| The Testicular Cancer Resource Center |
Plain-English definitions of terms you may encounter in pathology reports, scan reports, treatment discussions, fertility care and survivorship after testicular cancer.
Adenomatoid Tumor - A benign tumor that most often arises in the epididymis or other paratesticular tissue. Ultrasound may show a small, well-defined mass outside the testicle, but its appearance is not specific enough to diagnose it with certainty.
Adjuvant therapy - A treatment given in addition to the main treatment (for example, chemotherapy as well as surgery) to try to prevent a cancer from coming back, even though there is no indication that the cancer is still there.
AFP - see Alpha-fetoprotein.
Alopecia - Hair loss. Many chemotherapy regimens used for testicular cancer cause temporary hair loss. Radiation can cause hair loss only in the area being treated.
Alpha-fetoprotein (AFP) - A blood tumor marker used in testicular germ cell tumors. AFP may be elevated in nonseminoma, particularly tumors containing yolk sac tumor or embryonal carcinoma. Pure seminoma does not produce AFP. If AFP is convincingly elevated in a patient whose pathology appears to show pure seminoma, doctors look for an unrecognized nonseminomatous component or another cause such as liver disease. AFP has a serum half-life of about 5 to 7 days, so the trend after orchiectomy or treatment is important. Normal ranges vary by laboratory, and mild persistent elevations can occasionally occur for noncancer reasons.
Androgen - A hormone that promotes the development and maintenance of male sex characteristics. The main Androgen is testosterone.
Andrologist - A specialist in male reproductive health, which may include fertility, sexual function and hormone problems. Depending on the country and setting, an andrologist may be a urologist, endocrinologist or laboratory scientist with specialized training.
Anemia- A reduction in the number of red blood cells (these carry oxygen). Symptoms of anemia include feeling tired, weak or short of breath.
Antegrade ejaculation - Normal forward ejaculation.
Antiemetic - A medicine that controls or prevents nausea and vomiting.
Aorta - The large artery originating from the left ventricle of the heart. Its branches carry blood to all parts of the body. The lymph nodes most often affected by testicular cancer are located around the aorta and near the kidneys in the retroperitoneum.
Atrophic - Something that has decreased in size or shows evidence of arrested development. Testicles can become atrophic due to disease or cancer or abnormal development.
Azoospermia - Semen containing no sperm, either because the testicles cannot make sperm, there is a blockage in the reproductive tract, or the patient has had a vasectomy.
Benign tumor - A noncancerous growth that does not spread to other parts of the body.
Beta-hCG - see Human Chorionic Gonadotropin (hCG), beta subunit
BEP - BEP is a common combination of chemotherapeutic drugs (Cisplatin, Bleomycin, and Etoposide) used with germ cell tumors.
Biopsy - The removal and examination of a sample of tissue with a microscope to see whether cancer cells are present.
Bleomycin - A mixture of glycoprotein antibiotics derived from a streptomyces (Streptomyces verticillus) and used as an anticancer agent. aka BLENOXANE
Blood Count - The number of red blood cells, white blood cells, and platelets in a sample of blood. This is also called a complete blood count (CBC).
Cancer - A general term for more than 100 diseases in which there is an uncontrolled, abnormal growth of cells. Cancer cells can spread through the bloodstream and lymphatic system to other parts of the body.
Carboplatin - A platinum-based chemotherapy drug related to cisplatin. Cisplatin-based combinations remain standard for metastatic germ cell cancer. Carboplatin has a more limited role in testicular cancer, including single-dose adjuvant treatment as one option for selected men with stage I seminoma.
Carcinoma in situ (CIS) - An older term commonly used for what is now called germ cell neoplasia in situ (GCNIS), the precursor lesion for most adult testicular germ cell cancers.
Catheter - A thin flexible tube through which fluids can enter or leave the body.
Chemotherapy - Treatment with anticancer drugs. These may be used singly or in combination to kill or prevent the growth and division of cells. Although aimed at the cancer cells, chemotherapy will also unavoidably affect rapidly dividing normal cells such as in the hair (hair loss), and gut (nausea), blood & bone marrow (anemia or neutropenia), and sperm (infertility) which are usually temporary and reversible.
Chest X-ray - A chest x-ray is an x-ray picture of the upper chest. It is a quick and inexpensive diagnostic tool to detect lung metastases.
