Testicular (tes-TIK-yoo-lar) cancer occurs when cells in the testicle (TES-tikul), one of the two male sex glands located in the scrotum * below the penis, divide without control or order, forming a tumor * . Over time, these cancer cells can spread to other parts of the body.
In 1996, champion bicyclist Lance Armstrong (b. 1971) noticed that one of his testicles was enlarged. When he began coughing up blood, he went to his doctor. After discovering that he had cancer * in his testicle, he underwent an operation to remove the testicle. During the operation, doctors performed CT scans * , which showed that the cancer had metastasized (spread) to his abdomen, lungs, and brain. Lance immediately began an alternative chemotherapy * regimen to destroy the cancerous cells. He was given a 50 percent chance of survival.
For the next several months, Armstrong underwent chemotherapy in the hope that it would destroy the cancer. Fortunately, Armstrong was declared cancer free in 1997. Over the next year, Armstrong trained hard to get back into shape and was able to resume competitive cycling.
In 1997, before he even knew if he would survive cancer, Armstrong established the Lance Armstrong Foundation, a nonprofit intended to inspire and empower all people who are affected by cancer. As of 2015, it had raised more than $500 million for cancer awareness, research, prevention, screening, and treatment.
“Livestrong,” the motto of the Lance Armstrong Foundation, became a symbol of hope and perseverance worldwide. The simple yellow logo is printed on wristbands, clothing, and even laptop computers.
The testicles, also called the testes or male gonads, are the male sex glands located below the penis in a pouch of skin called the scrotum. The testicles are the body's main source of male hormones * , which control the development of the reproductive organs and male sex characteristics such as body and facial hair, low voice, and muscular arms. They also produce and store sperm (the tiny, tadpole-like cells that fertilize the female egg).
Testicular cancer usually begins when cells begin to divide without control or order, forming a tumor. Cells can break away from the tumor and enter the blood or the lymph, an almost colorless fluid produced by tissues all over the body. The fluid passes through lymph nodes * , the bean-shaped organs that filter the lymph, fight infection, and produce certain kinds of blood cells. When testicular cancer spreads, cancer cells are usually found in the nearby lymph nodes, the liver * , or the lungs.
Like most types of cancer, testicular cancer can be treated most easily when it is found early. That is why doctors encourage all teenage boys and men to perform monthly testicular self-examination (TSE), which involves rolling each testicle between the fingers and thumb. The testicles are smooth, oval-shaped, and rather firm, and men who examine themselves regularly become familiar with the way their testicles feel. If any change occurs, it should be reported to a doctor. For many men, it takes time to get comfortable with doing TSE, but it is the best way to find a lump early. This is usually the first sign of testicular cancer.
Other possible symptoms of testicular cancer include the following:
It is important for all men to be aware of these symptoms because doctors cannot predict who will get testicular cancer and who will not. As of 2015, the cause of testicular cancer was not known. Boys who are born with undescended testicles (located in the lower abdomen, rather than in the scrotum) have a higher risk of developing testicular cancer later in life. However, it usually develops for no apparent reason.
Doctors begin by examining the scrotum and testes carefully and ordering urine and blood tests. These tests can help determine whether an infection or some other disorder might be causing the symptoms. Also, if a tumor is present, certain substances in the blood may be found at elevated levels. These substances are called tumor markers, because they often are found in abnormal amounts in patients with some types of cancer. The doctor may also order tests that create images of the inside of the body, such as a CT scan or an ultrasound * .
After all of these tests, the doctor can be reasonably certain about the diagnosis. However, the only sure way to determine whether cancer is present is to examine a sample of tissue under a microscope. In an operation, surgeons remove the affected testicle.
Once cancer is diagnosed, doctors need to figure out whether it has spread to other parts of the body and formed metastases * . They may perform other tests to look for cancer elsewhere. Because the cancer frequently spreads through the lymph nodes in the abdomen, these may be removed and then checked for cancer cells.
