testis

testicular cancer


Testicular cancer is a relatively rare but highly treatable form of cancer that originates in the testicles, the male reproductive organs responsible for producing sperm and testosterone. These small, oval-shaped organs, housed within the scrotum, are essential for fertility and hormone regulation. Testicular cancer typically affects younger men, with the majority of cases occurring between the ages of 15 and 35. While the exact cause is often unknown, certain risk factors such as undescended testicles, a family history of testicular cancer, and congenital conditions may increase the likelihood of developing this disease.

The most common symptom of testicular cancer is the presence of a painless lump or swelling in one of the testicles. Other signs may include discomfort or pain in the testicle or scrotum, a feeling of heaviness, and changes in the size or shape of the testicles. Early detection is crucial for successful treatment, and regular self-examinations, coupled with routine medical check-ups, play a pivotal role in identifying potential issues. Treatment options for testicular cancer may include surgery, radiation therapy, and chemotherapy, depending on the stage and type of cancer. With advances in medical science, the prognosis for testicular cancer is generally favorable, and the majority of men can go on to lead healthy and fulfilling lives after successful treatment.

testicular cancer

Testicular cancer arises when normal, healthy cells in the testicles undergo genetic mutations, leading to uncontrolled growth and the formation of tumors. While the exact causes are often unclear, several risk factors contribute, including undescended testicles, a family history of testicular cancer, congenital conditions, and age, with the majority of cases occurring between 15 and 35 years old. It is important to note that the majority of men with testicular cancer do not have any known risk factors, emphasizing the importance of regular self-examinations and routine check-ups for early detection.

There are two main subtypes of testicular cancer: seminomas and non-seminomas. Seminomas typically grow more slowly and respond well to radiation therapy. Non-seminomas, on the other hand, tend to grow more quickly and may require a combination of treatments such as surgery and chemotherapy. Understanding the specific subtype is crucial for determining the most effective treatment plan. Advances in research and medical technology have significantly improved the prognosis for testicular cancer, with high cure rates and successful outcomes, especially when diagnosed in the early stages.

the symptoms

The most common symptom is the presence of a painless lump or swelling in one of the testicles.

  • Testicular pain or discomfort: Some individuals may experience pain or a feeling of heaviness in the testicle or scrotum.

  • Changes in size or shape: Testicular cancer can cause changes in the size, shape, or consistency of the testicles.

  • Fluid buildup in the scrotum: Accumulation of fluid, leading to swelling in the scrotum, may be a symptom.

  • Dull ache or pain in the lower abdomen or groin: Discomfort may radiate from the testicles to the lower abdomen or groin area.

  • Back pain or lower body pain: In more advanced cases, the cancer may spread, causing back or lower body pain.

  • Breast enlargement or tenderness: Certain types of testicular cancer can produce hormones that cause breast enlargement or tenderness.

  • Fatigue: Systemic symptoms like fatigue may occur as the cancer progresses.

  • Unexplained weight loss: Rapid, unexplained weight loss can be a symptom in advanced stages of testicular cancer.

  • Early puberty in boys: Rarely, certain types of testicular tumors may cause early puberty in boys.

It's important to note that the presence of these symptoms does not necessarily indicate testicular cancer. Still, if any of these signs are observed, it is crucial to seek prompt medical attention for a thorough evaluation and diagnosis. Regular self-examinations and routine check-ups play a vital role in the early detection of testicular cancer.

How is testicualr cancer diagnosed?

Diagnosing testicular cancer involves a multi-faceted approach that encompasses both self-awareness and professional medical evaluation. Men are encouraged to perform regular self-examinations, staying vigilant for any alterations in the size, shape, or texture of the testicles. During routine check-ups, healthcare providers conduct thorough clinical examinations to identify abnormalities, such as lumps or swelling, prompting further investigation if needed. Additionally, ultrasound imaging serves as a non-invasive and valuable tool, aiding in the visualization of the testicles to detect any suspicious masses or tumors. Blood tests, including tumor markers like alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (β-hCG), offer additional diagnostic insights. While a tissue biopsy may be performed in some cases, it is less common and generally reserved for confirming the diagnosis through microscopic examination of a small sample of the suspected tumor.

What happens after referral

After receiving your referral, our practice nurse will triage your case, and you'll be promptly contacted for a brief overview of your condition. Preceding your visit, several diagnostic tests, urine analysis, ultrasound, and CT scan are arranged to enhance the evaluation. At your appointment, A/Prof Homi Zargar will engage with you, conduct a thorough assessment, and review the gathered information.

Treatment

What are the treatment options?


Typically, radical removal of the testicle is the standard first step treatment for any suspected testicular cancer.

  1. Small biopsies of a testicular growth may miss cancer, making complete removal essential for accurate assessment.

  2. In cases where cancer is found, the removal of the testis might be sufficient, but chemotherapy or radiotherapy may be necessary.

  3. Testicular cancer and its treatment can impact fertility, emphasizing the importance of sperm banking before undergoing treatment.

  4. A testicular prosthesis (implant) is an option for those considering cosmetic reconstruction after testicle removal.

 


Treatment options for testicular cancer depend on factors such as the type and stage of cancer, as well as the patient's overall health. Common approaches include:

  • Orchiectomy: This surgical procedure involves the removal of the affected testicle and is a primary treatment for most cases of testicular cancer. After orchiectomy, some men may opt for a prosthetic testicle for cosmetic reasons.

    • read on radical orchidectomy

  • Active Surveillance: In some instances, especially for early-stage and slow-growing cancers, closely monitoring the cancer without immediate treatment may be an option.

  • Chemotherapy: Administering powerful drugs either before or after surgery is common, targeting and killing cancer cells throughout the body. Chemotherapy is particularly effective against certain types of testicular cancer.

  • Radiation Therapy: High-energy rays are directed at the cancer cells to destroy them. This is often used in cases where cancer has spread to lymph nodes or other areas.

  • Lymph Node Surgery: In cases where the cancer has spread to nearby lymph nodes, additional surgery may be necessary to remove affected nodes.

Patients must discuss these options with their healthcare team to determine the most suitable treatment plan based on their specific diagnosis and circumstances. Additionally, the potential impact on fertility and the availability of fertility preservation options, such as sperm banking, should be considered and discussed with the medical team.