Choriocarcinoma - A rare, highly malignant germ cell cancer. When seen as a small component of mixed germ cell tumors, it has little bearing on clinical behavior or outcome. In its pure form, seen in less than 1% of all germ cell tumors, it requires intensive chemotherapy. It can metastasize via the bloodstream to the lungs or central nervous system without affecting the retroperitoneum.
Chylous Ascites - Accumulation of lymphatic fluid in the abdomen. It is an uncommon complication of RPLND or other retroperitoneal surgery. Treatment may include dietary changes, drainage, medicines, specialized nutrition, or additional procedures depending on severity and persistence.
Cisplatin - A platinum based anticancer drug used especially in testicular and ovarian germ cell tumors. aka PLATINOL
Clinical trial - A study conducted with cancer patients to evaluate a new treatment to see if the new treatment is better or worse than existing treatments. Each study is designed to answer scientific questions and to find better ways to help patients.
CNS - Central Nervous System - Extragonadal germ cell tumors can arise in the CNS, often in the pineal gland. Metastatic germ cell tumors can also spread to the CNS.
Colony-stimulating factors - Medicines that stimulate the bone marrow to produce blood cells. Granulocyte colony-stimulating factors (G-CSF), such as filgrastim (Neupogen) and pegfilgrastim, can be used to reduce the duration or risk of severe neutropenia in selected chemotherapy patients.
Combination chemotherapy - Treatment with more than one anti-cancer drug at a time. The treatment for testicular cancer uses combination chemotherapy.
Contralateral - Referring to the opposite side of the body, in this case, the other testicle.
Computed tomography (CT Scan) - An X-ray procedure that uses a computer to produce a detailed picture of a cross-section of the body; also called CT scan or CAT scan.
Cryptorchidism - A condition in which one or both testicles fail to move from the abdomen, where they develop before birth, into the scrotum; also called undescended testicles.
Cycle - A planned block of chemotherapy followed by the time allowed before the next block begins. A BEP cycle is generally 21 days, although the exact schedule for cisplatin, etoposide and bleomycin depends on the protocol being used.
Cyst - An abnormal sac filled with gas, fluid, or semi-solid material that is lined by a membrane.
Cytotoxic - 'Toxic to cells' - anti-cancer treatment.
Differentiation - The degree to which a tumour resembles normal tissue. In general, the closer the resemblance, the better the prognosis. Well differentiated tumors closely resemble normal tissue.
Disseminated disease - Disease in which the cancerous cells have spread from the tissue of origin to other organs. (AKA: Metastasis)
Ejaculate - The semen and sperm expelled during ejaculation.
Ejaculation - The sudden, forceful discharge of semen.
Embryonal carcinoma - A type of germ cell tumor that tends to form glands or spaces. It usually is found as a component of a mixed germ cell tumor, however, as a pure form it is second in occurrence in TC only to seminoma. On clinical evaluation it is found to have spread beyond the testis in about 30% of cases.
Endodermal Sinus Tumor - see Yolk Sac Tumor
Epidermoid cyst - These are rare, slowly growing masses that are probably not of germ cell origin.
Epididymis - A soft, tubelike structure behind the testicle that collects and carries sperm. Within this organ the developing sperm complete their maturation and develop their powerful swimming capabilities. The matured sperm leave the epididymis through the vas deferens. Sperm may live here for several weeks.
Epididymitis - Inflammation of the epididymis. This is a common problem, usually caused by infection.
Etiology - The cause or possible cause of a disease. For example, smoking is a cause of lung cancer.
Etoposide - An anticancer drug commonly used in combination with other chemotherapeutic drugs. aka VP-16
Extragonadal germ cell tumor - A primary germ cell tumor that arises outside the gonads. In males, important sites include the mediastinum, retroperitoneum and central nervous system. A careful testicular evaluation is important because metastatic disease from a small or regressed testicular primary can sometimes mimic an extragonadal tumor. Prognosis depends on the site, histology and extent of disease; primary mediastinal nonseminoma is a recognized poor-prognosis category.
Extra-testicular - Outside the testicular parenchyma. Examples include lesions arising from the epididymis, spermatic cord or tunica vaginalis. Most extratesticular scrotal masses are benign, but malignant paratesticular tumors do occur.
Extravasation - Leaking of a chemotherapy drug out of the vein and into the skin
False Negative - A test that shows no evidence of disease when disease is actually present.
False Positive - A test that shows evidence of disease when disease is not actually present.
Fertility - The ability to father children.
Fraction - A term used in radiation oncology where the radiotherapy dose is divided into a number of smaller doses to reduce side effects. For example a planned course of radiotherapy for seminoma may consist of 15 fractions. There is normally one fraction per weekday.
