Q&A: Dr. Gregory Diorio on the Causes, Symptoms, Prognosis and Treatment of Testicular Cancer

  

Though testicular cancer accounts for about 1% of all cancers in men, it is the most common solid tumor found in younger men. MUSC Health urologist Dr. Gregory Diorio specializes in urologic oncology, with specific interest in the management of bladder cancer with urinary reconstruction, kidney cancer and testicular cancers. Working as part of the MUSC Health Prostate & Genitourinary Cancers Program at MUSC Hollings Cancer Center, Dr. Diorio offers insight into the causes of testicular cancer, how to prevent it, and what can happen if diagnosed with testicular cancer.  

What is testicular cancer?

Testicular cancer is relatively rare, accounting for approximately 1% of all cancers in men. It is more frequently diagnosed in younger men and is the most common solid tumor found in men between the ages of 18 and 34.Testicular Cancer is divided up into two main categories:  Germ cell tumors and non germ cell tumors. Germ cell tumors comprise 95% of all testicular tumors. The two most common are referred to as seminoma and non seminoma. Meanwhile, non germ cell tumors are less common though tend to have an indolent course.

What are the causes and risk factors of testicular cancer? 

Risk factors for testicular cancer have been established as strong family history as well as undescended testicles.

Are there ways to prevent testicular cancer?

 Prevention is generally centered around early detection with frequent self-testicular exams and wellness visits with primary care physicians. 

 

What are the signs/symptoms of testicular cancer?

Can it spread?The vast majority of testicular tumors present as a palpable mass within the testicle, which may or may not be associated with pain or inflammation.Testicular tumors can spread outside of the testicular to the lymph nodes as well as other organs, such as the lung, brain and chest, in advanced stages.

How is testicular cancer diagnosed? What tests are available to detect testicular cancer?

Testicular tumors can be detected by palpation as well as seen on an ultrasound of the scrotum.Blood tests are ordered to check for specific tumor markers associated with seminoma and non-seminoma, respectively.

What is the prognosis of testicular cancer?

The prognosis for all testicular cancers is overwhelmingly good, even for advanced stages, and patients can be cured with appropriate treatment. Rarely, testicular cancer at advanced stages can be fatal; this holds especially true for recurrent disease that does not respond to initial therapies.

What are the treatment options for testicular cancer?

Treatment for testicular tumors will most often require removal of the testicle through a small incision in the groin. This is called a radical orchiectomy. In patients with a high stage and/or involvement of lymph nodes and/or other organs, a combination of chemotherapy and/or radiation is recommended.Surgery to remove enlarged lymph nodes is recommended to appropriate patients both before and after chemotherapy treatments. This is referred to as retroperitoneal lymph node dissection, or RPLD. Close Surveillance with repeat blood tests and CT scans/X-Rays are used to follow patients after treatment to identify any recurrences.

What are the side effects of different treatment options?

Side effects can include hypogonadism (low testosterone), infertility, and ejaculatory dysfunction, as well as the common side effects seen with systemic chemotherapy, such as nausea, hair loss, low blood counts and infection.

Why is it important to stay up to date on testicular cancer screenings, even in a pandemic?

Early detection and treatment at an early stage is vital to the prognosis of patients with testicular cancer.  Very often, patients are cured with only the removal of the testicle and close surveillance. 

Why go to the MUSC Health Prostate & Genitourinary Cancer Program at Hollings Cancer Center?

At Hollings Cancer Center, we are able to provide the most up-to-date diagnostic modalities, and treatment regimens to patients across a wide spectrum of urologic cancers. As the only NCI-designated cancer center in the state, we offer ground breaking research and the latest clinical trials to our patients. Our multidisciplinary team of surgical specialists and medical experts strive to tailor treatments based on the most up-to-date science as well address the needs of each individual patient.

Learn more about the MUSC Health Prostate & Genitourinary Cancer Program. To make an appointment, call us at (843) 792-2883.