A National Cancer Institute-designated Comprehensive Cancer Center

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Testicular Cancer

Our Approach
At City of Hope, we are actively developing tomorrow’s treatment protocols today for testicular cancer. As a patient at City of Hope, you have a highly experienced and dedicated team to treat you and help you cope with a cancer diagnosis.
 
As one of a select group of institutes to attain the elite designation of Comprehensive Cancer Center by the National Cancer Institute, City of Hope is acknowledged as a leader in cancer research and treatment.  At City of Hope, patients have access to a team of nationally renowned specialists, state-of-the-art surgical techniques and innovative therapies, many of which are unavailable elsewhere. 
 
Testicular cancer patients receive the most personalized care possible, allowing them to recover faster, with fewer side effects. Because City of Hope concentrates experts in all cancer-related specialties in one location, patients receive greater continuity of care and more coordinated treatment planning. Our multidisciplinary team includes urologists, medical oncologists, radiation oncologists and surgical oncologists working cooperatively to create the most effective treatment plan and optimize outcomes.
 
Dramatic advances in the treatment of testicular cancer make it one of the most treatable of all cancers, with an overall cure rate of more than 95 percent.
 

About Testicular Cancer

Testicular cancer is a disease in which malignant (cancer) cells form in the tissues of one or both testicles.

The testicles are two egg-shaped glands located inside the scrotum (a sac of loose skin that lies directly below the penis). The testicles are held within the scrotum by the spermatic cord, which also contains the vas deferens and vessels and nerves of the testicles.

The testicles are the male sex glands and produce testosterone and sperm. Germ cells within the testicles produce immature sperm that travel through a network of tubules (tiny tubes) and larger tubes into the epididymis (a long coiled tube next to the testicles) where the sperm mature and are stored.

Almost all testicular cancers start in the germ cells.
  • The two main types of testicular germ cell tumors are seminomas and nonseminomas.
  • These two types grow and spread differently and are treated differently.
    • Nonseminomas tend to grow and spread more quickly than seminomas.
    • Seminomas are more sensitive to radiation. A testicular tumor that contains both seminoma and nonseminoma cells is treated as a nonseminoma.

Testicular cancer is the most common cancer in men 20 to 35 years old.

Testicular Cancer Risk Factors

Certain factors can increase the risk of developing testicular cancer, including:
 
  • Undescended testicle (cryptorchidism) - Normally, the testicles descend from inside the abdomen into the scrotum before birth. The risk of testicular cancer is increased in males with a testicle that does not move down into the scrotum. This risk does not change even after surgery to move the testicle into the scrotum. The increased risk applies to both testicles.
 
  • Congenital abnormalities - Men born with abnormalities of the testicles, penis or kidneys, as well as those with inguinal hernia (hernia in the groin area, where the thigh meets the abdomen), may be at increased risk.
 
  • History of testicular cancer - Men who have had testicular cancer are at increased risk of developing cancer in the other testicle.
 
  • Family history of testicular cancer - The risk for testicular cancer is greater in men whose brother or father has had the disease.
 

Testicular Cancer Symptoms

Possible signs of testicular cancer include swelling or discomfort in the scrotum.

These and other symptoms may be caused by testicular cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:
  • A painless lump or swelling in either testicle.
  • A change in how the testicle feels.
  • A dull ache in the lower abdomen or the groin.
  • A sudden build-up of fluid in the scrotum.
  • Pain or discomfort in a testicle or in the scrotum.

Diagnosing Testicular Cancer

Several different tests are used to detect testicular cancer:
 
  • Physical exam and history
 
  • Blood tests:  Blood tests measure the levels of tumor markers, which are substances often found in higher-than-normal amounts when cancer is present. Tumor markers such as alpha-fetoprotein, Beta-human chorionic gonadotropin and lactate dehydrogenase may suggest the presence of a testicular tumor, even if it is too small to be detected by physical exams or imaging.
 
  • Ultrasound:  This test uses high-frequency sound waves to produce a picture called a sonogram. Ultrasound of the scrotum can show the presence and size of a mass in the testicle. It is also helpful in ruling out other conditions such as swelling due to infection or a collection of fluid unrelated to cancer.
 
  • Biopsy:  A biopsy is a microscopic examination of testicular tissue by a pathologist to determine whether cancer is present. In nearly all cases of suspected cancer, the entire affected testicle is removed through an incision in the groin. This procedure is called radical inguinal orchiectomy. In rare cases (for example, when a man has only one testicle), the surgeon performs an inguinal biopsy, removing a sample of tissue from the testicle through an incision in the groin and proceeding with orchiectomy only if the pathologist finds cancer cells. (The surgeon does not cut through the scrotum to remove tissue. If the problem is cancer, this procedure could cause the disease to spread.)
 