FSH (Follicle-Stimulating Hormone) - A pituitary hormone that acts mainly on Sertoli cells and helps regulate sperm production. In men, an elevated FSH can be a sign of impaired sperm-producing function in the testicle.
Funiculitis - Inflammation of the spermatic cord.
Germ Cell Neoplasia in Situ (GCNIS) - A preinvasive abnormal germ-cell population from which most adult testicular germ cell cancers develop. GCNIS was previously called carcinoma in situ (CIS) or intratubular germ cell neoplasia. It can be found in testicular tissue adjacent to an invasive germ cell tumor.
Germ Cell - A reproductive cell lineage that gives rise to sperm in males and eggs in females. The great majority of testicular cancers in adolescents and adults are germ cell tumors.
Germ Cell Tumor - A tumor arising from germ cells. 95% of all testicular tumors are germ cell tumors. Germ cell tumors in men are classified as either seminomas or nonseminomas.
Germinoma - A germ cell tumor that most often arises in the central nervous system. It is biologically related to testicular seminoma and ovarian dysgerminoma.
Gonad - The gland that makes reproductive cells and "sex" hormones: the testicles, which make sperm and testosterone, and the ovaries, which make eggs (ova) and estrogen.
Gray (Gy) - The modern unit of radiation dosage.
Groin - The area where the thigh joins the abdomen.
Gynecomastia - Excessive development of the breast in the male.
Half Life - The time required for half the amount of a substance (such as a tumor marker) in or introduced into the body to be eliminated or disintegrated by natural processes.
Hernia (inguinal hernia) - Protrusion of abdominal tissue through a weak area in the groin. An inguinal hernia can sometimes extend into the scrotum.
High Dose Chemo - High dose chemo uses very high doses of chemotherapy to try to kill the cancer. It is very intense chemo, and is normally associated with a stem cell transplant.
Histology - The study of the appearance and behavior of tissue, usually carried out under a microscope by a pathologist (who is a physician) or a histologist (who is not necessarily a physician)
Hormones - Chemicals produced by certain glands in the body.
Human Chorionic Gonadotropin (hCG), beta subunit - A blood tumor marker that may be elevated in both nonseminoma and seminoma. It is especially associated with choriocarcinoma and tumors containing syncytiotrophoblastic cells. The serum half-life is roughly 24 to 36 hours, so the pattern of decline after orchiectomy or treatment is useful. Low-level elevations can occasionally result from pituitary hCG in hypogonadal men or from laboratory assay interference, so an unexpected result may need confirmation rather than being assumed to represent cancer.
Hydrocele - A swelling of (part of) the scrotal pouch because of an increased amount of fluid around the testicle/epididymis. Several causes may lead to an increase of the amount of liquid, causing the scrotal pouch to bulge. This condition is harmless, but may cause irritation when the bulge becomes too big. There is no cancer involved, and it does not lead to cancer.
Hyperechoic - An ultrasound description meaning that an area reflects more sound and therefore appears brighter than surrounding tissue. It does not by itself determine whether a lesion is solid, cystic, benign or malignant.
Hypoechoic - An ultrasound description meaning that an area reflects less sound and appears darker than surrounding tissue. Many testicular cancers are hypoechoic, so a solid intratesticular hypoechoic mass is suspicious, but ultrasound appearance alone cannot prove that a lesion is cancer.
IGCCCG - International Germ Cell Cancer Collaborative Group. Its prognostic classification places metastatic germ cell cancers into good-, intermediate- or poor-prognosis groups based on tumor type, primary site, sites of spread and post-orchiectomy tumor-marker levels. It is a prognosis system, not the same thing as AJCC stage.
Ifosfamide - An anticancer drug related to the nitrogen mustards. It is active in a number of cancers, including germ cell cancers. aka IFEX
Immature - Lacking complete growth, differentiation, or development. Rapidly growing malignant tumors show a significant degree of structural abnormality and resemble immature embryonal tissues or stem cells capable of proliferative activity. These cells may be referred to as undifferentiated or immature. In general, the more undifferentiated the tumor, the more malignant its biological behavior, as shown by tumor recurrence, vascular invasion, and metastasis.
Implant - A testicular prosthesis placed in the scrotum for cosmetic appearance after loss of a testicle. An FDA-approved saline-filled testicular prosthesis is available in the United States.
Impotent - An older term for erectile dysfunction, meaning persistent difficulty getting or maintaining an erection adequate for sexual activity.
