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Understanding Testicular Cancer

In this article:

Incidence and Mortality Statistics
Common Symptoms
Risk Factors
Diagnostic Methods
Treatment Methods
Personal Care

Overview of Testicular Cancer in Hong Kong

Testicular Cancer Incidence and Survival Rate: Cancer Data for Men in Hong Kong

The testicles are one of the male reproductive organs, responsible for producing sperm and secreting testosterone starting from puberty. When abnormal cell growth occurs in one or both testicles, it can lead to cancer.

Testicular tissue consists of various cell types, each of which can develop into one or more types of cancer, which can be categorised as follows:

  • Germ Cell Tumours
    Over 90% of testicular cancers originate from the cells that produce sperm. These tumours are primarily divided into seminomas and non-seminomas.
    • Seminomas
      It grows and spreads more slowly than non-seminomas and can be further categorised into classical and spermatocytic.
      • Classical seminomas
        Over 95% of seminomas commonly occur in men aged 25 to 45.
      • Spermatocytic seminomas
        It appears rarer and primarily affects older men around 65, growing more slowly and is less likely to metastasise.
    • Non-seminomas
      Commonly occur in males in their teens to thirties and are primarily divided into embryonal carcinoma, yolk sac carcinoma, choriocarcinoma, and teratoma.
      • Embryonal carcinoma
        Appears as tissue resembling early embryonic tissue under a microscope and grows and spreads quickly outside the testicle.
      • Yolk sac carcinoma
        Resembles the yolk sac of early human embryos and is the most common testicular tumour in prepubescent children.
      • Choriocarcinoma
        Rare and aggressive form of testicular cancer that spreads rapidly to other parts of the body, such as the lungs, bones, and brain.
      • Teratomas
        Rare testicular cancer types comprise tissues from all three germ layers: bone, muscle, cartilage, nerves, and skin.

Testicular cancer is relatively rare. According to data from the American Cancer Society, about 1 in 250 men will develop testicular cancer. Unlike other common male cancers, the average age of diagnosis is 33, indicating that it primarily affects young and middle-aged men.

Various factors, including the type and stage of the cancer, influence the survival rate for testicular cancer. Generally, the survival rates for testicular cancer are relatively high. According to the American Cancer Society, if cancer cells have not spread beyond the testicles, the survival rate is 99%. If cancer cells have spread to the retroperitoneal lymph nodes, the survival rate is approximately 96%. If cancer has spread to distant organs, such as the lungs, the 5-year survival rate drops to 73%.

While the exact causes of testicular cancer remain unclear, several factors may increase the risk:

  • Family history
    Having a family history of testicular cancer increases the risk of developing the disease.
  • Having a history of undescended testicles (cryptorchidism) or abnormal development of the testicles
    Where one or both testicles fail to descend from the abdomen into the scrotum before birth, significantly increases the risk of developing testicular cancer. Men with cryptorchidism are much more likely to develop testicular cancer compared to those with normally descended testicles.

Symptoms of Testicular Cancer

Common Testicular Cancer Symptoms: Warning Signs of Testicular Lumps and Heaviness

Patients with testicular cancer often first notice a hard lump or swelling in the testicles, making self-examination very important. Typical symptoms include:

  • A painless lump or swelling in the testicle
  • A feeling of heaviness in the scrotum
  • Dull ache in the lower abdomen or groin
  • Sudden accumulation of fluid in the scrotum
  • Testicular cancer can also produce hormones that may cause breast tissue enlargement or tenderness.

Common Diagnostic Methods

Testicular Cancer Diagnosis Methods: Ultrasound Examination and Tumor Markers

Due to the apparent symptoms of testicular cancer, many patients notice their condition themselves. If any abnormalities are detected, it is necessary to consult a doctor. When a doctor suspects testicular cancer, they will first inquire about the patient’s medical history and any family history of cancer. If needed, further tests will be conducted for a more accurate diagnosis, including:

  • Ultrasound: To determine whether the lump is a cancerous tumour.
  • Blood Tests: To check cancer markers.

