Testicular Cancer

Testicular cancer cells take root in one or both testicles, the glands held inside the scrotum along with vessels and nerves. Testicles make sperm and male sex hormones such as testosterone.

Wilmot Cancer Institute, in partnership with UR Medicine’s Department of Urology, is the leader in testicular cancer care in the region, and is conducting research  to improve care and better understand the disease. No other cancer center in Upstate New York has our level of expertise.

Testicular cancer types

Germ cell tumors comprise more than 90 percent of testicle cancers. These tumors develop in the cells that make sperm. There are two types of germ cell tumors. Each type grows and spreads differently and they are treated differently, although some tumors contain cells from both types:

• Seminomas, which tend to grow less rapidly. They usually occur in men ages 35 to 50, although one subtype afflicts older men.
• Non-seminomas, which occur in men between their late teen years and early 30s and tend to grow more quickly. There are four variations of non-seminomas, including a rare, aggressive subtype called choriocarcinoma. Often choriocarcinoma is mixed with other types of non-seminoma cells, which improves the outlook for patients.

Testicle cancer is sometimes discovered before it’s invasive. In that case it’s known as carcinoma in situ of the testicle.

In addition to the more common germ cell tumors, rarer types of testicular tumors include: Leydig cell tumors (which can be benign and arise in the cells producing testosterone); and Sertoli cell tumors (which are also usually benign). Sometimes pre-adolescent leukemia can arise in the testicles, and in older men lymphoma can occur in the testicles, too.

Testicular cancer facts

It’s the most common cancer in men ages 20 to 35. About 8,700 new cases are diagnosed annually (one of every 263 males) and the incidence has been rising in the U.S. but experts are not sure why. Testicular cancer is often treated successfully; the chance of dying from it is low.

Causes and risk factors

Many men who develop testicular cancer do not have risk factors other than being young. One primary condition that does increase the risk is having an undescended testicle. This occurs before birth, when one or both testicles fail to move from the belly, where they develop, down to the scrotum. If the testicles haven’t descended by a boy’s first birthday, surgery is possible during childhood but the risk for cancer remains in place. Even if only one testicle is undescended, the normal testicle is also at risk for developing cancer. Additional risk factors:

• Family history, especially a father or brother.
• Having HIV, particularly if the patient also has AIDS.
• Personal history of cancer in the other testicle.
• Race/Ethnicity. White men have five times the risk compared to black men and Asian-Americans.
• Body size. The studies that address this issue are mixed, but some research suggests that being tall slightly increases the risk of testicular cancer.

Prevention

It’s not possible to prevent testicular cancer since most of the risk factors (young age, undescended testicles, being white, etc.) cannot be changed or controlled.