The risk remains elevated even if the testicle has been surgically relocated to the scrotum. Still, the majority of men who develop testicular cancer don't have a history of undescended testicles. Some doctors recommend regular testicle self-examinations to identify testicular cancer at its earliest stage. But not all doctors agree.
Discuss testicular self-examination with your doctor if you're unsure about whether it's right for you. Testicular cancer care at Mayo Clinic.
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Testicular lumps Pain, swelling or lumps in your testicle or groin area may be a sign or symptom of testicular cancer or other medical conditions requiring treatment. Email address. First Name let us know your preferred name. Last Name. Thank you for subscribing Your in-depth coping with cancer guide will be in your inbox shortly. Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry.
Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Niederhuber JE, et al. Testicular cancer. In: Abeloff's Clinical Oncology. Philadelphia, Pa. Accessed Nov. Fort Washington, Pa. Accessed Dec. Wein AJ, et al. If the testicle s have not been surgically removed, the term "TX" is used. This is a precancerous condition in which there are germ cells that appear cancerous but are not yet behaving the way cancer cells do.
GCNIS becomes cancer when the cells grow into parts of the testicle s where they do not normally belong. It has not grown into blood vessels or lymph vessels in the testicles. The tumor may have grown into the inner membrane layer surrounding the testicle, called the tunica albuginea. It has not spread to the outer membrane layer surrounding the testicle, called the tunica vaginalis.
These small, bean-shaped organs help fight infection. Lymph is a fluid that flows from the different tissues and organs of the body and eventually drains into the bloodstream. It passes through specialized tubes called lymphatic vessels and is filtered along the way by the lymph nodes. Cancer cells often build up and grow in lymph nodes before they spread to other parts of the body. The first place the lymphatic fluid from the testicles drains to is the retroperitoneal lymph nodes located in the back of the abdomen in front of the spine, an area called the retroperitoneum.
These are called the regional lymph nodes for testicular cancer. Lymph nodes in the pelvis, chest, or other parts of the body are called distant lymph nodes, even though the testicles are closer to the pelvis than to the retroperitoneum. For testicular cancer, lymph nodes usually are not biopsied or removed. Instead, the N stage lymph node stage is most often estimated by using CT scans. N stage that is based on CT scans is the clinical stage.
When the N stage is based on a biopsy or removal of the lymph nodes, it is the pathological stage. The letter "c" stands for clinical stage. None of the lymph nodes are bigger than 2 centimeters cm. There is cancer in at least 1 lymph node, and the largest lymph node or lymph node mass is between 2 cm and 5 cm in size.
The "M" in the TNM system describes whether the cancer has spread to other parts of the body, called distant metastasis. When testicular cancer spreads, it most commonly spreads to the lung and the lymph nodes of the chest, pelvis, and the base of the neck.
More advanced stages may have spread to the liver and bones. Testicular cancer rarely spreads to the brain unless the primary tumor is a choriocarcinoma. M1a: There is cancer in the lungs or lymph nodes other than the retroperitoneal lymph nodes. M1b: The cancer has spread to organs other than a lung. The lungs may or may not also be involved. For example, a testicular cancer that has spread to the liver or the bones is stage M1b. Serum tumor markers also help to stage testicular cancer.
Blood tests for tumor markers will be done before and after surgical removal of the testicle s. Tumor marker levels usually decrease after the surgery. Generally, the levels need to be tested until they stop decreasing or begin to rise to determine the correct "S" stage.
For patients who will receive chemotherapy, the tumor marker levels on the first day of chemotherapy are used to determine the risk group see below.
S1: At least 1 tumor marker level is above normal. LDH is less than 1. S2: At least 1 tumor marker level is substantially above normal. This means that LDH is 1. None of the tumor markers is elevated high enough to qualify as S3 see below. S3: At least 1 or more tumor marker level is very highly elevated. Doctors assign the stage of the cancer by combining the T, N, and M classifications and the S level information. Stage 0: Refers to carcinoma in situ, also called intratubular germ cell neoplasia.
Stage I: Cancer is at any T level, and there is no evidence of spread to either lymph nodes or other organs. Serum tumor marker levels have not been done or are not available.
Stage IA: The cancer is only in the testicle. It may have grown into the rete testis, but it has not grown into the epididymis, hilar soft tissue, or lymphatic or blood vessels in the testis. It has not spread to lymph nodes or distant sites. The tumor in the testis may have grown into the inner membrane surrounding the testis, called the tunica albuginea, but not the outer membrane, called the tunica vaginalis. Serum markers are normal.
Stage IB: The testicular tumor has grown into the epididymis, hilar soft tissue, tunica vaginalis, the blood or lymphatic vessels within the testicle, the spermatic cord, or the scrotum.
The cancer has not spread to lymph nodes or distant sites. Stage IS: Cancer is of any T stage and has not spread to lymph nodes or distant sites. CT scanning is usually helpful in ruling out cancer as the primary factor causing lower back pain. If cancer is detected, detailed diagnostic imaging techniques help stage cancer, paving the way for more aggressive treatments.
As long as testicular cancer remains confined to the testes in its primary stage, symptoms of testicular discomfort may be the only indicator of the malady. If cancer is detected early, surgical removal of the testicle orchiectomy combined with radiation therapy and chemo treatments usually suffices to stop the cancer from spreading.
Pain in the lower back will be indicative of the fact that testicular cancer has penetrated the lymphatic system and is poised to spread outwards to the lungs and other important organs.
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