Testicular cancer

Testicular cancer affects men between the age of 20 and 40 in particular. The cancer usually only occurs on one side, in one of the two testicles. The recovery rates for testicular cancer are often excellent, even in a later stage when metastases have already formed.

Around 440 men are diagnosed with testicular cancer in Switzerland every year, of whom 85% are under 50 years old at the time of diagnosis. Different types of cancers can develop in the testicles, depending on the cells from which the tumours originate. It is important to differentiate between seminoma (tumours of the germ cells) and non-seminoma. Non-seminoma is the collective term for all types of testicular cancer which do not originate from germ cells.  The difference is important because these two tumours are treated differently. Non-seminoma are not irradiated because they are less radiation-sensitive.

The exact causes of this cancer are unknown. The most important risk factor is undescended testicles in childhood. In this case, the testicle does not “wander” sufficiently or “wanders” too late into the scrotum and remains in the abdomen. Genetic components also seem to play a certain role. Testicular cancer sometimes occurs more frequently in one family.

Testicular cancer initially causes few or almost no symptoms. Some early symptoms are swelling or enlargement of the scrotum as well as calluses or lumps in the testicles. These are usually pain-free. With time, a feeling of heaviness or a pulling in the testicles can become noticeable. If the illness is advanced, fatigue, loss of appetite, weight loss and back pain can occur.

Testicular cancer is usually discovered coincidentally while palpating the testicles. Changes in the size of the testicles or calluses and lumps should be checked by a doctor. If there is suspected testicular cancer, different examinations such as an ultrasound, computed tomography or biopsy are carried out.

The treatment depends on the type of tumour and the stage of the disease. To begin with, the affected testicle is usually removed surgically. As only one testicle is normally affected, this has no effect on sexual function and fertility. No further treatment is necessary in most cases if the cancer is in an early stage without affecting the lymph nodes or causing metastases. Regular check-ups are required to monitor the success of the treatment. If the testicular cancer is advanced, chemotherapy will be carried out after the surgery, and, depending on the type of cancer, radiation therapy. Testicular cancer responds very well to these treatment methods. Thus, later stages of the disease with metastases can be cured in the majority of cases.

Sometimes the amount of sex hormone (testosterone) formed after removing the testicle is no longer sufficient. In such cases, medical testosterone must be administered.