What is Testicular Cancer?
Testicular cancer is a type of cancer that develops in the testicles, which are the male reproductive glands located in the scrotum. The most common type of testicular cancer is germ cell tumors, which start in the cells that make sperm. Testicular cancer is relatively rare, but it is the most common cancer in men between the ages of 15 and 35. Symptoms of testicular cancer may include a lump or swelling in the testicle, pain or discomfort in the testicle or scrotum, and a heavy feeling in the scrotum. If caught early, testicular cancer is highly treatable, with a cure rate of greater than 95%.
Testicular Cancer Symptoms
The most common symptom of testicular cancer is a lump or swelling in one of the testicles. Other symptoms may include:
A feeling of heaviness in the scrotum
A dull ache or sharp pain in the lower abdomen or the scrotum
A sudden collection of fluid in the scrotum
A change in the way the testicle feels
Enlargement or tenderness of the breasts
Lower back pain
Fatigue
It's important to note that many of these symptoms can also be caused by other conditions, such as an infection or an injury. However, if you notice any changes in your testicles, it's important to see a doctor as soon as possible to rule out testicular cancer.
Causes of Testicular Cancer
The exact cause of testicular cancer is not known. However, there are several risk factors that have been identified:
Age: Testicular cancer is most common in men between the ages of 20 and 39.
Family history: Men with a family history of testicular cancer are at an increased risk of developing the disease.
Cryptorchidism: Men born with one or both testicles that have not descended into the scrotum are at an increased risk.
Racial and Ethnic background: Testicular cancer is more common among white men than men of other racial or ethnic groups.
Other risk factors include:
Injury to the testicles
Abnormal testicle development
Exposure to certain chemicals or toxins
HIV and other immunodeficiency diseases
It's important to note that having one or more of these risk factors does not mean that a person will definitely develop testicular cancer. Most men with these risk factors do not develop the disease.
Testicular Cancer Diagnosis
Testicular cancer is typically diagnosed through a physical examination and imaging tests.
Physical examination: The doctor will examine the testicles and the surrounding area for any lumps or swelling. They will also check for any other signs of testicular cancer, such as a change in the way the testicle feels or a feeling of heaviness in the scrotum.
Ultrasound: An ultrasound is often used to create images of the testicles and scrotum. This test can help the doctor determine if there is a mass present, and if so, whether it is a solid or fluid-filled growth.
Blood tests: Blood tests may be performed to check for levels of certain proteins that can be elevated in men with testicular cancer. These include alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (beta-hCG).
Biopsy: If a lump or mass is found, a biopsy may be performed to remove a small sample of tissue from the testicle. The tissue will be examined under a microscope to determine if it is cancerous.
If the diagnosis is confirmed, the doctor may also perform additional tests to determine the stage of the cancer and whether it has spread to other parts of the body. This may include a CT scan, MRI, or chest x-ray.
It's important to note that a self-examination is not considered as a diagnostic method, but it can help in early detection.
What are the Types of Testicular Cancer?
There are several types of testicular cancer, but the most common is germ cell tumors. Germ cell tumors are a type of cancer that develops in the cells that produce sperm. They account for around 95% of all testicular cancers. The two main types of germ cell tumors are:
Seminomas: These are slow-growing tumors that usually occur in men between the ages of 25 and 45. Seminomas are sensitive to radiation therapy, so they are often treated with radiation alone.
Non-seminomas: These are more aggressive tumors that tend to occur in younger men. They include embryonal carcinoma, yolk sac carcinoma, choriocarcinoma, and teratoma. Non-seminomas tend to grow and spread more quickly than seminomas, and they are often treated with a combination of surgery, chemotherapy, and radiation therapy.
There are also other types of testicular cancer that are much less common, such as stromal tumors and lymphomas. Each type has its own characteristics, so it's important that the diagnosis is confirmed by a specialist in order to determine the best course of treatment.
What are the Stages of Testicular Cancer?
The stage of testicular cancer refers to how advanced the cancer is and if it has spread to other parts of the body. There are several different staging systems used for testicular cancer, but the most commonly used is the TNM system. The TNM system assigns a stage based on the following factors:
T (Tumor)
T1: The tumor is limited to the testicle, and is less than 2 cm in size.
T2: The tumor is limited to the testicle and is greater than 2 cm in size.
T3: The tumor has spread to the lymph nodes in the abdomen.
T4: The tumor has spread to other parts of the body such as the lungs, liver, or brain.
N (Node)
N0: No cancerous lymph nodes are present.
N1: Cancerous lymph nodes are present in the abdomen.
N2: Cancerous lymph nodes are present in the chest.
M (Metastasis)
M0: The cancer has not spread to other parts of the body.
M1: The cancer has spread to other parts of the body.
Based on these factors, testicular cancer is usually staged as follows:
Stage I: T1N0M0
Stage II: T2N0M0
Stage III: T3N0M0, T1-3N1M0, T1-3N2M0
Stage IV: T4N0-2M0, Any T N3M0, Any T M1
It's important to note that the stage of the cancer is an important factor in determining the best course of treatment, and the prognosis. In general, the earlier the cancer is caught and diagnosed, the better the chances of a successful outcome.
How Is Testicular Cancer Treated?
Treatment for testicular cancer depends on the stage of the cancer and the type of tumor. The most common treatments for testicular cancer include surgery, radiation therapy, and chemotherapy.
Surgery: The most common surgical procedure for testicular cancer is called a radical inguinal orchiectomy. This procedure involves removing the affected testicle through an incision in the groin. In some cases, lymph nodes in the abdomen may also be removed.
Radiation therapy: Radiation therapy uses high-energy rays to kill cancer cells. It is usually used to treat seminomas and is often used after surgery to destroy any remaining cancer cells.
Chemotherapy: Chemotherapy uses drugs to kill cancer cells. It is often used to treat non-seminomas and is usually administered through a vein.
Retroperitoneal lymph node dissection (RPLND) is a surgical procedure that involves removing lymph nodes from the back of the abdomen.
Monitoring: Testicular cancer patients may need to undergo regular monitoring for recurrence, as some patients may have a higher risk of relapse.
It's important to note that treatment plans are tailored to each individual patient and the type of cancer they have. The treatment option chosen will also depend on the stage of the cancer, the general health of the patient, and the patient's personal preferences. Working closely with a specialist oncologist and a multidisciplinary team is crucial to finding the best treatment plan.