Testicular Cancer Treatment Options

 
City of Hope brings together highly skilled specialists and the latest treatment options – some found only here – for men in every stage of testicular cancer. Our multidisciplinary team includes urologists, medical oncologists, radiation oncologists and surgical oncologists, who work cooperatively to create the most effective treatment plan and optimize outcomes for each patient with testicular cancer. Because City of Hope includes experts in all cancer specialties in one location, patients receive greater continuity of care and more coordinated treatment planning.
 

Surgery

City of Hope surgeons are among the most experienced in the country and have excellent success rates using a range of advanced technologies.  Many of the most complex cases of testicular cancer are sent to our specialists.

Minimally Invasive and Laparoscopic Surgery
Whenever possible, our testicular cancer patients are treated with minimally invasive techniques. These include laparoscopic surgery, which is performed using thin, flexible instruments that are inserted through small “keyhole” incisions.

City of Hope is also a leader in use of the new robotic-assisted da Vinci S Surgical System for the treatment of testicular cancer. Controlled by an experienced surgeon, the system combines extremely precise movements with three-dimensional imaging to achieve excellent surgical results.

Potential benefits of minimally invasive surgeries include:
  • Less blood loss, pain and visible incisions
  • Shorter hospital stays and recovery time
  • Fewer post-operative complications
  • Quicker return to normal activities
 
Surgical Procedures
 

Radical inguinal orchietomy
In nearly all of cases of suspected testicular cancer, the affected testicle is removed through an incision in the groin in a surgical procedure called radical inguinal orchietomy.  Men may be concerned that losing a testicle will affect their ability to have sexual intercourse or make them sterile. However, a man with one healthy testicle can still have a normal erection and produce sperm.
After a testicle is removal, the type of tumor subsequently identified on the pathology report combined with information gathered from X-rays or blood tests directs subsequent treatment.

Retroperitoneal lymph node dissection (RPLND)
RPLND is a high-level complex surgery performed at City of Hope that only a limited number of centers will attempt. A urological surgeon performs this operation to remove the lymph nodes surrounding the great vessels in the abdomen. A pathologist then examines the lymph nodes under a microscope to determine whether the cancer has spread.

Radiation Therapy
Radiation has long been used to treat many kinds of cancers. In testicular cancer, radiation may be given to relieve pain, used in combination with chemotherapy as a treatment modality, or delivered after surgery to minimize the risk of recurrence.
Treatments in which beams of energy are directed at the tumor from an outside source are referred to as external beam radiation.  At City of Hope, external beam radiation treatments may include:
  • Three-dimensional conformal therapy
  • Helical TomoTherapy - Considered the most advanced radiation therapy available, Helical TomoTherapy allows doctors to target and destroy cancer cells very precisely while sparing healthy tissues nearby.
 

Chemotherapy

Chemotherapy – the use of anticancer medicines – includes a wide range of drugs and treatment strategies. City of Hope provides standard chemotherapies as well as access to newly developed drugs through an extensive program of clinical trials. For instance, high-dose chemotherapy with stem cell rescue/stem cell transplantation is a unique approach that has proven to be a very tolerable regimen with good efficacy for patients at more advanced stages of cancer. As part of the treatment team, a medical oncologist will evaluate the best options so that a course of chemotherapy, if appropriate, can be tailored to the patient.
 
 
 

Testicular Cancer Resources

All of our patients have access to the Sheri & Les Biller Patient and Family Resource Center, which offers a wide array of support and educational services. Patients and loved ones may work with a coordinated group of social workers, psychiatrists, psychologists, patient navigators, pain management specialists and spiritual care providers at the center, as well as participate in programs.

 

Additional Resources

American Urological Association
1-866-746-4282
The American Urological Association ( AUA ) is the premier professional association for the advancement of urologic patient care, and works to ensure that its members are current on the latest research and practices in urology.

American Cancer Society
800-ACS-2345
866-228-4327 for TYY
The American Cancer Society has many national and local programs, as well as a 24-hour support line, to help cancer survivors with problems such as travel, lodging and emotional issues.

City of Hope Patient Support Groups and Community
Support groups at City of Hope for patients with specific types of cancer or specific needs. View our calendar for specific groups and meeting times.