If initial tests are positive, doctors may perform further examinations, such as:

  • Computed Tomography (CT) Scan:
    A special X-ray examination that uses computer analysis to assess the tumour’s size and extent and to check for metastasis to lymph nodes, lungs, liver, or other organs, aiding in cancer staging.
  • MRI:
    This can also assess the degree of tumour invasion and staging.
  • PET Scan:
    This can help detect small amounts of cancer cells, primarily used for checking seminomas.
  • Chest X-ray:
    To determine whether cancer has spread to the lungs.
  • Bone Scan:
    To check for metastasis to the bones.

After these diagnostic methods, if a doctor identifies testicular cancer, further tests may be performed to determine the cancer stage accurately. Factors for determining whether the cancer is early or late stage include tumour size, whether it has spread, and if it has metastasised to distant tissues, categorised as follows:

Stage Description
0 Tumours are confined to the seminiferous tubules (small tubes in the testicle) and have not grown into other testicle areas of the testicle. Cancer cells have not spread to nearby lymph nodes or distant organs, and all tumour markers are normal.
I Tumours have grown beyond the seminiferous tubules and may have spread into nearby structures, but cancer cells have not spread to nearby lymph nodes or distant organs. No tumour marker test results are available, or testing has not been completed.
IA Tumours remain within the testicle and have not grown into nearby blood vessels or lymph nodes. Cancer cells have not spread to nearby lymph nodes or distant organs, and all tumour markers are normal.
IB Tumours have grown into nearby structures, but cancer cells have not spread to nearby lymph nodes or distant organs. All tumour markers are at normal levels.
IS Tumours may or may not have grown outside the testicle, or it may not be possible to assess the degree of the tumour for some reason. Cancer cells have not spread to nearby lymph nodes or distant organs, but at least one tumour marker is elevated.
II Tumours may or may not have grown outside the testicle, or it may not be possible to assess the degree of the tumour for some reason. Cancer cells have spread to at least one nearby lymph node but have not spread to distant organs, and no tumour marker test results are available, or testing has not been completed.
Tumours may or may not have grown outside the testicle, or it may not be possible to assess the degree of the tumour for some reason. Cancer cells have spread to at least one nearby lymph node, measuring no more than 2 cm. Cancer cells have not spread to distant organs; all tumour markers are at normal levels, or at least one tumour marker is slightly elevated.
IIC Tumours may or may not have grown outside the testicle, or it may not be possible to assess the degree of the tumour for some reason. Cancer cells have spread to at least one nearby lymph node measuring more than 5 cm. Cancer cells have not spread to distant organs; all tumour markers are at normal levels, or at least one tumour marker is slightly elevated.
III Tumours may or may not have grown outside the testicle, or it may not be possible to assess the degree of the tumour for some reason. Cancer cells may or may not have spread to nearby lymph nodes, but have spread to distant organs. No tumour marker test results are available, or testing has not been completed.
IIIA Tumours may or may not have grown outside the testicle, or it may not be possible to assess the degree of the tumour for some reason. Cancer cells may or may not have spread to nearby lymph nodes, but have spread to distant lymph nodes or lungs. All tumour markers are at normal levels, or at least one tumour marker is slightly elevated.
IIIB Tumours may or may not have grown outside the testicle, or it may not be possible to assess the degree of the tumour for some reason. Cancer cells have spread to at least one nearby lymph node but have not spread to distant organs. At least one tumour marker is significantly elevated.
IIIC Tumours may or may not have grown outside the testicle, or it may not be possible to assess the degree of the tumour for some reason. Cancer cells have spread to at least one nearby lymph node but have not spread to distant organs. At least one tumour marker is very high.