Infertility - The inability to conceive after a year of unprotected intercourse or the inability to carry a pregnancy to term.
Infusion - Slow and/or prolonged intravenous delivery of a drug or fluids.
Inguinal orchiectomy - Removal of the testicle through an incision in the groin (roughly to the right or left of the pubic bone and a couple of inches below the belt line). Cancerous testicles are always removed through an inguinal incision, never through the scrotum.
Injection - Using a syringe and needle to push fluids or drugs into the body; aka a "shot."
Intra-testicular - Within the testicle. This is where spermatozoa and testosterone are made. This is also where testicular cancers originate.
Intravenous pyelography (IVP) - An older X-ray examination of the kidneys and urinary tract using injected contrast. CT and other modern imaging have largely replaced IVP.
Klinefelter's syndrome - A genetic abnormality in a male characterized by two X chromosomes and one Y chromosome, infertility, smallness of the testes, and gynecomastia. It is associated with primary mediastinal extragonadal germ cell tumors found during puberty.
LH (Luteinizing Hormone) - A pituitary hormone that tells Leydig cells in the testicle to make testosterone. A high LH with a low testosterone suggests primary testicular failure. A high LH with a testosterone level still inside the laboratory range can show compensated or partial Leydig-cell dysfunction.
Lactate dehydrogenase (LDH) - An enzyme found throughout the body. LDH is one of the three standard serum tumor markers used in testicular cancer staging, but it is much less specific than AFP or beta-hCG because many noncancer conditions can raise it. It can be elevated in either seminoma or nonseminoma and often reflects overall tumor burden.
Laparoscopy - Minimally invasive surgery performed through several small abdominal incisions using a camera and long instruments. Laparoscopic and robotic approaches can be used for selected RPLND cases at experienced centers, although open RPLND remains an established approach, particularly for complex or post-chemotherapy surgery.
Leydig Cell - The testicular cell that produces the male hormone testosterone. Also referred to as interstitial cells or stromal cells.
Leydig cell tumor - See Sertoli cell tumor.
Local treatment - Treatment that affects the tumor and the area close to it. (Ex: Radiation therapy)
Lymph - A nearly colorless fluid that bathes body tissues and contains cells that help the body fight infection.
Lymph nodes - Small bean-shaped structures located throughout the body along the channels of the lymphatic system: also called lymph glands. Nodes filter circulating lymph and trap bacteria or cancer cells that may travel through the lymphatic system.
Lymphangiography - Imaging of lymphatic vessels after injection of contrast material. Traditional lymphangiography is no longer part of routine testicular cancer staging, although specialized lymphatic imaging and intervention may be used for problems such as persistent chylous leaks.
Lymphatic system - The tissues and organs--including the bone marrow, spleen, thymus, and lymph nodes--that produce and store cells that fight infection and the network of channels that carry lymph.
Malignant - Cancerous (see Cancer)
Malignant Teratoma, Intermediate - The British Tumor Panel's term for Teratocarcinoma.
Malignant Teratoma, Trophoblastic - The British Tumor Panel's term for Choriocarcinoma.
Malignant Teratoma, Undifferentiated - The British Tumor Panel's term for Embryonal Carcinoma.
Margin - The surgical edge of a pathology specimen. Positive margins means that cancer cells were found at the surgical edge of the specimen, and this implies that cancer was left behind in the body.
Marker - See Tumor Marker.
Mass - A mass usually refers to a lump or a tumor.
Mature - Having completed natural growth and development. Some neoplasms, such as benign tumors and some slowly growing malignant tumors, have a cellular structure and organization similar to normal adult tissues at the site of origin and are said to be well differentiated or mature.
Mediastinum - The centermost part of the chest, between the ribs and spine (front to back) and between the lungs. Testicular cancer can metastasize to the anterior mediastinum - i.e., in front of the heart
Metastasize - To spread from one part of the body to another. When cancer cells metastasize and cause secondary tumors, the cells in the metastatic tumor are like those in the original cancer. In cancer slang, to have "mets" means that the disease has spread.
Microlithiasis - Tiny calcifications seen within the testicle on ultrasound. Microlithiasis by itself is not considered an indication for routine ultrasound surveillance, tumor-marker testing or biopsy. Follow-up becomes more relevant when additional risk factors are present, such as prior testicular cancer, an undescended or atrophic testicle, infertility, or a strong family history.
miR-371a-3p - A microRNA blood marker that is highly promising for detecting many active germ cell tumors and may be more sensitive than AFP, beta-hCG and LDH in several settings. It does not reliably detect teratoma and is not yet part of the standard AJCC staging system.
