What is testicular cancer?
Testicular cancer is the most common cancer in young men, and it is also the most curable form of cancer. However, the disease can still result in death, and it can have a significant impact on a man’s life. Testicle cancer can cause infertility, nerve damage, and other health problems. If caught early, testicular cancer can be treated with surgery or radiation therapy. However, if left untreated, testicular cancer can spread to other parts of the body. In this article, we will discuss everything related to testicular cancer. So, continue reading to explore the topic further!
Cancer of the testicles, also known as testes, develops in the testicles themselves, which are found inside the scrotum, which is a loose bag of skin placed underneath the penis. The testicles are responsible for the synthesis of male reproductive hormones as well as sperm. Testicular cancer age is the most prevalent form of cancer in young adult males in the United States who are between the ages of 15 and 35. The risk of developing testicular cancer increases as men get older, and it’s particularly common in men over age 50. Symptoms of testicular cancer may include pain or swelling in the scrotum, difficulty urinating, or a rash. If you think you may have testicular cancer, see your doctor for an exam and testing. Are you thinking about how I know if I have testicular cancer? If yes, then read the symptoms of testicular cancer.
Testicular Cancer Symptoms
People with testicular cancer may suffer a range of symptoms or indicators. Sometimes, persons with testicular cancer do not experience any of these alterations. Or, the origin of a symptom may be a distinct medical disease that is not cancer. So, having these symptoms does not guarantee that a person definitely has cancer.
Usually, an enlarged testicle or a tiny lump or patch of hardness are the first indicators of testicular cancer. Any lump, enlargement, hardness, soreness, or tenderness should be checked by a doctor as soon as possible. Other symptoms of testicular cancer normally do not develop until after cancer has spread to other parts of the body. It is very important to know what are the early warning signs of testicular cancer. Here are some symptoms of testicular cancer that you should know about:
- An enlargement or painless lump on one of the testicles. If identified early, a testicular tumor maybe around the size of a pea or a marble, but it can develop considerably larger.
- Pain, or numbness in a testicle or the scrotum, with or without swelling.
- One testicle may feel to be firmer than the other one. Or testicular cancer may cause the testicle to become bigger or to become smaller.
- You may face some discomfort in the lower abdomen or groin area.
- Symptoms of breast growth or soreness. Even though it’s not very common, certain testicular tumors can produce hormones that lead to gynecomastia, which is when breast tissue grows and causes the breasts to feel painful.
- In advanced stages of testicular cancer, patients may experience symptoms such as lower back pain, shortness of breath, chest pain, and bloody sputum or phlegm.
In some cases, signs of testicular cancer include swelling in one or both legs, as well as shortness of breath brought on by a blood clot. Deep Venous Thrombosis, often known as DVT, is the formation of a blood clot in a major vein. A pulmonary embolism is a medical term for a blood clot that forms in an artery in the lung and is the leading cause of shortness of breath. The formation of a blood clot may be the initial indicator that a person has testicular cancer for those who are younger or in the middle of their life. There is a high degree of overlap between the symptoms and signs caused by testicular cancer and those caused by illnesses that are not malignant. Here are a few of these:
- Symptoms include enlargement or a lump in one of the testicles.
- The epididymis may be the site of the development of a cyst known as a spermatocele. The epididymis is a tiny organ that is linked to the testicle and is composed of coiled tubes that transport sperm out from the testicle. This structure is called the epididymis.
- Varicocele is the medical term for an expansion of the blood vessels that come from the testicle.
- A hydrocele is a medical term for an accumulation of fluid in the membrane that surrounds the testicle.
- A hernia is a medical term for an opening in the abdominal muscle.
- Infection. Orchitis is the medical term for an infection of the testicles. Epididymitis is the medical term for an infection of the epididymis. Antibiotics may be prescribed to a patient if there is a reason to assume that they have an infection. If antibiotics do not resolve the issue, it is common practice to perform testing to look for testicular cancer.
Connect with your physician if you are concerned about any changes that you have been experiencing in your body or if you are able to point out any signs of testicular cancer. In addition to asking you other questions, your doctor will inquire how long you’ve been experiencing the symptom(s) and how frequently you’ve had them. This is to assist in determining the cause of the issue, as a part of the diagnosis.
In the event that cancer is identified, symptom management will continue to be an essential component of cancer care and therapy. Care of this is also referred to as palliative care or supportive care. It is frequently begun shortly after the diagnosis and maintained all the way through treatment. Be sure to discuss the symptoms you are experiencing with your health care team, especially any new symptoms or changes in the symptoms you have been experiencing.
How do you get testicular cancer?
The following are the testicular cancer risk factors that may raise your risk of developing testicular cancer:
- A testicle that has not yet descended (cryptorchidism): During the development of the fetus, the testicles originate in the abdominal region and, in most cases, move into the scrotum prior to birth. Those who were born with a testicle that did not descend into the scrotum are at an increased risk of developing testicular cancer compared to men whose testicles descended as expected. Even if the testicle has been surgically moved to the scrotum, there is still an increased likelihood of developing cancer. However, the vast majority of men who are diagnosed with testicular cancer have no history of their testicles being undescended.
