Brad Coleman Cancer Foundation

Testicular Cancer is the number one cancer killer of young men 15 through 35 years of age. Yet it is one of the least talked about forms of cancer and because of this the mortality rate is very high. Testicular cancer is very successfully treated if caught early but you need to know the early warning signs!

What is Testicular Cancer?
  • Cancer that develops in one or both testicles in young boys and men.
  • It is highly treatable.
  • It is usually curable if caught early.

Risk Factors
  • Ages 15 - 35
  • Undecended testicle(s).
  • Klinefelter's syndrome
  • Family history. If family members have had testicular cancer, you may have an increased risk
  • Race & ethnicity - Testicular cancer is more common in white men than in black men.

Signs & Symptoms

  • A lump, enlargement or swelling in either testicle.
  • A feeling of heaviness in the scrotum.
  • A dull ache in the abdomen or groin.
  • Pain or discomfort in a testicle or scrotum.
  • A sudden collection of fluid in the scrotum.
  • Enlargement or tenderness of the breasts.
  • Lower back pain.

Early Detection is Your Best Protection
 Don't ignore early signs & symptoms!

Self-Examination of the Testes    

Self-examination of the testes is important for early detection of cancer of the testicle, which can be felt as a small lump. The self-examination technique is simple, and should be performed once a month as follows:
  • When:

    The best time is right after a warm shower when the scrotal skin is relaxed and its contents can be felt most easily.
  • How:

    Examine each testicle gently with the fingers of both hands by rolling the testicle between the thumb and forefingers
 
  • What to look for:

    Look for a small lump about the size of a pea on the front or the side of the testicle. A natural rope-like structure, the epididymis, is situated along the back of the testicle. Learn what it feels like so that you do not confuse it with an abnormal mass.
  • What to do:

    Not all lumps are cancerous, but if you do find one, tell your physician at once. When diagnosed early, testicular cancer is completely curable.

 

Anatomy of the Scrotum The testes (singular, testis) are two glandular organs located within the scrotum which produce spermatozoa (sperm) and male hormones. Each testis is ovoid in shape, and a tubular structure called the epididymis is situated along its back portion. At its lower end, the epididymis connects to a longer tubular structure called the vas deferens, or seminal duct, which leads to the prostate gland.

The epididymis collects sperm produced in the testis. The sperm then travel up the vas deferens to the prostate gland in the seminal fluid. There, secretions are added which aid sperm motility (ability to move about), producing semen. Semen is released from the prostate gland into the urethra, through which it exits the body during sexual intercourse.


Treatment

  • Surgery - as it usually doesn't involve both testicles, you still have one testicle for hormone & sperm production. Prosthesis implants that look and feel like a normal testicle are available.
  • Chemotherapy
  • Radiation Therapy

Types of  Testicular Cancer

Types of testicular cancer and the symptoms they can cause There are different types of testicular cancer. Certain types can cause symptoms in other parts of the body, too.

Germ cell tumors Germ cell tumors are the most common type of testicular cancer. They start in the cells that make sperm. The 2 main types of male germ cell cancers are seminoma and non-seminoma. There are many sub-types of non-seminoma. Often, tumors contain a mixture of both semonoma and non-seminoma. The most common symptom of a testicular germ cell tumor is a lump on the testicle. These tumors sometimes make a hormone called human chorionic gonadotropin (HCG). A very high level of HCG can cause a man's breasts to grow larger or become tender.

Stromal tumors Cancer can also develop in the supportive and hormone-producing tissues, or stroma, of the testicles. These tumors are known as gonadal stromal tumors. These are much less common than testicular germ cell tumors. The 2 main types are Leydig cell tumors and Sertoli cell tumors.

Leydig cell tumors start in the Leydig cells that normally make male sex hormones. This type of tumor can make androgens (male sex hormones) or estrogens (female sex hormones) leading to certain symptoms:

    Estrogen-producing tumors: In men these tumors can cause loss of sexual desire or make the breasts grow.

    Androgen-producing tumors: These might not cause symptoms in men, but in boys they can cause growth of facial and body hair at an abnormally early age.

Sertoli cell tumors develop from normal Sertoli cells, which support and nourish the sperm-producing germ cells. These tumors do not make hormones, and again the main symptom is a testicular lump.

Ovarian Germ Cell Cancer

When cancer cells form in the egg cells of the ovary, it is called ovarian germ cell cancer. Possible signs include swelling of the abdomen or vaginal bleeding after menopause. Tests that examine the ovaries, pelvic area, blood, and ovarian tissue are used to make a diagnosis. A woman's prognosis and treatment options will depend on the cancer's stage and whether it has spread.   

