self-Help During Treatment
Radiation Therapy and You: A Guide to Self-Help During Treatment
Eating Hints for Cancer Patients
Advanced Cancer: Living Each Day
When Cancer Recurs: Meeting the Challenge Again
There are many other places where people can get material and information
about cancer treatment and services. The social service office at a hospital
can be checked for local and national agencies that help with getting
information about finances, getting to and from treatment, getting care at
home, and dealing with problems.
For more information from the National Cancer Institute, please write to
this address:
- National Cancer Institute
Office of Cancer Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580
Date Last Modified: 07/1998
If you want to know more about cancer and how it is treated, or if you if
you wish to know about clinical trials for your type of cancer, you can call
the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained
information specialist can talk with you and answer your questions.
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