Testicular cancer develops in the testicles, a part of the male reproductive system. Testicular cancers are more frequent in the age range between 20 and 35. In 95% of cases, they occur from the testicular cells or germ cells and in 95% of cases they occur in the testes, but may also occur in unusual locations such as the chest, abdomen or other areas.

STAFF

At the IEO testicular cancer is treated by a multidisciplinary team consisting of specialists in:

• Urogenital and Head and Neck Tumors Medical Treatment
• Urologic Surgery
• New Drugs and Early Drug Development for Innovative Therapies
• Department of Pathology and Laboratory Medicine
• Department of Medical Imaging and Radiation Sciences

The main risk factors of testicular cancer are:

• cryptorchidism (testes failed to descend into the scrotum)
• Klinefelter syndrome (presence of one extra X chromosome in men)
• personal or family history of testicular cancer and abnormal testicular development (gonadal dysgenesis).

 Testicular cancer is divided into germinal seminomas, non-seminomas (embryonal, choriocarcinoma, teratoma, yolk sac tumours) and stromal cancers.

The main testicular cancer symptoms are the presence of an often painless nodule, an increase in testicular volume, swelling, a change in the testicular consistency, a feeling of heaviness in the testicle, a sharp pain in the abdomen or groin, or lastly, fluid in the scrotum. 

If a testicular cancer is suspected, the indications are for urological objective examination, blood tests that include beta HCG, LDH markers and alpha-fetoprotein markers, as well as testicular ultrasound. CT scan of the chest, abdomen, and pelvis is used for staging and for visits follow-up therapy.

The initial stages of testicular cancer are cured with testis surgery alone. Medical treatment for testicular cancer is chemotherapy which is proposed after surgery for a number of cycles varying according to the stage of the testicular cancer and the purpose of the treatment.

Systemic chemotherapy is also proposed in the event of metastasized testicular cancer or incomplete healing after initial chemotherapy. Given the young age of patients affected by testicular cancer, increased attention to problems related to fertility is important. In the young male, testicular cancer is the most serious malignancy, with 410 new cases per 100,000 males per year in Europe and a mortality of 0.3 cases per 100,000 males per year. Seminomas comprise up to 60% of all germ cell tumors, with their incidence still increasing over time. Approximately 85% of patients with seminoma present with a testicular cancer confined to the testis. Most patients can be cured with orchiectomy, in some cases, adjuvant radiotherapy or chemotherapy is discussed. Of them, 15% have metastases from testicular cancer at diagnosis and eventually up to 25% will require chemotherapy.