Testicular Cancer

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Testicular cancers are relatively rare, but often curable. They occur predominantly in young and middle-aged men. Testicular cancers are also called germ cell tumors, which classifies them within the group of cancers arising from reproductive organs or gonads.

Since testicular cancer is rare, a multidisciplinary team of experienced physicians, surgeons and other specialists is needed for the best possible outcome and cure. All Swedish testicular-cancer patients benefit from a comprehensive approach to care that begins with state-of-the-art imaging techniques and features the latest treatments and a wide range of high-quality support services. 

Symptoms

Testicular cancers usually present as a lump or swelling of one testicle. Some patients may notice dull ache or even acute pain in scrotum or groin. When testicular cancers present at a more advanced stage, patients may experience shortness of breath and back pain. 

Diagnosis

Lumps in testicle are often detected by physical exam. Ultrasound is then used to determine the nature of the lumps. If suspicion of cancer is high, removal of the affected testicle by surgery would be recommended. Tumor markers will be checked before surgery and after surgery, which may help to determine diagnosis, stage and prognosis.

There are 2 types of testicle cancer, namely seminoma and nonseminoma. Nonseminoma germ cell cancers include embryonal carcinoma, choriocarcinoma, yolk sac tumor and teratoma. Sometimes seminoma and different types of nonseminoma can present as a mixed germ cell tumor in testicle of the same patient.

In addition to tumor markers, CT scan and x-ray are used to determine if testicle cancer has spread to lymph nodes in abdomen, lungs or other visceral organs. This is called staging. The stage of cancer, along with tumor markers, helps your doctor to choose optimal treatment. 

Treatment

Surgery

  • Radical orchiectomy. Surgical removal of affected testicle, called radical orchiectomy, not only helps doctor to make diagnosis, but also serves as primary treatment of testicle cancer. Patients with early stage testicle cancer can be cured by orchiectomy alone. 
  • Retroperitoneal lymph node dissection (RPLND). Surgical removal of lymph nodes in abdomen may be needed if there is concern of residual cancer in adjacent lymph nodes after orchiectomy. 

Radiation therapy

Radiation therapy kills cancer cells through X-rays. Radiation therapy may be recommended for some patient if there is concern of residual cancer in adjacent lymph nodes after orchiectomy. 

Chemotherapy

For patients at high risk for recurrent testicular cancer or with cancer spread to lymph nodes or visceral organs, chemotherapy may be recommended. There are several well-established chemotherapy regimens that can provide a cure even when testicle cancer has spread to other organs. Since chemotherapy may result in infertility, patients are advised to preserve sperm (sperm banking) before starting chemotherapy.

If cancer persists despite of chemotherapy, stem cell transplantation may be recommended. Swedish has a team of highly experienced physicians specializing in stem cell transplantation for those patients.

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Research and Clinical Trials

If your physician believes you are a good candidate to participate in a clinical trial evaluating a new treatment or more effective combinations of treatments — and you agree — you will have access to the very latest in research treatments.

At any given time, the Swedish Cancer Institute offers patients more than 140 clinical-research studies involving most types of cancers.  Additionally, our physician specialists collaborate with other regional and national research groups, including  Southwest Oncology Group, National Cancer Institute, Puget Sound Oncology Consortium and Fred Hutchinson Cancer Research Center.

Education and Support for Patients and Families

Beyond physical health, the Swedish Cancer Institute is committed to the emotional well-being of our patients and their families. We offer:

Complementary therapies include:

See Patient Support and Resources and Services for the Body, Mind and Spirit at Swedish.

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