The removal of the testicle, which is necessary to diagnose the cancer, is also the first step in treating it. In addition, tumors that have spread to other parts of the body may be removed partly or entirely by surgery. In most cases, surgery will be followed by radiation therapy, which focuses high-energy rays on the remaining tumor to kill cancer cells and stop their growth.
In some cases, chemotherapy may be used either before or after surgery. During chemotherapy, anticancer drugs are given by mouth or by injection into a muscle or vein.
Fortunately, this disease responds well to treatment, even when it has spread from the testicle to other parts of the body. Men who have had testicular cancer need to see their doctors for regular follow-up appointments to make sure that the cancer has not returned.
A man with one healthy testicle can still have sex and father children. Radiation therapy and chemotherapy may cause a temporary drop in sperm production, but it usually returns to normal within a few months. Patients who are concerned about how they look can also have an artificial testicle, called a testicular prosthesis * , placed in the scrotum. It looks and feels just like a normal testicle.
See also Cancer: Overview • Prostate Problems: Overview
Rettner, Rachael. “Testicular Cancer and Cycling: Is There a Link?” Live Science, July 13, 2015. http://www.livescience.com/51538-testicularcancer-cycling.html (accessed November 17, 2015).
Sachdeva, Kush. “Testicular Cancer.” Medscape, February 16, 2015. http://emedicine.medscape.com/article/279007-overview (accessed November 17, 2015).
American Society of Clinical Oncology. “Testicular Cancer.” Cancer. http://www.cancer.net/cancer-types/testicular-cancer (accessed November 17, 2015).
MedlinePlus. “Testicular Cancer.” U.S. National Library of Medicine, National Institutes of Health. https://www.nlm.nih.gov/medlineplus/testicularcancer.html (accessed November 17, 2015).
NHS Choices. “Testicular Cancer.” National Health Service. (accessed November 17, 2015).
American Cancer Society. 250 Williams St. NW, Atlanta, GA 30303. Toll-free: 800-227-2345. Website: http://www.cancer.org (accessed November 17, 2015).
Lance Armstrong Foundation. 2201 East Sixth St., Austin, TX 78702. Toll-free: 877-236-8820. Website: http://www.livestrong.org (accessed November 17, 2015).
National Cancer Institute. 9609 Medical Center Dr., Building 9609, MSC 9760, Bethesda, MD 20892-9760. Toll-free: 800-4-CANCER. Website: http://www.cancer.gov (accessed November 17, 2015).
Urology Care Foundation. 1000 Corporate Blvd., Linthicum, MD 21090. Toll-free: 800-828-7866. Website: http://www.urologyhealth.org (accessed November 17, 2015).
* scrotum (SKRO-tum) is the pouch on a male body that contains the testicles.
* tumor (TOO-mor) is an abnormal growth of body tissue that has no known cause or physiologic purpose. A tumor may or may not be cancerous.
* cancer is a condition characterized by abnormal overgrowth of certain cells, which may be fatal.
* CT scans is the shortened name for computed tomography (to-MOG-ra-fee), which uses computers to view structures inside the body. Formerly called computerized axial tomography (CAT).
* chemotherapy (KEE-mo-THER-apee) is the treatment of cancer with powerful drugs that kill cancer cells.
* hormones are chemical substances that are produced by various glands and sent into the bloodstream carrying messages that have certain effects on other parts of the body.
* lymph node (LIMF) is a small, bean-shaped mass of tissue containing immune system cells that fight harmful microorganisms. The lymph node may swell during infections.
* liver is a large organ located beneath the ribs on the right side of the body. The liver performs numerous digestive and chemical functions essential for health.
* ultrasound, also called a sonogram, is a diagnostic test in which sound waves passing through the body create images on a computer screen.
* metastases (me-TAS-ta-seez) are new tumors formed when cancer cells from a tumor spread to other parts of the body.
* prosthesis (pros-THEE-sis) is an artificial substitute for a missing body part. It can be used for appearance only or to replace the function of the missing part (as with a prosthetic leg).