Mixed Germ Cell Tumor - A tumor containing more than one type of germ cell cancer (for example, teratoma and seminoma).
Necrosis - Dead cells. Many germ cell tumors contain necrotic regions. Residual masses after chemotherapy often are composed completely of necrotic tissue.
Neoplasm - Another name for a tumor or cancer.
Nerve sparing - Term used to describe a type of RPLND surgery in which the surgeon saves the nerves that affect ejaculation.
Neupogen - A drug known as a granulocyte colony-stimulating factor (G-CSF). It is often used to stimulate the production of white blood cells during or after chemotherapy.
Neutropenia - An abnormally low number of neutrophils, a type of white blood cell important for fighting bacterial and fungal infections. Leukopenia is a broader term meaning a low total white blood cell count.
Nomogram - A graphic representation that consists of several lines marked off to scale and arranged in such a way that by using a straightedge to connect known values on two lines an unknown value can be read at the point of intersection with another line. One is used to calculate surface area of a person based on height and weight for the purpose of calculating dosages for chemotherapy.
Nonseminoma - A classification of testicular cancers that arise in specialized sex cells called germ cells. Nonseminomas include embryonal carcinoma, teratoma, teratocarcinoma, choriocarcinoma, and yolk sac tumor. The majority of nonseminomas have more than one cell type and are known as mixed germ cell tumors. The cell type of these tumors is important for estimating the risk of metastases and response to chemotherapy.
Occult metastasis - A metastasis that is hidden. In testicular cancer, tumor markers such as AFP and beta HCG are used to detect occult metastases.
Oligospermia - Having few sperm.
Oncologist - A doctor who specializes in treating cancer. Medical Oncologists specialize in treating cancer with chemotherapy while Radiation Oncologists specialize in treating cancer with high dose radiation.
Orchiectomy - Surgery to remove a testicle. Most men with one healthy remaining testicle continue to make enough testosterone and sperm, but fertility or hormone production can be reduced in some men. When testicular cancer is suspected, the standard operation is a radical inguinal orchiectomy; a scrotal approach is generally avoided.
Orchiopexy - An operation to lower an undescended testicle and stitch it into the scrotum.
Orchitis - Inflammation of a testicle, usually causing pain and swelling. It may be viral or bacterial and can occur together with epididymitis.
Para-aortic - "Para" is a prefix meaning besides. The para-aortic lymph nodes are lymph nodes besides the aorta in the retroperitoneum.
Parenchyma - The key elements of an organ essential to its functioning. In other words, the parenchyma is the normal working part of an organ and not the stuff that holds the organ together. The parenchyma of the testis consists of the seminiferous tubules and leydig cells.
Pathologist - A doctor who specializes in the diagnosis of disease by studying cells and tissues removed from the body.
Perineum - The tissue located between the anus and scrotum in the male or between the anus and vaginal opening in the female.
Peripheral neuropathy - A condition of the nervous system that usually begins in the hands and/or feet with symptoms of numbness, tingling, burning and/or weakness. Can be caused by certain anticancer drugs like cisplatin.
PET Scan (Positron Emission Tomography) - Imaging that uses a small amount of radioactive tracer, usually FDG, to show metabolically active tissue. PET is not recommended for routine initial staging or surveillance of testicular cancer. Its main established role is in selected men with seminoma who have a residual mass larger than about 3 cm after chemotherapy, when performed after enough time has passed to reduce false-positive inflammation. PET is not useful for detecting teratoma.
Pineal Gland - A small gland in the center of the brain that appears to function primarily as an endocrine gland that produces melatonin. The pineal gland is one of a number of primary sites for extragonadal germ cell tumors, particularly in children.
Placental Alkaline Phosphatase (PLAP) - A protein that can be detected by immunohistochemical staining in some germ cell tumors, particularly seminoma and GCNIS. PLAP is mainly a pathology marker and is not one of the standard serum tumor markers used for routine testicular cancer staging.
Planning - This consists of individualizing the patient's treatment plan by the study of published literature, consultation with specialist colleagues, calculation of dosages and schedules, and designing the protocol.
