Can Testicular Cancer Kill You?

Can Testicular Cancer Kill You?

Testicular cancer arises from the  male reproductive system. The testicles are responsible for the production of male sex hormones and sperm. They are located within the scrotum, a loose bag of skin below the penis. Testicular cancer is the most common type of cancer occurring in American males from the ages of 15 through 35.

Testicular cancer can be aggressive, growing and spreading rapidly. However, testicular cancer is highly treatable even after it spreads. Hence, the prognosis for men with testicular cancer is good because the disease can usually be treated successfully. 

One of every 250 males develops testicular cancer at some point in their lifetime, according to the American Cancer Society. Because testicular cancer is usually treated successfully, the risk of dying due to the cancer is about 1 in 5,000 of diagnosed men.

The exact cause of testicular cancer is not known. Some factors increase the risk of testicular cancer, such as

• Age: Testicular cancer usually occurs between the age of 20 to 35.
• Race: It is more common in white men than other races.
• Undescended testes (cryptorchidism): Surgical correction of undescended testes before puberty reduces the risk of testicular cancer. 
• Genetic conditions like Klinefelter syndrome causing abnormal development of the testes  
• Family history 
• Human immunodeficiency virus (HIV) infection

The initial signs and symptoms of testicular cancer include

• A painless lump in the testicle
• The affected testicle feels firmer and harder than the other 
• Dull aching in the scrotum or the groin

The other signs and symptoms that may develop later include

• Formation of blood clots, which can travel to the lungs causing chest pain and breathlessness.
• Varicocele (swollen blood vessels) appearing as enlarged, dark blue veins
• Hydrocele (Fluid around the testicle) causing swelling
• Infection of the testicle can occur causing pain
• Injury of the testes
• Twisting of the testicle (torsion)

Most testicular cancers are germ cell (cells that produce sperm) tumors. There are two main types of testicular cancer.

Seminomas grow and spread slowly. There are two subtypes 

• Classical seminoma: This is the most common and usually happens in men ages 25 to 45.
• Spermatocytic seminoma: Commonly occurs in older men and usually does not spread.

Nonseminomas grow and spread more quickly. They usually consist of multiple types of cancer cells, including

• Embryonal carcinoma: Contains cells look like cells from embryos under microscopic examination.
• Yolk sac carcinoma: These cells look like the sac that surrounds the embryos and usually occurs in children.
• Choriocarcinoma: Usually rare and spreads to the rest of the body quickly.
• Teratoma: A rare tumor that contains other tissue and organs, including teeth and hair.

Self-examination can help in early diagnosis and treatment. The affected testes is enlarged, firm and usually painless. The physician performs a complete physical assessment. Complete blood and radiological assessment is performed. 

• Blood Tests
  • Alpha fetoprotein levels (Alpha FP)
  • Human chorionic gonadotrophin levels (hCG)
  • Lactate dehydrate hydrogenase levels (LDH)
• Testicular USG
• Testicular CT Scan
• Lymphangiography to study tumor spread in lymph nodes
• A biopsy is usually performed to confirm the diagnosis. It is a minimally invasive procedure that involves obtaining a small sample of the testicle and examining the cells for cancer.

The treatment may involve one or a combination of multiple treatment modalities, which depends on the extent of the disease.

Treatment options include the following

• Surgery
  • Orchiectomy: Removal of the testicle. A prosthetic can be placed.
  • Testes-sparing surgery (TSS): The tumor is carefully removed and the healthy part of the testis is left behind. This is ideal for patients with small tumors or benign/ non-cancerous tumors. 
  • Retroperitoneal lymph node dissection: Surgical removal of the lymph nodes which the cancer commonly spreads to. 
• Radiation therapy: This targets and selectively kills cancer cells and shrinks tumors using radiation. 
• Chemotherapy: The tumor cells are killed with cancer medication. 
• Targeted therapy: This treatment uses medication to target certain genetic, protein, or other changes in and around cancer cells.
• Stem cell therapy may be a treatment option in some cases