Everything You Should Know About Testicular Cancer

Posted by Barsha Dey

Testicular cancer is one of the rare cancers and tends to mostly affect men between 15 and 49 years of age. India has one of the lowest incidences of testicular cancer with less than 1 man in every 1,00,000 affected by this disease. The incidence might be less at a younger age, but awareness can help prevent it from developing to an advanced stage. Read on!

As the name suggests, it develops in the testicles, which is a part of the male reproductive system. The functions of the testicles are to produce both sperm and androgens, primarily testosterone. Testicular cancer is highly treatable and curable when diagnosed early. So how can you catch testicular cancer early in its track?

Symptoms

Men may experience a variety of symptoms or signs. Usually, a small lump or area of hardness are the first signs of testicular cancer. The symptoms of testicular cancer mostly appear after cancer has spread to other parts of the body.

Some symptoms may include:

  • A lump or enlargement in either testicle
  • A feeling of heaviness in the scrotum
  • Mild pain in the abdomen or groin
  • Fluid accumulation in the scrotum
  • Pain in a testicle or the scrotum
  • Back pain

Cancer usually affects only one testicle. However, having these symptoms does not mean that a man definitely has cancer.

Causes

The exact cause of testicular cancer is unclear. Doctors know that testicular cancer occurs when healthy cells in a testicle are altered. Healthy cells grow and function normally but sometimes some cells develop abnormalities, causing uncontrolled growth. These are cancerous cells that continue dividing even when new cells aren’t needed, forming a mass in the testicle.

Almost all testicular cancers begin in the germ cells — the cells in the testicles that produce immature sperm. However, what exactly causes the germ cells to become cancerous is not known.

Risk Factors

The risk factors for testicular cancer are as follows:

  • Age: More than half of testicular cancer cases occur in men between the ages of 20 – 45. However, men can develop this disease at any age.
  • Cryptorchidism: In cryptorchidism or undescended testicle, one or both testicles do not move down into the scrotum before birth as they should. Men with this condition are at a higher risk of developing testicular cancer.
  • Family history: A man who has a close relative, particularly a brother, who has had testicular cancer is at an increased risk of developing the disease.
  • Personal history: If a man had cancer in 1 testicle, they have an increased risk of developing cancer in the other testicle.
  • Race: White men are more likely to be diagnosed with testicular cancer than other races.
  • Human immunodeficiency virus (HIV): Men with HIV or acquired immune deficiency syndrome (AIDS) caused by HIV have a slightly higher risk of developing the disease.

Screening

Testicular cancer can often be detected at an early stage. Many men find the cancer themselves while doing a self-examination. Monthly testicular self-examinations, performed after a warm shower, can help find the cancer at an early stage, If you notice any lump, hardness, enlargement, pain, or any other change in 1 or both of your testicles, visit a doctor immediately.

Diagnosis

Having a lump in your testicles does not mean you have testicular cancer. To determine whether a lump is a testicular cancer or not the following tests may be recommended:

  • Ultrasound: A testicular ultrasound test uses sound waves to create an image of the scrotum and testicles which helps your doctor identify the nature of the lump.
  • Blood tests: Blood tests help determine the levels of tumour markers in your blood. Tumour markers are substances that occur normally in your blood, but the levels of these substances may be elevated during testicular cancer.

Types

The type of testicular cancer you have determines your treatment.

  • Seminoma: Seminoma tumours occur in all age groups, but if an older man develops testicular cancer, it is more likely to be seminoma. Seminomas are less aggressive than nonseminomas.
  • Nonseminoma: Nonseminoma tumours develop earlier in life and grow and spread rapidly. There are different types of nonseminoma tumours such as choriocarcinoma, embryonal carcinoma, teratoma and yolk sac tumour.

Stages

After a testicular cancer diagnosis, the doctors will try to figure out if it has spread, and if so, how far. This process is known as staging.

There are two ways of staging testicular cancer. The first is the TNM staging system:

  • T indicates the size of the tumour
  • N indicates whether the cancer has spread to nearby lymph nodes or not
  • M indicates whether the cancer has spread to other parts of the body (metastasized) or not

Testicular cancer can also be staged numerically which includes 4 main stages.

Stage 1 – It is the earliest stage of testicular cancer. In this stage, the cancer is only in the testicle and hasn’t spread to nearby lymph nodes or other organs. This stage consists of two types – stage 1A and 1B depending on the size of the tumour.

Stage 2 – In this stage, the cancer has spread from the testicles into the lymph nodes (small glands that help fight infection). Testicular cancer in this stage can be split into 2A, 2B and 2C which depends on how many lymph nodes the cancer has spread to and the size of the lymph nodes.

Stage 3 – In this stage, the cancer has spread to lymph nodes or other organs. It is of 3 types – 3A, 3B and 3C. These refer to where the cancer has spread and the levels of tumour markers in the blood.

Treatment

The options for treating testicular cancer depend on several factors such as the type and stage of cancer, overall health, and personal preferences. Treatment generally involves surgery, radiotherapy, chemotherapy, or a combination.

Surgery

Surgery (radical inguinal orchiectomy) is a treatment option if the lump in the testicle is diagnosed to be cancerous. This procedure involves removing one or both of your testicles.

Radiation therapy

Radiation therapy uses X-rays to kill cancer cells. It is a treatment option for people who have the seminoma type of testicular cancer. Side effects may include fatigue, skin redness or irritation in your abdominal and groin areas. It can also lead to infertility.

Chemotherapy

Chemotherapy treatment uses drugs to kill cancerous cells. Common side effects are hair loss, fatigue, nausea and an increased risk of infection. It is also likely to cause infertility, which can be permanent.

Conclusion

Preventing testicular cancer is not possible, as the causes are largely unknown. Many men develop testicular cancer even when they don’t have any known risk factors. However, self-examinations can help detect the cancer at an early stage when it is more likely to be successfully treated.

Each man comes to terms with his condition in his own way. One may feel scared and unsure of their future after a cancer diagnosis. However, it is important to stay positive and follow a healthy lifestyle to prepare oneself for the cancer treatment. Around 95 % of all men with this ailment make a full recovery after receiving treatment.

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