Testicular Cancer

Introduction

Cancer which has one of the highest curable rates, testicular cancer is also the rarest form of cancer amongst Indian men. Testicular cancer is not common: about 1 of every 250 males will develop testicular cancer at some point during their lifetime.

Testicular cancer is a form of cancer that occurs in the testes, or testicles. Testicular cancer affects the testicles, which produce male sex hormones and sperm used for reproduction. In most instances, there is no clear-cut cause behind testicular cancer. The problem occurs when healthy cells in the testicle are altered and start growing and dividing rapidly, to the point where no new cells are needed. This causes accumulating cells to form a mass in the testicle.

Testicular cancer, which generally affects men between the ages of 15 and 35, is a form of cancer that originates in one or both testes or testicles.

Types of Testicular Cancer:

There are two main types of testicular cancer:

  • Seminomas: This is a slow-growing form of testicular cancer found in men in their 40s and 50s. The cancer is in the testes, but it can spread to the lymph nodes. Lymph node involvement is either treated with radiotherapy or chemotherapy. Seminomas are very sensitive to radiation therapy.
  • Nonseminomas: This more common type of testicular cancer tends to grow more quickly than seminomas.

Causes

The exact cause of testicular cancer is poorly understood. However, some factors may increase a man's risk of developing testicular cancer.

Risk factor

There are many risk factors associated with testicular cancer, and these include:

  • Undescended Testicle: Men who have a testicle that never descended are at greater risk of testicular cancer than men whose testicles have descended normally.
  • Abnormal Testicle: Klinefelter syndrome and other conditions sometimes cause the testicles to develop abnormally as well as increase an individual's risk of testicular cancer.
  • Family History: An individual with a father, brother, or another blood relative who experienced testicular cancer may be more susceptible to the disease than others.
  • Age: testicular cancer can occur at any age, but it is most common in men between the ages of 15 and 35.
  • Race: testicular cancer is more common in white men than in black men.

Signs & Symptoms

Some men show no symptoms when diagnosed with testicular cancer. When symptoms appear, they include:

  • Lump or swelling in the testicle
  • testicular pain or discomfort
  • Heaviness in the scrotum
  • Size change of the testicle
  • testicular swelling
  • lower abdominal or back pain
  • breast sensitivity

Diagnosis

Treatment for testicular cancer is highly effective whendiagnosed in an early stage. An expert would first conduct a physical examination to check for the signs of testicular cancer. The doctor may also check other parts of the body followed by other diagnostics which include:

The diagnosis includes:

  • Physical examination: Physical Examination helps in diagnosing testicular cancer any hardness, swelling or mass, or loss of sensation by the patients is significant. Also, the neck, armpits, legs, groin, upper chest, and abdomen may be examined for any possible evidence of enlarged lymph nodes.
  • Blood tests/tumor markers: Serum tumor marker levels are quantified before surgery for removing a testicle. Such markers include Alpha feto Protein, Beta HCG, or Lactate Dehydrogenase.
  • Ultrasound Scan : This imaging test is used to see inside the scrotum and to check a suspicious lump. Other scans or x-rays may be done if your doctor would like to see inside your chest or abdomen. This is done to see if cancer has spread to lymph nodes, the lungs, or the liver. MRIs are rarely used, but needed in some cases to check the brain and spinal cord.

Management

There are three general categories of treatments used for testicular cancer. Depending on the stage of cancer, you may be treated with one or more options.

  • High Inguinal Orchiectomy/surgical pathology tests: Radical inguinal orchiectomy is thefirst step in the treatment in case of a suspicious testicular tumor.
  • Surgery: Surgery is used to remove one or both testicles and some surrounding lymph nodes to both stages and treat cancer.
  • Stem cell: In very advanced cases of testicular cancer, high-dose chemotherapy may be followed by a stem cell transplant. Once the chemotherapy has destroyed the cancer cells, the stem cells are administered and develop into healthy blood cells.
  • Radiation therapy: Radiation therapy uses high-energy rays to kill cancer cells. It may be administered externally or internally.External radiation uses a machine that aims the radiation at the cancerous area. Internal radiation involves the use of radioactive seeds or wires placed into the affected area. This form is often successful in treating seminomas.
  • Chemotherapy: Chemotherapy uses medication to kill cancer cells. It's a systemic treatment, which means it can kill cancer cells that have traveled to other parts of your body. When it's taken orally or through the veins, it can travel through your bloodstream to kill cancer cells.
  • Lymph node blockdissection : Block dissection surgery involves surgically removing most of the lymph nodes (glands) from a specific part of the body. Surgery can be performed on the neck, armpit, or groin.

Follow-Up

Follow-up visits for testicular cancer are usually scheduled for 5 to 10 years after the initial treatment: every 2 to 6 months for the first 3 years. Every 6 to 12 months after 3 years.

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