Testicular cancer

Testicular cancer is cancer that develops in the testicles, a part of the male reproductive system.[2] Symptoms may include a lump in the testicle, or swelling or pain in the scrotum.[2] Treatment may result in infertility.

Risk factors include an undescended testis, family history of the disease, and previous history of testicular cancer.[5] The most common type is germ cell tumors which are divided into seminomas and nonseminomas.[5] Other types include sex-cord stromal tumors and lymphomas.[4] Diagnosis is typically based on a physical exam, ultrasound, and blood tests.[2] Surgical removal of the testicle with examination under a microscope is then done to determine the type.[2]

Testicular cancer is highly treatable and usually curable.[5] Treatment options may include surgery, radiation therapy, chemotherapy, or stem cell transplantation.[2] Even in cases in which cancer has spread widely, chemotherapy offers a cure rate greater than 80%.[4]

Globally testicular cancer affected about 686,000 people in 2015.[6] That year it resulted in 9,400 deaths up from 7,000 deaths in 1990.[7][8] Rates are lower in the developing than the developed world.[9] Onset most commonly occurs in males 20 to 34 years old, rarely before 15 years old.[3][10] The five-year survival rate in the United States is about 95%.[3] Outcomes are better when the disease remains localized.[3]

Signs and symptoms:

Image showing the first sign of testicular cancer One of the first signs of testicular cancer is often a lump or swelling in the testes. The U.S. Preventive Services Task Force (USPSTF) recommends against routine screening for testicular cancer in asymptomatic adolescent and adults including routine testicular self-exams.[11] However, the American Cancer Society suggests that some men should examine their testicles monthly, especially if they have a family history of cancer, and the American Urological Association recommends monthly testicular self-examinations for all young men.

Symptoms may also include one or more of the following:

A lump in one testis which may or may not be painful[14][15]
Sharp pain or a dull ache in the lower abdomen or scrotum[15]
A feeling often described as "heaviness" in the scrotum[15]
Firmness of the testicle[15]
Breast enlargement (gynecomastia) from hormonal effects of β-hCG[14][15]
Low back pain (lumbago) due to the cancer spreading to the lymph nodes along the back[14][15]

It is not very common for testicular cancer to spread to other organs, apart from the lungs. If it has, however, the following symptoms may be present:

shortness of breath (dyspnea), cough or coughing up blood (hemoptysis) from metastatic spread to the lungs[14][15]
a lump in the neck due to metastases to the lymph nodes

Testicular cancer, cryptorchidism, hypospadias, and poor semen quality make up the syndrome known as testicular dysgenesis syndrome.[citation needed]

Causes

A major risk factor for the development of testis cancer is cryptorchidism (undescended testicles). It is generally believed that the presence of a tumor contributes to cryptorchidism; when cryptorchidism occurs in conjunction with a tumor then the tumor tends to be large. Other risk factors include inguinal hernias, Klinefelter syndrome, and[16] mumps orc