Port - (1) A well defined area on the body at which the radiation beam is aimed. For testicular cancer, the port is often referred to as a "hockey stick" or "dog leg" shaped area that includes the retroperitoneal and pelvic lymph nodes. (2) A small plastic or metal container surgically placed under the skin and attached to a central venous catheter inside the body. Blood and fluids can enter or leave the body through the port using a special needle. These devices are expensive and are not free of problems; they should not be implanted without good indications. Normally implantation is performed by a surgeon with experience in this technique, in a operational theatre under local anaesthetic
Primary - The initial tumor or site of cancer.
Prognosis - The probable outcome of a disease; the prospect of recovery.
Prognostic factors - Factors which are associated with a better or worse outcome of the disease. They are not the same as causes. For example, vascular invasion and percentage of embryonal cancer are prognostic factors when predicting whether Stage I nonseminoma will relapse.
Prostate Gland - A gland in the male reproductive system that produces a portion of the semen.
Prosthesis - An artificial replacement for a missing body part. A testicular prosthesis is placed in the scrotum to restore appearance after a testicle has been removed or is absent. FDA-approved saline-filled testicular prostheses are available in the United States. See Testicular Implants.
Protocol - A detailed treatment plan. For example, the BEP chemotherapy protocol is a specific treatment plan using certain drugs on certain days.
Rad - An old unit of radiation dose now superseded by the Gray. 1 Gray = 100 rads.
Radiation Oncologist - A medically qualified doctor who specializes in the use of irradiation for the treatment of cancer.
Radiation therapy - Treatment with high-energy radiation from X-rays or other sources of radiation. Also known as XRT.
Radiation Physicist - A non-medically qualified person who specializes in the application of physics to plan and deliver irradiation, assisting the radiotherapist in planning and treatment.
Radical (radical orchiectomy) - Surgical attempt to cure disease by taking out the entire specimen and surrounding structures.
Recurrence - Return of cancer after a period in which it was no longer detectable. A new cancer arising later in the opposite testicle is a second primary cancer, not a recurrence of the first testicular tumor.
Refractory - A severe disease that is resistant to treatment. For example, a cisplatin refractory disease no longer responds to cisplatin.
Relapse - Recurrence of disease after apparent recovery.
Rete Testis - A network of tubules that basically connects the seminiferous tubules in the testis to the epididymis.
Retrograde ejaculation - Ejaculation in which semen travels backward into the bladder rather than out through the penis. Damage to sympathetic nerves can also cause little or no emission of semen. Modern nerve-sparing RPLND techniques are designed to preserve antegrade ejaculation whenever oncologically safe.
Retroperitoneal Lymph Node Dissection - RPLND - Surgery to remove lymph nodes from the retroperitoneum, the main lymph-node drainage area for testicular cancer. RPLND may be used as primary treatment in selected nonseminoma patients or to remove residual masses after chemotherapy. It is commonly performed through an open abdominal incision, although minimally invasive approaches are used in selected patients at experienced centers. Modern templates and nerve-sparing techniques can reduce the risk of ejaculatory problems.
Retroperitoneum - The back of the abdomen where the kidneys lie and the great blood vessels run.
Salvage - Treatment for individuals who don't respond to or who can't take other treatments for a condition.
Sarcoma - A cancer of connective tissues such as bone, cartilage, fat, muscle, nerve sheath, or blood vessels.
Scrotum - The pouch of skin and thin muscles that contains the testicles.
Semen - The fluid portion of the ejaculate consisting of secretions from the seminal vesicles, prostate gland, and several other glands in the male reproductive tract. Semen may also refer to the entire ejaculate, including the sperm.
Semen Analysis - A laboratory test used to assess semen quality:sperm quantity, concentration, morphology (form), and motility. In addition, it measures semen (fluid) volume and whether or not white blood cells are present, indicating an infection.
Seminal Vesicles - Glands in the male reproductive system which produce much of the semen volume.
Seminiferous Tubules - Tiny tubules within the testicle where sperm cells are produced. Sperm then move to the epididymis, where they continue to mature.
Seminoma - One of the two major clinical categories of testicular germ cell tumor. A tumor is treated as seminoma only when the pathology is entirely seminoma and AFP is not elevated from the cancer. Seminoma is highly sensitive to both cisplatin-based chemotherapy and radiation, although radiation is now used much more selectively than in the past.
Sertoli Cell - A supporting cell inside the seminiferous tubules that helps regulate and nourish developing sperm. Sertoli cells also form the blood-testis barrier and respond to hormones such as FSH and testosterone that are important for sperm production.
Sertoli Cell Tumor - A rare sex-cord/stromal tumor of the testicle. Most are benign, but a minority behave malignantly. Management depends on tumor size, pathology, hormone effects and whether there are features suggesting malignancy; selected small lesions may be suitable for testis-sparing surgery.
