Testicular cancer originates in the testicles. Metastatic testicular cancer is an advanced stage of the disease. It occurs when cancer cells in the original sites travel through the lymphatic system or bloodstream to distant sites.

As a result, the cancer can affect the lymph nodes and organs such as the lungs, liver, or brain. It is critical to detect and treat testicular cancer at an early stage. Doctors find it more challenging to treat and cure metastatic testicular cancer than localized testicular cancer that is confined to the testicles.

With appropriate treatment, the outlook for those with metastatic testicular cancer remains favorable. However, people should be aware of the symptoms of testicular cancer so they can alert their doctor to any relevant issues.

This article explores metastatic testicular cancer, its causes, symptoms, and when a person should contact their doctor.

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Metastatic testicular cancer is a form of testicular cancer that has spread beyond the testicles to other parts of the body.

Testicular cancer originates in the testicles, which are the organs involved in male reproduction and responsible for producing sperm and hormones. When cancer cells grow uncontrollably in the testicles, they form a tumor. If a person does not seek diagnosis and treatment at this stage, cancer may spread to other areas of the body, becoming metastatic testicular cancer.

The cancer cells usually spread through the lymphatic system or bloodstream, reaching other organs such as the lymph nodes, lungs, liver, or brain.

Metastatic testicular cancer is less common than localized testicular cancer, as most people seek medical advice and treatment at earlier stages when the cancer is still confined to the testes.

Is it common?

Overall, testicular cancer is not a common type of cancer. It represents just 1% of male tumors, affecting around 6.3 people per 100,000. Of these cases, around 5% of people experience symptoms of metastatic cancer.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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A person may not experience testicular cancer symptoms, even when it spreads to other areas. However, as cancer progresses, it may cause various symptoms depending on the affected areas.

The following are common symptoms of late stage testicular cancer:

  • Lower back pain: Pain in the lower back can result from cancer spreading to the lymph nodes. These bean-sized collections of immune cells are at the back of the abdomen and can become enlarged, causing discomfort or pain.
  • Respiratory symptoms: Shortness of breath, chest pain, or a persistent cough, sometimes accompanied by blood, can result from cancer that has spread to the lungs.
  • Abdominal pain: If cancer spreads to the liver, it can cause abdominal pain. Likewise, enlarged lymph nodes in the abdomen can cause discomfort. A person may also experience digestive symptoms such as nausea, vomiting, or a change in bowel habits.
  • Neurological symptoms: Headaches or confusion could indicate that cancer has spread to the brain. A person may also have other neurological changes, such as difficulty with balance, vision problems, or seizures.

People with testicles should perform routine self-examinations to become familiar with their normal size, shape, and firmness. This allows them to notify their doctor if they notice any changes or experience testicular pain or discomfort.

Individuals should also contact their doctor if they have general health issues, such as fatigue, abdominal pain, or headaches. Although it is unlikely that these problems relate to testicular cancer, a doctor can rule out any underlying health conditions, make a diagnosis, and recommend suitable treatments.

Doctors are unsure why most cases of testicular cancer occur. However, the underlying mechanism appears to involve changes in cellular DNA that trigger the cells to grow uncontrollably.

Cellular DNA forms genes. Oncogenes are genes that control cell growth and division, while tumor suppressor genes suppress cell division and trigger cell death when necessary.

If cells undergo genetic changes that activate oncogenes or deactivate tumor suppressor genes, cancer may develop.

Many testicular cancer cells carry additional copies of part of chromosome 12, known as isochromosome 12p or i12p. In addition, there may also be abnormal chromosome numbers or other chromosome changes. Research is ongoing to understand the role of these genetic changes in testicular cancer development.

While a person cannot change some testicular cancer risk factors, understanding them enables a person to monitor their health more closely and seek medical advice if they experience symptoms. The risk factors for testicular cancer include:

  • Age: Testicular cancer predominantly affects people ages 20 to 34 years.
  • Cryptorchidism: This condition occurs when one or both testicles fail to descend into the scrotum before birth.
  • Race and ethnicity: Testicular cancer is more common among white and Hispanic individuals.
  • Family history: If an individual’s father or brother has experienced testicular cancer, their risk is higher than those with no family history.
  • Personal history: People previously diagnosed with testicular cancer have an increased risk of developing it in the other testicle.
  • Infections: Infections with human papillomavirus (HPV), human immunodeficiency virus (HIV), and Epstein bar virus (EBV) increase the risk of testicular cancer.

Having one or more risk factors does not guarantee the development of testicular cancer. Similarly, people with no known risk factors can still develop the disease.

When testicular cancer has spread to other parts of the body, doctors tailor the treatment according to the individual’s age, overall health, previous treatments, type of cancer, and affected organs.

An individual may have a combination of the following treatments:

  • Surgery: A surgeon removes the affected testicle during an orchiectomy procedure. This helps prevent the further spread of cancer from the original site.
  • Chemotherapy: Chemotherapy agents are potent drugs that kill cancer cells. In cases of metastasized testicular cancer, doctors may use chemotherapy combinations such as bleomycin, etoposide, and cisplatin (BEP), etoposide and cisplatin (EP), or etoposide, ifosfamide, and cisplatin (VIP).
  • High dose chemotherapy and stem cell transplant: In cases where standard chemotherapy is ineffective, doctors may recommend high dose chemo followed by a stem cell transplant. This involves transplanting healthy stem cells, either from the individual or a donor. The new cells help rebuild the immune system and promote the growth of new, healthy blood cells.
  • Radiation therapy: If testicular cancer metastasizes to the brain, doctors may first surgically remove tumors and then use radiation therapy. These high energy X-rays or gamma rays damage and destroy cancer cells, helping control cancer growth and alleviate symptoms.

The outlook for those with testicular cancer is generally very positive, even if it spreads to other areas. This means a person’s likelihood of recovery and long-term survival is relatively high compared with some other cancers.

According to the American Cancer Society (ACS), the 5-year survival rate for testicular cancer with regional spread is 96%. Even in cases where the cancer has spread to distant parts of the body, more than 7 in 10 people can expect to live for at least 5 years following their diagnosis.

Metastatic testicular cancer is an advanced stage of the disease where cancer cells have spread beyond the testicles to other parts of the body.

The outlook for those with metastatic testicular cancer remains generally positive, thanks to effective treatment options and high cure rates.

Early detection plays a vital role in ensuring successful outcomes. People should understand the importance of regular self-examinations and a prompt visit with a doctor if they spot any changes.

By staying vigilant and informed about testicular cancer, individuals can take charge of their health and improve their chances of a favorable outlook.