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In Brief... Testicular cancer is the most common cancer in young men between the ages of 15 and 40 years old and is almost always curable if it is found early. Most testicular cancers are found by men themselves, either as a painless lump, a hardening or change in size of the testicle, or pain in the testicle. Testicular cancer can be treated with surgery, radiation therapy, chemotherapy, surveillance, or a combination of these treatments.

What is Cancer?

Cancer is a group of more than 100 diseases. Although each kind differs from the others in many ways, every type of cancer is a disease of some of the body's cells. Healthy cells that make up the body's tissues grow, divide, and replace themselves in an orderly way. This process keeps the body in good repair. Sometimes, however, some cells lose the ability to limit and direct their growth. They grow too rapidly and without any order. Too many cells are produced, and tumors are formed. Tumors can be either benign or malignant.

Benign tumors are not cancer. They do not spread to other parts of the body and are seldom a threat to life. Benign tumors can often be removed by surgery, and they are not likely to return. Some tumors of the testicle are benign, but most are not.

Malignant tumors are cancer. They can invade and destroy nearby healthy tissues and organs. Cancerous cells can also spread, or metastasize, to other parts of the body and form new tumors.

Cancer that develops in a testicle is called testicular cancer. When testicular cancer spreads, the cancer cells are carried by blood or by lymph, an almost colorless fluid produced by tissues all over the body. The fluid passes through lymph nodes, which filter out bacteria and other abnormal substances such as cancer cells. Doctors use CT (computed tomography) scans of the abdomen and chest to help determine if the cancer has spread to the lymph nodes or lungs.

What is Testicular Cancer?

Testicular cancer is one of the most common cancers in young men between the ages of 15 and 35, but the disease also occurs in other age groups, so all men should be aware of its symptoms. While testicular cancer is common among young men, young men typically do not get a lot of cancer, so overall testicular cancer is a relatively rare disease.

In the year 2000, an estimated 7600 cases of testicular cancer will be diagnosed in the United States, and a little less than 400 of them will die. Caucasians are more likely to get it than Hispanics, and much more likely to get it than Blacks or Asians. The instance of testicular cancer around the world has basically doubled in the past 30-40 years.

Most testicular cancer cases are found by men themselves when doing a self-examination or by accident. The testicles are smooth, oval-shaped, and rather firm. Men who examine themselves routinely become familiar with the way their testicles normally feel. Any changes in the way they feel from month-to-month should be checked by a doctor, preferably a urologist.

In men under 60, 95% of testicular tumors originate in the germ cells, the special sperm-forming cells within the testicles. These tumors fall into one of two types, seminomas or nonseminomas. (Note that in the UK and a few other places, nonseminomas are called teratoma instead.) Other forms of testicular cancer include leydig and sertoli cell tumors. Rarely tumors such as PNET, leiomyosarcoma, rhabdomyosarcoma, mesothelioma and others can arise in the testicle. Men over the age of 60 can still get a germ cell tumor, but they are more likely to get leukemia, lymphoma, or a benign tumor called spermatocytic seminoma. Unless otherwise noted, all the information on this web site concerns testicular germ cell tumors.

• Pure seminomas account for about 40 percent of all testicular cancer and are made up of immature germ cells. Usually, seminomas are slow growing and tend to stay localized in the testicle for long periods.

• Nonseminomas are a group of cancers that often occur in combination with one another, including choriocarcinoma, embryonal carcinoma, immature teratoma and yolk sac tumors. Nonseminomas arise from more mature, specialized germ cells and tend to be more aggressive than seminomas.