Seminoma vs. Nonseminoma — What's the Difference?

Seminoma testicular cancer is known for its relatively slow progression, making it one of the more treatable forms of cancer when detected early. It tends to occur in men aged 30 to 40 and is highly responsive to radiation therapy, often leading to favorable outcomes. Nonseminoma testicular cancer, on the other hand, encompasses a group of more aggressive cancers including embryonal carcinoma, yolk sac tumors, choriocarcinoma, and teratoma. These types tend to grow and spread more quickly than seminomas and are usually found in younger men, typically in their late teens to early 30s.

The treatment approach for seminoma usually involves surgery followed by radiation therapy or, in some cases, surveillance. Due to its sensitivity to radiation, seminoma has high cure rates even when the disease is more advanced. Nonseminomas, while also treatable, often require a more aggressive treatment strategy that includes surgery followed by chemotherapy to address their faster rate of growth and higher likelihood of spreading.

Histologically, seminomas are relatively uniform, with cells that resemble primitive germ cells and have a clear appearance under a microscope. Nonseminomas are more varied in their appearance, reflecting the different types of cells they originate from, and often present a mix of different histological features within the same tumor.

Seminomas are generally less likely to produce markers such as alpha-fetoprotein (AFP), while nonseminomas may elevate levels of AFP, human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH), which can be used in diagnosis and monitoring response to treatment.

In terms of prognosis, seminomas typically have a very high cure rate, especially in early stages, due to their slow growth and responsiveness to treatment. Nonseminomas, although more aggressive, also have a high cure rate when detected early and treated promptly, but they may require more extensive treatment and closer monitoring to prevent recurrence.