- Abnormal testicle development: Cancer of the testicles is more likely to occur in those who have conditions like Klinefelter syndrome, which result in faulty testicular development.
- The past of the family: If other people in your family have had testicular cancer, your likelihood of developing the disease is higher.
- Age: Teenagers and younger men, particularly those between the ages of 15 and 35, are most at risk for developing testicular cancer. On the other hand, it can manifest itself at any age.
- Race: White males have a higher incidence rate of testicular cancer compared to black men.
When should I go to the hospital? And when should I see the doctor?
If you discover a lump, swelling, or any other change in one of your testicles, you should make an appointment with a primary care physician as soon as you can. It’s crucial to be checked out as soon as possible if you find a lump in your scrotum, even though the vast majority of scrotal tumors are not malignant. When cancer of the testicles is detected at an earlier stage, treatment is significantly more successful.
Testicular Cancer Causes
The abnormal multiplication of cells in the testicles can lead to the development of cancer, which manifests as a lump or a tumor. In general, testicular cancer is one of the most common types of cancer and it accounts for about 20% of all male cancers. The disease usually starts as a small, non-cancerous lump or tumor in one or both testicles. If left untreated, testicular cancer can spread to other parts of the body. The researchers aren’t entirely clear on what it is that makes cells act in this manner. They are aware of the fact that germ cells are typically the cells that develop into testicular cancer. Testicular cancer is still an unknown cause and there is no specific cure, but it has been linked to many environmental factors such as smoking, alcohol, and exposure to radiation from CT scans and radiotherapy.
What Is The Primary Cause Of Testicular Cancer?
The primary risk factor for testicular cancer is known as cryptorchidism, which refers to undescended testicles. It is estimated that between 3 and 5 % of boys are born with their testicles located inside their abdominal cavities. In most guys, the testicles move down into the scrotum sometime during their first year of life. However, in some males, the testicles never move down.
The most recent research indicates that exposure to low doses of ionizing radiation may be a factor in testicular cancer. There are genetic predispositions for testicular cancer but the exact reason why this occurs is not yet known. It seems that DNA damage can occur during normal cell division, leading to mutations that eventually lead to genetic changes that can cause disease in a person’s body. This means that DNA damage can occur during normal cell division or cell replication, leading to mutations that may or may not be tested for by your doctor. If you are concerned about whether you have been exposed to ionizing radiation, speak with your physician for a full assessment of the risk of cancer in relation to exposure.
Types Of Testicular Cancer
An estimated 90% of all cases of testicular cancer are caused by germ cells found in the testicles being clumped together and forming a mass or tumor. Sperm are ultimately formed from the development of germ cells. There are two subtypes of testicular cancer that originate in the testicle’s germ cells:
Cancer has a slow growth rate known as seminoma, which typically strikes adults in their forties or fifties.
Cancer that does not originate from a seminoma has a more fast growth rate than seminomas. People in their late teens, 20s, and early 30s are most likely to be affected by this condition. There are four distinct kinds of tumors that are not seminomas. Each is referred to by the category of germ cells that can be found within the tumor. Non-seminoma cancers include embryonal carcinoma, yolk sac carcinoma, choriocarcinoma, and teratoma.
Some testicular cancer tumors include seminoma cells as well as non-seminoma cells in their composition.
How Is Testicular Cancer Diagnosed?
After studying a lump or other alteration in your testicle that you found while performing a self-exam, your healthcare practitioner may diagnose you with testicular cancer. A testicular cancer diagnosis can occasionally be made during a normal physical examination.
The following are examples of common diagnostic methods and testing for testicular cancer:
Medical History as well as a physical examination:
Your healthcare practitioner will question you about your symptoms and perform a thorough check-up on you in order to look for indications of testicular cancer. They will probably examine your lymph nodes and testicles for any symptoms that cancer has spread. They may also feel your testicles for any lumps.
If during the checkup your healthcare professional finds anything out of the ordinary, they will most likely prescribe an ultrasound. An ultrasound is a non-invasive medical treatment that creates photographs of the organs and tissue inside of your body by making use of high-energy sound waves.
If the ultrasound reveals any signs of cancer, your healthcare professional will remove the afflicted testicle from your body. Radical inguinal orchiectomy is the medical term for the procedure that removes a testicle that has cancer. Just above the pubic region, an incision (cut) is made, and the testicle is carefully extracted from the scrotum through the opening created by the incision. After that, the doctor will remove the affected testicle along with the tumor, as well as the spermatic cord.
A biopsy will also be performed. To determine whether or not you have cancer, a specialist will analyze tissue taken from your testicle under a microscope. The only option to evaluate a testicular lump, in most situations, is to totally remove the diseased testicle and inspect it under a microscope. This is in contrast to the removal of a small portion of cancer from other tumors, which is called a biopsy. This is due to the fact that it is typically possible to arrive at a conclusive diagnosis using only the combination of the ultrasound and the blood marker tests.
