Testicular cancer (specifically, germ cell tumors) is an aggressive cancer, doubling in size every 10 to 30 days. If not treated, testicular cancer can spread via the lymphatic pathways. The lymph glands around the aorta and the vena cava at the level of the kidneys are the first to be involved. Testicular cancer then may spread to other lymph glands. In advanced cases it can spread to the lungs, liver, brain, bone, kidney, adrenal gland, and spleen. Without treatment, a testicular cancer patient will die on average 2-3 years from time of diagnosis.
Testicular cancer is staged using various systems in different countries. Using the TNM Classification of Malignant Tumors, testicular cancer is staged as follows: Stage I--tumor confined to testes; Stage II--tumor has spread to para-aortic lymph glands; Stage III--lymph gland involvement in chest or neck; Stage IV--cancer has spread outside of lymph glands, such as to lungs or liver.
Because of modern advancements in medicine, testicular cancer has one of the highest cure rates of all cancers. In 1970, a man with testicular cancer had only a 10% chance of survival. Today, modern treatments are so successful that with early detection the cure rate is almost 100%. Even if the cancer has widely metastasized, the cure rate is still 80%. Treatments include orchiectomy (removal of testes), removal of lymph glands around the aorta and vena cava, radiation therapy and chemotherapy. Most of the treatment options will affect fertility.
See Your Doctor
According to the American Cancer Society, about 8,400 cases of testicular cancer will be diagnosed in the United States each year, and 380 will die from the disease. The lifetime incidence of testicular cancer is 1 in 300. Some experts recommend regular monthly testicular self-examination. Any irregularity of your testes should be reported to your doctor immediately. Testicular cancer usually presents as a hard, painless lump in the scrotum; unexplained enlargement of a testicle; or an unexplained pain, ache or swelling within the scrotum. High-risk patients should be extra vigilant. High risk is defined as having an undescended testes, a previous history of a testes tumor, a brother or father with a testes tumor, and infertile men. Early treatment is essential.