National Comprehensive Cancer Network
888-909- NCCN (6226)
The National Comprehensive Cancer Network, an alliance of 19 of the world's leading cancer centers, is an authoritative source of information to help patients and health professionals make informed decisions about cancer care.
 
National Cancer Institute
800-4-CANCER
The National Cancer Institute, established under the National Cancer Act of 1937, is the federal government's principal agency for cancer research and training.

 

U.S. Dept. of Health & Human Services National Institutes of Health

301-496-4000
301-402-9612 for TYY
The National Institutes of Health (NIH) is one of the world's foremost medical research centers, and the federal focal point for medical research in the United States. The NIH, comprising 27 separate institutes and centers, is one of eight health agencies of the Public Health Service, which, in turn, is part of the U.S. Department of Health and Human Services.

 

 

Testicular Cancer Research and Clinical Trials

Pioneering Research

Scientists at City of Hope are involved in pioneering research that will generate the next generation of medical advances. These studies are in the emerging fields of molecular biology, molecular genetics, nanoscience and nanotechnology.

The molecular biology research has two goals. One set of experiments is aimed at understanding how the RNA used by human cells to copy the ends of chromosomes is made and assembled in normal cells and cancer cells. The second set of experiments is aimed at understanding how patterns of methyl groups on DNA are lost and miscopied as we age and as cancer cells form.

The molecular genetics research is aimed at understanding how prostate cancer cells interfere with normal pathways in the synthesis of the building blocks of fat. Normally these pathways tell a cell that is about to become a cancer cell that it should stop growing and die in order to best preserve the whole body. Cancer cells, on the other hand, have special genes that block this process allowing them to continue to grow and ultimately form a cancerous growth.

The nanotechnology research seeks to exploit City of Hope’s patented bionanotechnology to use engineered DNA and protein to build tiny programmable machines (smaller than one thousandth the width of a human hair) that can find cancer cells and either mark them in a diagnostic procedure or perhaps selectively destroy them.

Additionally, various basic research programs are under way in other city of Hope and Beckman Research Institute departments related to urologic oncology, including molecular medicine and gene-based therapy.
 
Clinical Trials

City of Hope has long been a leader in cancer research, including testicular cancer. Multiple clinical trials are ongoing, offering patients access to new and advanced treatments involving chemotherapy, radioimmunotherapy and radiation.

To learn more about our clinical trials program – and how you can participate in trials for testicular cancer – click here.
 

Testicular Cancer Team

City of Hope cancer research hospital's multidisciplinary team includes urologists, medical oncologists, radiation oncologists and surgical oncologists working cooperatively to create the most effective testicular cancer treatment plan and optimize outcomes. Locations in southern California near Los Angeles (Duarte),   South Pasadena,   Antelope Valley (Lancaster and Palmdale), Palm Springs and Santa Clarita.

Support This Program

It takes the help of a lot of caring people to make hope a reality for our patients. City of Hope was founded by individuals' philanthropic efforts 100 years ago. Their efforts − and those of our supporters today − have built the foundation for the care we provide and the research we conduct. It enables us to strive for new breakthroughs and better therapies − helping more people enjoy longer, better lives.

For more information on supporting this specific program, please contact us below.

Rick Leonard
Associate Vice President
Direct: 213-241-7218
Email: rleonard@coh.org

 
 
Urologic Cancers - Advances in Research and Treatments
 
Timothy Wilson, M.D.: Pauline & Martin Collins Family Chair in Urology, talks about City of Hope advances in research and treatments of urologic cancers.
 
For more information on prostate cancer: Watch the City of Hope prostate cancer YouTube playlist.
Urology and Urologic Oncology Research

City of Hopes's Division of Urology strives to improve quality of care through innovative research that helps expand our understanding of urologic cancers. This brochure provides the key areas of research and studies our division is focusing on.
 
 
The Division of Urology and Urologic Oncology at City of Hope offers a Fellowship in Urologic Oncology with special emphasis on minimally invasive and robotic techniques.
City of Hope is committed to making the process of becoming a patient here as easy as possible. Call 800-826-HOPE (4673) or complete the Schedule a Callback form.
Led by multidisciplinary teams of volunteers and professionals, the Sheri & Les Biller Patient and Family Resource Center offers an integrated array of cancer support services.
Learn more about City of Hope's institutional distinctions, breakthrough innovations and collaborations.
Clinical Trials
Our aggressive pursuit to discover better ways to help patients now – not years from now – places us among the leaders worldwide in the administration of clinical trials.
 
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