What Is Ovarian Germ Cell Cancer?
 Ovarian germ cell cancer is a disease in which malignant (cancerous) cells form in the germ (egg) cells of the ovary. Germ cell cancer begins in the reproductive cells (egg or sperm) of the body. Ovarian germ cell cancer usually occurs in teenage girls or young women, and usually affects just one ovary.  

Types of Ovarian Germ Cell Cancer
Ovarian germ cell cancer is a general name that is used to describe several different types of cancer. The most common type of ovarian germ cell cancer is called dysgerminoma. Other types include:    
What Are the Symptoms? 
Possible symptoms of ovarian germ cell cancer are:  
  • Swelling of the abdomen
  • Vaginal bleeding after menopause.
 
Diagnosing Ovarian Germ Cell Cancer

 Ovarian germ cell cancer can be difficult to diagnose (find) early. In most cases, there are no symptoms in the early stages, but tumors may be found during regular gynecologic examinations.   Women should see their doctor if they have swelling of the abdomen without weight gain in other places or bleeding from the vagina if they have gone through menopause and no longer have menstrual periods.   Tests that examine the ovaries, pelvic area, blood, and ovarian tissue are used to detect and diagnose ovarian germ cell cancer. Tests and procedures that may be used to diagnose ovarian germ cell cancer include:  
  • Pelvic exam
  • Surgery (laparotomy)
  • Lymphangiogram
  • Computed tomography scan
  • Blood tests.
 
How Is It Treated?
Different types of treatments are available for ovarian germ cell cancer. Some treatments are standard, meaning they are the usual treatment for the disease. Others are being tested in clinical trials.   Treatment options for ovarian germ cell cancer include:  
  • Surgery
  • Chemotherapy
  • Radiation therapy.
  Surgery for Ovarian Germ Cell Cancer Surgery is the most common treatment for ovarian germ cell cancer. Types of surgery that may be used to remove the cancer include:  
  • Unilateral salpingo-oophorectomy: A surgical procedure to remove one ovary and one fallopian tube.
 
  • Total hysterectomy: A surgical procedure to remove the uterus, including the cervix. If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision (cut) in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are taken out through a small incision in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy.
   
  •      Tumor debulking:  A surgical procedure in which as much of the tumor as possible is removed. Some tumors may not be able to be co
    • Bilateral salpingo-oophorectomy: A surgical procedure to completly remove both ovaries and both fallopian tubes.
  Chemotherapy for Ovarian Germ Cell Cancer Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.   When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (this is called systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (this is called regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Radiation Therapy for Ovarian Germ Cell Cancer Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells.   There are two types of radiation therapy:  
  • External radiation
  • Internal radiation.
  External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.   The way the radiation therapy is given will depend on the type and stage of the cancer that is being treated. Some women receive a treatment called intraperitoneal radiation therapy, in which radioactive liquid is put directly into the abdomen through a catheter (a small, narrow tube).   Even if the doctor removes all the cancer that can be seen at the time of the operation, some patients may be offered chemotherapy or radiation after surgery to kill any cancer cells that are left. Treatment that is given after the surgery to increase the chances of a cure is called adjuvant therapy.   Following radiation or chemotherapy, an operation called a second-look laparotomy is sometimes performed. This is similar to the laparotomy that is done to determine the stage of the cancer. During the second-look operation, the doctor will take samples of lymph nodes and other tissues in the abdomen to see if any cancer is left. 

  Clinical Trials
Before starting treatment for ovarian germ cell cancer, patients may want to consider taking part in a clinical trial. A clinical trial is a research study that is meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new ovarian germ cell cancer treatment is better than the current standard treatment, the new treatment may become the standard treatment.

Prognosis for Ovarian Germ Cell Cancer
 The prognosis (chance of recovery) and treatment options for ovarian germ cell cancer will depend on:  
  • The type of cancer
  • The size of the tumor
  • The way the cancer cells look under a microscope
  • The patient's general health
  • The stage of cancer (whether it affects part of the ovary, involves the whole ovary, or has spread to other places in the body).
  Ovarian germ cell cancer is generally curable if found and treated early.
 
  Summary

 Key points to keep in mind regarding ovarian germ cell cancer include:  
  • Ovarian germ cell cancer is a disease in which malignant (cancerous) cells form in the germ (egg) cells of the ovary
  • Possible signs of ovarian germ cell cancer are swelling of the abdomen or vaginal bleeding after menopause
  • Tests that examine the ovaries, pelvic area, blood, and ovarian tissue are used to detect this type of cancer
  • Certain factors affect the prognosis and treatment options for ovarian germ cell cancer.