Overview of testicular cancer
Testicles are located behind the penis in a pouch of skin called the scrotum and are also called the testes or gonads. These are the male sex glands. The main job of testicles is to produce and store sperm. However they are also the body's main source of male hormones such as testosterone. These hormones control and are responsible for the development of the reproductive organs and other male characteristics, such as body and facial hair, low voice, and wide shoulders. When the cells in either one or both testicles become malignant, such a condition is termed as testicular cancer.
Classification of testicular cancer
The characteristics of the cells in the tumor govern the type of testicular cancer. The testicular cancer is of following types:
Seminomas
Nonseminomas
Some other types of rare testicular cancers
Seminomas may be one of three types: classic, choriocarcinoma, embryonal carcinoma, teratoma, and yolk sac tumors. Testicular tumors may contain both seminoma and nonseminoma cells.
Causes/risk factors for testicular cancer
Studies have shown that several factors increase a man's chance of developing testicular cancer. They may include:
Age: Testicular cancer occurs most often in men between the ages of 20 and 39, and is the most common form of cancer in men between the ages of 15 and 34.
Family history of testicular cancer: The risk for testicular cancer is greater in men whose brother or father has had the disease.
History of testicular cancer: Men who have had testicular cancer are at increased risk of developing cancer in the other testicle.
Congenital abnormalities: Many congenital abnormalities, especially in the male reproductive organ account for testicular cancer. Abnormalities of the testicles, penis, or kidneys, as well as those with inguinal hernia (hernia in the groin area, where the thigh meets the abdomen), may be at increased risk.
Undescended testicle (cryptorchidism): Normally, the testicles descend from inside the abdomen into the scrotum before birth. However in some cases the testicles do not move down into the scrotum. This increases the risk of testicular cancer. This condition can be treated surgically but this risk does not change even after surgery to move the testicle into the scrotum. The increased risk applies to both testicles.
Symptoms of testicular cancer
Testicular cancer may be diagnosed by a doctor generally during routine physical exam where he examines the testicles. But most testicular cancers are found by men themselves. If a man notices anything unusual about his testicles, he should talk with his doctor. Men should see a doctor if they notice any of the following symptoms:
- Painless lump or swelling in a testicle
- Pain or discomfort in a testicle or in the scrotum
- Enlargement of a testicle or change in the way it feels
- Feeling of heaviness in the scrotum
- Dull ache in the lower abdomen, back, or groin
- Sudden collection of fluid in the scrotum
Other conditions may also cause these symptoms. But if such symptoms occur it is important to see a doctor.
Diagnosis of testicular cancer
To help find the cause of symptoms, the doctor evaluates a man's general health. The doctor also performs a physical exam and may order laboratory and diagnostic tests. These tests include:
Blood tests: Blood tests are conducted to check for the levels of tumor markers. These markers are generally substances, if, found in hisgher than normal level indicate the presence of cancer. Tumor markers such as alpha-fetoprotein (AFP), Beta-human chorionic gonadotropin (ßHCG), and lactate dehydrogenase (LDH) may suggest the presence of a testicular tumor, even if it is too small to be detected by physical exams or imaging tests.
Ultrasound
Biopsy
If testicular cancer is found, more tests are needed to find out if the cancer has spread from the testicle to other parts of the body. Determining the stage (extent) of the disease helps the doctor to plan appropriate treatment.
Treatment of testicular cancer
Although the incidence of testicular cancer has risen in recent years, more than 95 percent of cases can be cured. Treatment is more likely to be successful when testicular cancer is found early. In addition, treatment can often be less aggressive and may cause fewer side effects.
Most men with testicular cancer can be cured with surgery, radiation therapy, and/or chemotherapy. The side effects depend on the type of treatment and may be different for each person.
Seminomas and nonseminomas grow and spread differently and are treated differently. Nonseminomas tend to grow and spread more quickly; seminomas are more sensitive to radiation. If the tumor contains both seminoma and nonseminoma cells, it is treated as a nonseminoma. Treatment also depends on the stage of the cancer, the patient's age and general health, and other factors. Treatment is often provided by a team of specialists, which may include a surgeon, a medical oncologist, and a radiation oncologist.
The three types of standard treatment are described below.
Surgery: The surgery involves removal of either one or both the testicles, depending on the extent of cancer, called orchidectomy. Surgery can be a radical inguinal orchidectomy where testicle is removed through an incision in the groin. If only one testicle is removed men are concerned about being sterile. However, a man with one healthy testicle can still have a normal erection and produce sperm. Therefore, an operation to remove one testicle does not make a man impotent (unable to have an erection) and seldom interferes with fertility (the ability to produce children). For cosmetic purposes, men can have a prosthesis (an artificial testicle) placed in the scrotum at the time of their orchidectomy or at any time afterward.Some of the lymph nodes located deep in the abdomen may also be removed (lymph node dissection). This type of surgery does not usually change a man's ability to have an erection or an orgasm, but it can cause problems with fertility if it interferes with ejaculation. Patients may wish to talk with their doctor about the possibility of removing the lymph nodes using a special nerve-sparing surgical technique that may preserve the ability to ejaculate normally.
Radiation therapy
Chemotherapy
Men with testicular cancer should discuss their concerns about sexual function and fertility with their doctor.
Source
Visitors' count