Primary Treatment Methods

Testicular Cancer Treatment Methods: Radical Inguinal Orchiectomy and Chemotherapy

Once diagnosed, doctors will choose the most appropriate treatment for patients with confirmed testicular cancer. The treatment methods depend on the testicular cancer type, the spread extent, and other factors.
For early-stage testicular cancer, such as cancer in situ (CIS), the most common treatments are:

  • Surgery
    • Chemotherapy Drugs Implanted in the Bladder:
      Directly placing chemotherapy drugs, commonly mitomycin-C or epirubicin, into the bladder through a soft catheter significantly reduces side effects compared to intravenous chemotherapy.
    • Retroperitoneal Lymph Node Dissection
      Doctors may remove the lymph nodes around the major blood vessels in the abdomen either during the orchiectomy or in a second surgery, depending on the type and stage of the patient’s cancer.
  • Radiation Therapy
    Radiation therapy uses high doses of radiation to destroy cancer cells, primarily used for patients with seminomas or those whose cancer has spread to the lymph nodes.
  • Chemotherapy
    Chemotherapy utilises drugs to disrupt the growth of cancer cells. It is mainly used for patients whose cancer has spread beyond the testicle and who have undergone surgical removal, to reduce the risk of recurrence. Doctors may use two or more chemotherapy drugs simultaneously to enhance effectiveness.
  • Stem Cell Transplant
    First, the patient’s blood stem cells are collected, after which the patient receives high doses of chemotherapy, followed by autologous stem cell transplantation. However, this treatment is expensive and may not be the patient’s first choice.

Healthy Living

Post-Testicular Cancer Surgery Care: Fertility Preservation and Hormone Supplementation

Testicular cancer is generally regarded as a treatable cancer. However, patients need regular follow-up appointments to monitor for any signs of recurrence or treatment side effects. Additionally, patients should frequently self-examine the remaining testicle for any abnormalities.

Prevention Methods

Testicular Cancer Prevention: Self-Examination and Cryptorchidism Treatment

While the exact causes of testicular cancer remain unclear, addressing the risk factors mentioned above is essential. Regular self-examinations, particularly during bathing, can help identify any lumps. For those with undescended testicles, regular medical check-ups are recommended. Also, protecting the testicles from trauma and practising good hygiene during sexual activity can help prevent inflammation and serious complications.

Frequently Asked Questions

Testicular Cancer FAQs

How should I self-examine for testicular cancer?

According to the National Cancer Institute, the self-examination steps are as follows:

Stand in front of a mirror and check the skin of the scrotum for any swelling.
Use both hands to examine each testicle, placing the thumb on the testicle and the index and middle fingers underneath. Gently roll the testicle between the thumb and fingers.
Locate the epididymis, the soft tube behind the testicle responsible for collecting and transporting sperm. If any lumps are found, consult a doctor as soon as possible.

Is it necessary to undergo orchiectomy for testicular cancer?

While there are various types of testicular cancer with differing treatment approaches, orchiectomy should generally be the first consideration, followed by possible radiation or chemotherapy. Prompt treatment is essential as cancer cells can spread quickly if not addressed, so surgical intervention can significantly improve survival rates.

Will testicular cancer treatment affect sexual function?

Most testicular cancer occurs in one testicle. After treatment, the remaining testicle can still produce necessary hormones, so sexual function is usually not affected.

Will testicular cancer treatment affect fertility?

Generally, after the removal of one testicle, the remaining testicle maintains fertility and sexual function is unaffected. However, if radiation therapy affects the healthy testicle, it may impact fertility, which is why doctors typically place a protective shield over the remaining testicle during treatment.

Is there a risk of recurrence for testicular cancer?

Data from the UK Cancer Research Fund indicates that the risk of recurrence for testicular cancer depends on the type and stage of the cancer. If recurrence occurs, it typically happens within two years of treatment, and it is rare for it to happen later.



▣ The information on this website has been reviewed by the HEAL Medical Team and is regularly updated according to the most recent clinical evidence. All content is provided for general informational purposes only and should not replace professional medical advice. Please consult your doctor or another qualified healthcare professional for personalized medical guidance.

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