It originates in the sperm-producing cells and generally presents as a painless mass, sometimes associated with dull and persistent pain. It is the most common cancer in males, though it is still rare as it accounts for 2% of all tumors in men. Most have a good prognosis, even in advanced stages with dissemination, although it will depend on the type and extent.
Testicular germ cell cancer
The exact cause or causes of testicular cancer are unknown, but several factors have been identified that increase the risk.
Cryptorchidism or undescended testicles before birth, after their formation in the abdominal area during fetal development, carry a higher risk of testicular cancer. Even if the testicle has been surgically repositioned in the scrotum, the risk remains elevated. Additionally, conditions that cause the testicles to develop abnormally, such as Klinefelter syndrome, among others, can also increase the risk.
Similarly, HIV infection or its clinical form of acquired immunodeficiency syndrome (AIDS) also slightly increases the risk of developing seminoma-type germ cell testicular cancer. Other infections such as human papillomavirus (HPV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), or parvovirus B-19 have also been associated with a higher risk of this cancer.
Other risk factors include exposure to certain chemicals or tobacco use.
Finally, race also influences the risk, with white men being more likely to develop this type of cancer than African Americans and Asian Americans.
Symptoms
Testicular cancer is most frequently diagnosed between the ages of 18-45 but can occur at any age. Generally, the first signs consist of the enlargement of a testicle or a small lump or area of hardness, while other symptoms usually appear when there is dissemination to other areas. Broadly speaking, the symptoms of testicular cancer can include:
- Lump or enlargement in either testicle.
- A change in the shape of the testicle or a feeling of heaviness in the scrotum.
- Pain, discomfort, or numbness in a testicle or the scrotum, with or without swelling.
- Dull ache in the lower abdomen or groin.
- Sudden accumulation of fluid in the scrotum.
- Tenderness or enlargement of the breasts.
Prevention
There is no way to prevent testicular cancer. As with the prevention of all diseases, one should maintain a healthy and active lifestyle, quit smoking, follow a diet rich in fruits, vegetables, and whole grains, and engage in regular physical exercise. The possibility of performing regular self-examinations of the testicles has also been suggested; however, the most advisable course of action is to attend regular medical check-ups established for each age.
13.5 million variants
39 loci
Bibliography
American Society of Clinical Oncology [March 2022]
Gaddam SJ et al. Testicle Cancer [Updated 2021]
Litchfield K et al . Identification of 19 new risk loci and potential regulatory mechanisms influencing susceptibility to testicular germ cell tumor. Nat Genet. 2017 Jul;49(7):1133-1140.