SHBG (Sex Hormone-Binding Globulin) - A blood protein that binds testosterone and other sex hormones. When SHBG is unusually high or low, the total testosterone level can be misleading, so SHBG may be used to calculate or interpret free testosterone.
Simulation - A process involving special x-ray pictures that are used to plan radiation treatment so that the area to be treated is precisely located and marked for treatment.
Sperm - The microscopic cell that carries the male's genetic information to the female's egg; the male reproductive cell; the male gamete.
Sperm Bank - A laboratory that freezes and stores sperm for future use. Banked sperm may later be used with intrauterine insemination, IVF, ICSI or other assisted-reproduction techniques depending on sperm quality and quantity.
Sperm Count - The number of sperm in the ejaculate (When given as the number of sperm per milliliter, it is called the sperm concentration or sperm density. )
Sperm Morphology -A semen analysis factor that indicates the number or percentage of sperm in the sample that appear to have been formed normally. Abnormal morphology includes sperm with kinked, doubled, or coiled tails. The higher the percentage of misshapen sperm, the less likely fertilization can take place.
Sperm Motility - The ability of sperm to swim. Poor motility means the sperm have a difficult time swimming toward their goal - the egg.
Spermatic cord - A cord that suspends the testis within the scrotum. It contains the vas deferens and vessels and nerves of the testis.
Spermatocele - A spermatocele is (usually) a small cavity, filled with watery liquid, in the epididymis. A spermatocele does not usually cause pain or discomfort unless it becomes very large, in which case it may cause irritation because it is 'in the way'.
Spermatocytic Tumor - Formerly called spermatocytic seminoma. This is a rare testicular germ cell tumor that is biologically distinct from ordinary seminoma, is not derived from GCNIS and usually occurs in older men. It is generally indolent and does not typically produce AFP or beta-hCG.
Staging - Classifying a cancer by looking at the size of the tumor and whether it has spread. Used to decide the best course of treatment. Clinical staging is based upon clinical or radiological evidence, while Pathological staging is based upon histological evidence. In general, the higher the stage, the more extensive the disease / farther the spread.
Stem Cells - Undifferentiated, primitive cells in the bone marrow with the ability both to multiply and to differentiate into all the components of blood and marrow.
Stem Cell Transplant - High dose chemotherapy can severely damage or destroy a patient's bone marrow so that the patient is no longer able to produce needed blood cells. Sometimes destroying the marrow may be a part of treatment for diseases that affect the bone marrow (leukemias and other diseases), or, like in the case of testicular cancer, it may simply be a side effect of treatment. A stem cell transplant allows stem cells that were damaged by treatment to be replaced with healthy stems cells that can produce the blood cells the patient needs.
Sterile - Unable to produce sperm capable of achieving biological conception through intercourse. A man who has had both testicles removed is sterile because he can no longer make sperm, although sperm banked before surgery can still be used with assisted reproduction.
Stomatitis - Sores on the inside lining of the mouth.
Surveillance - Planned follow-up without immediate additional treatment after orchiectomy in patients for whom surveillance is an accepted management option. The schedule depends on tumor type, stage and guideline, and may include physical examinations, tumor markers and CT or MRI imaging at specified intervals.
Sympathetic Nervous System - The part of the autonomic nervous system that is concerned especially with preparing the body to react to situations of stress or emergency. The nerves that allow normal ejaculation are part of the sympathetic nervous system. If these nerves are cut during the RPLND, normal antegrade ejaculation becomes impossible.
Synctiotrophoblastic Cells - Syncytiotrophoblastic cells are giant cells with multiple nuclei. Together with Cytotrophoblasts, these two cells form choriocarcinoma. Synctiotrophoblastic Giant Cells (STGs) may be found by themselves, in which case they do not constitute choriocarcinoma. STGs produce human chorionic gonadotropin (HCG)
Systemic treatment - Treatment that reaches and affects cells all over the body. (ex: Chemo)
Template - A pattern used as a guide in determining the extent of surgery. In the Retroperitoneal Lymph Node Dissection, different templates are used depending on the location of the primary tumor (right or left testicle).
Teratocarcinoma - A mixed germ cell tumor comprised of embryonal carcinoma and teratoma. It is more differentiated than embryonal carcinoma, but less than teratoma.
