Tumors that develop in the sperm-producing cells, also known as germ cells, can lead to testicular cancer. Tumors in germ cells can occur in different parts of the body like the testicles, between the lungs, the back of the spine, or the lower spine. In very rare instances, they can also occur in the pineal gland of the brain. At an early stage, the tumor on the testicle appears as a painless lump, and is the size of a marble or pea. However, later, it might grow larger in size.

Patients can experience pain in the abdomen, lower back, testicle, or groin. They might have a fluid buildup in the scrotum. An affected person’s testicle might undergo changes in terms of size. There are two categories of Testicular Cancer – Seminoma and Non-seminoma. Both these cancers start from the germ cells. Non-Seminoma has further sub-types such as Yolk sac tumor, Choriocarcinoma, Teratoma, and Embryonal Carcinoma.

Tests to diagnose testicular cancer

• Physical exam – Physicians will check for lumps or swelling as well as any kind of hardness or tenderness in the testicles, neck, armpits, abdomen, and groin to check the presence of any enlarged lymph nodes, which might indicate the spread of cancer. Swelling in the legs will also be checked as they can develop from blood clots in veins in abdomen, pelvis, or legs.
• Ultrasound – An ultrasound will be carried out to check the presence of tumor in the testicles.
• Blood tests – If the tumor is identified through ultrasound, blood tests will be conducted to check the level of serum tumor marker to detect the stage of cancer.
• X-ray – If cancer is suspected, X-rays of chest, pelvis, or abdomen might be carried out to determine the stage of cancer.
• CT scan – CT scan of chest, abdomen, and pelvis can help in measuring the size of the tumor.
• MRI scan – MRI of the brain is only conducted, if the physicians felt during the physical exam, that testicular cancer has spread to the brain.
• Biopsy – It is the process by which tissue is removed and examined under a microscope if cancer is suspected it spreads other parts of the body.

Treatment after a diagnosis
The initial treatment for this type of cancer is surgery if cancer has spread beyond the testicle. This may be followed by chemotherapy or radiation. However, in events when cancer reaches an advanced stage, chemotherapy might be conducted before surgery. The different types of surgeries conducted are mentioned below:

• Radical Inguinal Orchiectomy – In this surgery, the entire testicle is removed through a surgical cut of the groin. This is used as both diagnoses as well as a treatment method in an early and late stage of cancer.
• Retroperitoneal Lymph Node Dissection (RPLND) – This surgery is conducted to remove the retroperitoneal lymph nodes. It is performed to treat the initial stages of non-seminoma or to remove residual tumors after chemotherapy.

Timely detection of testicular cancer helps in starting the treatment procedure sooner. However, patients need both physical as well as emotional support in their postoperative period to recover completely.