Testicular Cancer, Spreading

What is testicular cancer?

Testicular cancer is a growth of abnormal cells in a testicle. Growths of cancer cells are called tumors.

The testicles are part of the male reproductive system. They make sperm and the male hormone testosterone. They are in the scrotum, which is the sac of loose skin below the penis.

Spread of cancer cells from the testicles to other parts of the body is called metastasis.

What causes spread of the cancer?

The cancer spreads when cancer cells from the tumor in the testicle travels through the lymph system and bloodstream to other parts of the body. New tumors then grow in these other areas. How far the cancer spreads depends on the type of cells, their location, and your response to treatment. The most common places for new tumors are the lymph nodes, lungs, liver, and brain.

The cause of testicular cancer is not known. However, there are risk factors, such as an undescended testicle.

What are the symptoms?

Usually you feel a lump in your scrotum. Sometimes the first symptoms of the cancer are caused by spread of the cancer to other parts of the body. The symptoms depend on where the tumors are. For example, if a new tumor has spread to lymph nodes in the belly and lungs, possible symptoms are:

• lower back pain and discomfort
• a cough
• trouble breathing

How is it diagnosed?

A physical exam or X-rays may show tumors growing in other parts of the body. Other tests used to detect the spread of cancer are:

• ultrasound scan, which uses sound waves and their echoes passed through your body from a small device held against your skin to create pictures of the inside of your body
• CT scan, which is a series of X-rays taken from different angles and arranged by a computer to show thin cross sections of parts of the body
• blood tests

How is it treated?

The treatment for cancer that has spread to other parts of your body depends on:

• your symptoms
• how much the cancer has spread to other parts of the body
• which treatments you have already had
• your overall health

Some of the treatment options, which may be used alone or together, are:

• Surgery to remove the cancerous testicle. This is almost always done even when the cancer has spread to other parts of the body.
• Surgery to remove lymph nodes: The lymph nodes in the area around the bones of the lower spine may be removed. Testicular cancer usually spreads to these lymph nodes first. Lymph is body tissue fluid. The lymph nodes drain and filter lymph as it flows back to the lungs and heart. They often catch cancer cells floating away from a testicular tumor. Lymph nodes that are removed are examined under a microscope to check for cancer.
• Radiation therapy: Cancerous areas may be exposed to high doses of radiation to:
  • shrink the size of a tumor or destroy some of the cancer cells
  • lessen pain if a tumor is pressing on a nerve or spreading to the bones
• Chemotherapy: Anticancer drugs may be used to kill the cancer cells. Testicular cancer that has spread to other parts of the body can often be cured with chemotherapy after the testicle is removed.

Ask your healthcare provider about your ability to have children after treatment. After some treatments you may be sterile for a while or possibly for the rest of your life. Your provider may recommend that you put some sperm in a sperm bank before you start treatment. The sperm might then be used later on if you want to have children.

After treatment your healthcare provider will recommend frequent checkups during the first year. Then you will need checkups slightly less often for the next 2 years to see if the cancer comes back (recurs). Be sure to follow your provider's recommendations so that if the cancer does come back, it can be found early. Most recurrences happen within the first 2 years after treatment, but they can happen up to 5 years after your diagnosis.

How can I take care of myself?

• Follow the full course of treatment prescribed by your healthcare provider.
• Eat a healthy diet and get regular exercise and rest.
• Try to reduce stress and take time for activities that you enjoy. It may help to talk with a counselor about your illness.
• Ask your provider any questions you have about the course of the disease, treatments, side effects of the treatments, sexuality, support groups, and anything else that concerns you.
• Ask your provider about alternative methods of pain control, such as relaxation techniques, guided imagery, and hypnosis.
• For more information, contact:
  • American Cancer Society, Inc.
    Phone: 800-ACS-2345 (800-227-2345)
    Web site: http://www.cancer.org
  • National Cancer Institute
    Phone: 1-800-4CANCER, or 1-800-422-6237 (TTY: 1-800-332-8615)
    Web site: http://www.cancer.gov

How can I help prevent the spread of testicular cancer?

The spread of cancer may be prevented by finding and treating testicular cancer early, before it spreads to other parts of the body. Follow your healthcare provider’s recommendations for treatment and have checkups as often as your provider recommends. Regular checkups with your provider are especially important if you have had an undescended testicle.