The most observable symptom of testicular cancer is the abnormal mass of tissue which arises from the testicles contained within the scrotum. There are two major categories of testicular cancer:
- Germ cell tumors – about 95% of testicular cancer cases arise from germ cells (spermatocytes). This type of tumor is highly aggressive and metastatic but is mostly curable. Germ cell tumors are further classified as seminoma, spermatocytic seminoma, embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma.
- Nongerminal tumors – are benign tumors that arise from cells surrounding the spermatocytes. While they do not metastasize, nongerminal tumors secrete steroids that may contribute to observable endocrinologic symptoms of testicular cancer. Nongerminal tumors may be leydig cell tumors or sertoli cell tumors.
Symptoms of testicular cancer are not always observed in many patients. There are cases where a lump on the testicle is painful, while others do not report pain. Patients have also reported feeling heaviness and/ or a dull ache in the testicles and lower abdominal area. Another symptom of testicular cancer is observed when there is increased secretion of alpha-fetoprotein and human chorionic gonadotropin (hCG) by the cancerous tissues. In rare cases, the excess hCG stimulates breast development in males (gynecomastia), resulting to breast tenderness or enlargement.
As mentioned above, nongerminal tumors such as leydig cell tumor and sertoli cell tumor produces steroids such as male and female sex hormones. These symptoms of testicular cancer, however, are not specific as other medical conditions may exhibit them. Elaboration of estrogen, the female sex hormone, may lead to loss of sex drive and breast development, such as that observed in excessive hCG. The male hormone androgen does not cause any notable symptoms in adults, but excess androgen in prepubertal children causes prominent development of facial and body hair.
While testicular cancer is usually asymptomatic, it is particularly dangerous once it has metastasized to other sites in the body. Cancer that has spread to lymph nodes in the liver or abdomen may cause pain in that area. If the cancer has spread through the lungs, symptoms may include shortness of breath, chest pain, and coughing that may be accompanied with blood. Cancer that has spread to the brain may cause headaches and other neurologic manifestations.
There are a number of benign conditions that also manifest symptoms of testicular cancer. Traumatic injury and inflammation of the testicles (orchitis) or epididymis (epididymitis) produces painful swellings. Orchitis and epididymitis are caused by either viruses or bacteria. Thus, it is important to consult with a medical practitioner to rule out these causes.
Cryptorchidism – this is a developmental abnormality in which the testes fail to descend from the abdomen to the scrotal sac.
Testicular dysgenesis – abnormal development of the testes is observed in conditions such as testicular feminization and Klinefelter syndrome
Genes – a person who has close relatives with a history of testicular cancer is at greater risk, in addition to those with chromosomal abnormalities, specifically at chromosome 12.
Age – testicular cancer can be observed in all ages, but is particularly common in males from the ages of 15 to 35.
Race – testicular cancer has a higher prevalence in Caucasians than in Africans or Asians.
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