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Young male with testicular cancer talks to nurse

Testicular cancer develops in the testicles (testes), two egg-shaped male reproductive glands enclosed in a loose pouch of skin (scrotum) at the base of the penis. After detecting a testicular tumor, a physician will typically order blood work and other diagnostic tests to determine the tumor type. Some testicular cancers produce high levels of certain proteins, which can be measured in a blood sample and used to type the tumor.

Germ cell tumors

Most testicular tumors originate in germ cells in the testes. In a male baby, germ cells normally develop into sperm-producing cells. If germ cells do not fully mature, they may begin to grow and divide uncontrollably. The abnormal germ cells can then build up, bind together and form a testicular tumor.

The two main types of germ cell tumors are seminoma and nonseminoma. Some testicular cancers are classified as mixed germ cell tumors, which contain a combination of seminoma and nonseminoma cancer cells.

Seminoma

Germ cell tumors that contain only seminoma cancer cells are classified as seminoma, which is slightly more common—and tends to grow and spread more slowly—than nonseminoma. Seminoma germ cell tumors can be further classified as:

  • Classical (typical) seminoma - Accounting for up to 95% of seminoma tumors, typical seminoma is most often diagnosed in men between ages 25 and 45.
  • Spermatocytic seminoma - Extremely rare and unlikely to spread, spermatocytic seminoma is usually diagnosed after age 55.

Some seminoma tumors can increase the level of a protein known as human chorionic gonadotropin (HCG) in the bloodstream. Considered a tumor marker for certain types of testicular cancer, HCG levels can be checked with a simple blood test.

Nonseminomatous germ cell tumors (NSGCTs)

Testicular NSGCTs are most frequently diagnosed before age 30. These testicular tumors are more likely than seminoma tumors to spread beyond the testicle where they originated and metastasize to distant areas of the body.

NSGCTs usually contain two or more types of cells. The main subtypes are:

  • Embryonal carcinoma - When viewed under a microscope, the tumor cells resemble the premature cells in an embryo.
  • Choriocarcinoma - When choriocarcinoma cells are present in a testicular tumor, they are usually mixed with other types of cells. On their own, however, choriocarcinoma cells can form a very rare and aggressive type of tumor.
  • Yolk sac carcinoma - When viewed under the microscope, the tumor cells resemble the cells that make up the yolk sac of an embryo, which transfers nutrients to the embryo before the placenta forms. Children who develop testicular cancer are usually diagnosed with yolk sac carcinoma.
  • Teratoma - When teratoma cells are viewed under a microscope, three layers can be distinguished, much like an embryo.

Some NSGCTs produce a substance known as alpha-fetoprotein (APF), which is not produced by seminoma tumors. APF levels can be measured through a simple blood test.

Stromal tumors

As part of the body’s endocrine system, the testicles produce male hormones (androgens) such as testosterone in addition to sperm. A small percentage of testicular tumors originate in hormone-producing stromal cells. Unlike germ cell tumors, stromal tumors are usually not cancerous.

Benefit from world-class care at Moffitt Cancer Center

When detected early, testicular cancer can often be treated effectively with the surgical removal of the tumor and affected testicle. From there, treatment can vary depending on the tumor type. For instance, seminoma tumors usually respond well to radiation therapy and the chemotherapy drug carboplatin, while NSGCTs tend to respond less favorably to these treatments. Therefore, an accurate diagnosis of the tumor type is essential to ensure the most appropriate treatment strategy as well as the best possible outcome and quality of life.

The multispecialty team in Moffitt’s renowned Urologic Oncology Program takes an individualized approach to testicular cancer treatment. After analyzing the type and stage of the tumor and other unique factors, we can suggest a tailored regimen designed to maximize the effectiveness of treatment while minimizing any side effects. We offer the latest treatment options for all types of testicular cancer, including a robust portfolio of clinical trials.

If you would like to review your testicular cancer diagnosis or explore your treatment options with an expert at Moffitt, call 1-888-663-3488  or submit a new patient registration form online to request an appointment. We do not require referrals.