Teratoma - A germ cell tumor made up of mature or immature tissues resembling tissues from other parts of the body. In a postpubertal male, testicular teratoma is managed as a component of nonseminomatous germ cell cancer even when the cells look mature or benign under the microscope. Teratoma is relatively resistant to chemotherapy, can continue to grow, and can rarely undergo transformation into a different type of malignancy, which is why residual teratoma after chemotherapy is often removed surgically. Prepubertal-type teratoma is biologically different and is usually benign. Older British classifications used the word "teratoma" much more broadly for what would now be called nonseminoma. The table below is useful mainly when reading older records:
| British | WHO |
| Teratoma | Non seminomatous germ cell tumour |
| teratoma differentiated | mature teratoma |
| malignant teratoma intermediate (MTI) | teratocarcinoma, embryonal carcinoma with teratoma |
| malignant teratoma undifferentiated (MTU) | embryonal carcinoma |
| yolk sac tumour | yolk sac tumor, endodermal sinus tumor |
| malignant teratoma trophoblastic | choriocarcinoma |
Testicular torsion - Twisting of the spermatic cord, cutting off the blood supply to the testicle and causing severe pain. A medical EMERGENCY because the testicle will die after a few hours.
Testis (Testicle)- One of two male reproductive glands located inside the scrotum which are the primary source of the male hormone testosterone. Roughly 4 cm in length, 2.5 cm in diameter, and 10-14 g in weight, but normal testes can be larger or smaller, and it is normal for one testicle (typically the left one) to be slightly larger than the other.
Testosterone - The male hormone responsible for the formation of secondary sex characteristics and for supporting the sex drive. Testosterone is also necessary for spermatogenesis.
Tumor - An abnormal mass of tissue.
Tumor Marker - A measurable substance that can provide information about a cancer. The three standard serum markers used in testicular germ cell cancer are AFP, beta-hCG and LDH. They are used before and after orchiectomy and during treatment or follow-up when appropriate. Many testicular cancers do not elevate any serum marker, so normal markers do not rule out cancer.
Tunica Albuginea - A white fibrous tissue that encapsulates testis.
Tunica Vaginalis - A double-layered serous membrane that surrounds much of the testicle and allows it to move smoothly within the scrotum.
Ultrasound - Imaging that uses high-frequency sound waves to create pictures of the testicle and surrounding structures. Scrotal ultrasound is the first-line imaging test for a suspected testicular mass and is highly accurate at showing whether a lesion is inside or outside the testicle and whether it is solid or cystic. It cannot always determine with certainty whether a solid testicular lesion is malignant.
Undescended Testicles - see Cryptorchidism
Urologist - A doctor who specializes in diseases of the urinary organs in females and the urinary and sex organs in males.
Varicocele - This is a complex of dilated veins which surround the testicle, usually on the left side. Varicoceles occurs in approximately 15% of normal males and are usually not important clinically, unless they are associated with infertility. A varicocele feels like a "bag of worms" surrounding the testicle, and may be accompanied by a constant pulling, dragging, or dull pain in the scrotum.
Vascular invasion - Invasion by cancer cells of the lymphatics or veins. It is a sign that the tumour is more likely to have spread. A pathologist determines if vascular invasion is present when they examine the surgically removed cancerous testicle.
Vas deferens - The vas deferens is a small cord about the size of a pencil lead, which carries sperm which have matured from the testicle and epididymis to the ejaculatory ducts near the prostate gland in the urethra.
VeIP - A salvage chemotherapy regimen using vinblastine, ifosfamide and cisplatin.
Vena Cava - Either of two large veins by which the blood is returned to the right atrium of the heart. The Superior Vena Cava comes from above the heart while the Inferior Vena Cava comes from below the heart. Most testicular tumors in the abdomen appear in the lymph nodes near the Inferior Vena Cava.
Vinblastin - An alkaloid based anticancer drug obtained from the periwinkle plant. aka VELBAN
VIP - A chemotherapy protocol using Etoposide, Ifosfamide, and Cisplatin.
X-ray - High-energy radiation used in low doses to diagnose cancer and in high doses to treat the disease.
Yolk sac carcinoma - A malignant neoplasm occurring in the gonads, in sacrococcygeal teratomas, and in the mediastinum. It produces alpha-fetoprotein and is thought to be derived from primitive endodermal cells. As a pure tumor, the yolk sac tumor is the most common testicular tumor among infants and children up to age 3. A pure yolk sac tumor is extremely rare in adults, but it is seen as a component in a mixed germ cell tumor in about 30% of cases. Also known as an endodermal sinus tumor or infantile embryonal carcinoma.
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