What are the differences between prostate and testicular cancer?

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Prostate cancer occurs when genetic changes cause cancerous cells to grow in the prostate. It is the second most common form of cancer in American men, after skin cancer. The prostate is a small, walnut-shaped gland in the male reproductive system. It sits directly below the bladder, inside the groin. The male hormone testosterone controls how the prostate functions.

The prostate produces fluids that mix with sperm from the testicles to make semen. It produces prostate-specific antigen (PSA), which is a protein that makes semen watery. Semen production is an important function of the prostate, but its muscles also help to push semen into the urethra during sex. The prostate also converts testosterone into a biologically active form called dihydrotestosterone (DHT).

Testicular cancer occurs when cancerous cells develop in the testicles, or testes. Testicular cancer is uncommon, affecting around 1 in every 250 American men during their lifetime.

The testicles are another part of the male reproductive system. They include two small, rounded organs that sit in the scrotum, which is a sac of skin below the penis. The testicles produce sperm and male hormones, including testosterone.

Prostate and testicular cancer both start in male reproductive organs that share similar functions. For example, the prostate and testicles are central to semen production. The testicles also produce testosterone, which influences prostate functioning.

Prostate cancer is much more common than testicular cancer. The American Cancer Society (ACS) estimates that there are around 248,530 new cases of prostate cancer every year. However, there are only around 9,470 new cases of testicular cancer annually.

Prostate cancer also causes around 34,130 deaths each year, while testicular cancer kills only around 440 people annually.

All forms of cancer are genetic diseases. This means that genetic changes cause cells to become cancerous, where they grow and divide uncontrollably. However, the initial cause of prostate or testicular cancer is unclear.

Testicular and prostate cancer share some risk factors, such as:

• a family history of either cancer
• African American ethnicity
• living in North America or Europe

There are also some similarities in the treatment options for these cancers. For example, doctors may suggest watchful waiting or active surveillance as a treatment option for prostate or testicular cancer. This involves monitoring the cancer with regular check-ups to see whether treatment is necessary.

Men who have either cancer without symptoms or other medical problems may not require treatment. This can be a good option to avoid the risks and side effects of cancer treatments. However, doctors may suggest intervening if the condition worsens.

Surgery is the main treatment for testicular cancer, which typically involves removing the testicles. Surgery is also an option for people with prostate cancer when the tumor has not spread and the person is in good health. Other treatment options for these conditions can include radiation therapy or chemotherapy. These are useful approaches for cancers that have spread beyond their original location.

There are several differences between prostate and testicular cancer, despite both starting in the male reproductive system. For example, prostate cancer is most common in men over 40, but testicular cancer is more common in men aged 20–34.

Risks

An undescended testicle is one of the main risk factors for testicular cancer. This is where one or both testicles fail to move into the scrotum. Other risk factors for testicular cancer can include:

• HIV infection
• being tall
• carcinoma in situ of the testicle

Scientists have identified several gene mutations that pass through families and increase the risk of prostate cancer — for example, mutations of the BRCA1 or BRCA2 genes.

Symptoms

The main symptom of testicular cancer is a painless lump in the testicles. Other symptoms include:

• swelling of the testicles
• feeling of a weight in the scrotum
• pain or ache in the testicles, scrotum, or groin
• tenderness of the breast tissue

The symptoms of prostate cancer largely affect urinary habits and include:

• weak urine flow
• frequent and urgent need for urination
• waking up to urinate multiple times during the night
• difficulty emptying the bladder
• pain or burning while urinating or ejaculating
• blood in the urine or semen
• signs of anemia, such as pale skin
• pain in the back, hips, or pelvis

Diagnosis

While a doctor can perform a physical exam to help diagnose both conditions, testicular cancer is easier to identify through self-examination than prostate cancer because it is simpler to access the testes, where the cancer typically causes detectable lumps.

Blood tests for both cancers also check for different substances. For testicular cancer, the test checks for alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (β-hCG), while the test for prostate cancer checks for the presence of PSA.

Complications

Both cancers can be deadly without treatment. However, testicular cancer is highly treatable and has a lower risk of death. The ACS estimates that around 1 in 5,000 people dies from testicular cancer.

Prostate cancer is the second leading cause of cancer deaths in American men, with around 1 in 41 males dying from it. Many more people die from prostate cancer than testicular cancer partially due to how common it is. Prostate cancer is also highly treatable, and most people with the disease do not die from it.

Men can perform self-examinations to identify testicular cancer. A doctor may recommend performing a testicular self-exam after a bath or shower by:

• checking each testicle for lumps using the thumb and fingers to gently roll each testicle
• finding the tube-like structures that connect to the testicles and check for anything unusual
• looking for any lumps or swollen areas, even if they cause no pain

A person should contact a doctor if they notice anything unusual on their testicles.

It is difficult to identify prostate cancer through self-examination because physical changes are hard to detect without a doctor or nurse.

There are currently no standard screening tests available for prostate cancer. However, a doctor may recommend certain tests if a person meets risk factors and experiences pain or difficulty when urinating. Screening options include:

• digital rectal examinations, where a doctor or nurse inserts a finger in the rectum to check for lumps
• PSA tests, which measure the amount of PSA in the blood
• genetic tests that identify certain genes. These are still undergoing clinical trials

It is not always possible to prevent prostate or testicular cancer. However, the ACS suggests the following factors can reduce the risk of prostate cancer:

• keeping a healthy body weight
• regularly exercising
• following a healthy diet
• avoiding smoking
• taking 5-alpha reductase inhibitors
• taking aspirin

However, medical professionals know much less about factors that can prevent testicular cancer. The ACS states that it is currently not possible to prevent testicular cancer.

Prostate and testicular cancer affect different organs of the male reproductive system. They have some similar risk factors and treatments but also many differences. Prostate cancer typically affects men over 40 and is common, while testicular cancer typically affects men under 35 and is rare.

Testicular cancer is often easier to identify through self-examination and is highly treatable at all stages. Prostate cancer is also highly treatable but is still the second leading cause of cancer deaths in American males due to delays in diagnosis and treatments.