A Serum Tumor Marker Test:
A test known as a serum tumor marker test involves analyzing a sample of blood in order to determine the concentrations of several compounds that have been related to particular forms of cancer. The medical community refers to these chemicals as tumor markers. Testicular cancer is characterized by an increase in the levels of several tumor markers, including Alpha-Fetoprotein (AFP), Human Chorionic Gonadotropin (HCG or beta-HCG), and Lactate Dehydrogenase (LDH). Various forms of tumors are associated with the elevation of a variety of markers. For example, seminomas sometimes elevate HCG but not AFP. Non-seminomas may elevate AFP but not HCG. If your LDH levels are high, it could mean that cancer has spread.
MRIs, CT scans, and X-rays are the following: A computed tomography scan, sometimes known as a CAT scan, is an imaging procedure that creates pictures of the inside of your body using X-rays. In order to determine whether or not your cancer has spread to the organs in your abdomen, your healthcare professional may conduct a CT scan of your pelvis and abdomen. To determine whether or not cancer has gone to the lungs, they may do a CT scan or a regular X-ray on you. An MRI may be recommended by your provider if they have reason to believe that cancer has spread to your central nervous system, which includes your brain and spinal cord. An MRI takes photos of the inside of your body by using magnets and radio waves to create the images.
A CT scan is an imaging procedure that creates pictures of the inside of your body using X-rays. A series of X-ray images of the patient’s abdominal region, chest, and pelvis are taken. Your CT scans will help your doctor look for any evidence that cancer has spread to other parts of the body. To determine whether or not cancer has gone to the lungs, they may do a CT scan or a regular X-ray on you. An MRI may be recommended by your provider if they have reason to believe that cancer has spread to your central nervous system, which includes your brain and spinal cord. An MRI takes photos of the inside of your body by using magnets and radio waves to create the images.
Stages Of Testicular Cancer
In the context of testicular cancer, staging refers to the process of determining the extent of cancer, as well as whether or not the disease has spread and whether or not the cancer is producing tumor markers. This is done in addition to noting the level of those proteins in the serum, which is another name for blood. The TNM staging recommendations that were developed by the American Joint Committee on Cancer are frequently utilized in the process of staging testicular cancer.
The stages can be broken down into four different categories:
T (tumor): This indicates whether or not the tumor has spread to tissues close to the testicle. T stands for “tumor.”
N (node): This determines whether or not the testicular cancer cells have moved to the regional lymph nodes. N stands for “node.”
M (metastasis): M stands for “metastasis,” which indicates whether or not cancer has spread to other parts of the body (spread to distant areas of the body).
S (serum): S, which stands for “serum,” is an abbreviation that represents the concentration of tumor marker proteins in the blood or serum.
After each of the T, N, M, and S components of testicular cancer has been assessed separately, the total scores are used to define the overall stage group for testicular cancer. The following is a list of the stages of testicular cancer:
Stage 0: In the initial stage, known as stage 0, the cancer cells have not yet spread outside of the testicle. Tumors can sometimes be referred to as carcinomas in situ when they have reached this stage.
In the first stage of testicular cancer, cancer has invaded tissues close to the testicle, but it has not yet progressed to lymph nodes or other parts of the body further afield. It is possible that the levels of tumor marker proteins are normal or that they are high. The following are the three subtypes that fall under the stage 1 testicular cancer umbrella:
- Stage 1A: The tumor may have grown through the inner layer of tissue that surrounds the testicle, but it has not grown through the outer layer of tissue, nor has it spread to the blood or lymph arteries. This stage is referred to as stage 1A. The levels of tumor markers found in the serum are normal.
- Stage 1B: Tumors at this stage may have spread to blood or lymph vessels. The levels of tumor markers found in the serum are normal.
- Stage 1S: It is possible for these tumors to show any degree of invasion into the tissues close by, and the levels of tumor markers evaluated after the tumor has been removed surgically are high. malignancies fall into this category.
Testicular cancers that have advanced to stage 2 have spread to the tissues next to the testicle and can now be discovered in at least one of the lymph nodes that are located in close proximity to the testicle. Tumor marker levels may be normal or slightly increased. There are three subgroups that makeup stage 2 testicular cancer:
- Stage 2A: At this stage, cancer has already spread to one or more lymph nodes, but no lymph node is greater than 2 centimeters in diameter.
- Stage 2B: At this stage, the tumors have progressed to at least one lymph node and are between 2 and 5 centimeters in size.
- Stage 2C: These tumors have progressed to at least one lymph node that is more than 5 centimeters in size and is considered to be stage 2C.
Testicular tumors that have progressed to stage 3 have metastasized, or spread, to lymph nodes or organs in other parts of the body. There are three subgroups that fall under the stage 3 testicular cancer umbrella:
- Stage 3A: These tumors have progressed to a lymph node further away or to the lungs at the stage known as stage 3A. It appears that the levels of the tumor marker protein are either normal or slightly raised.
- Stage 3B: At stage 3B of testicular cancer, patients have moderately elevated levels of tumor marker proteins and the illness has progressed to either adjacent or distant lymph nodes or the lungs. Additionally, patients have moderately elevated levels of tumor marker proteins. Cancers diagnosed at this stage include elevated amounts of tumor marker proteins and have likely progressed to lymph nodes in the vicinity or further afield, as well as the lungs.
Testicular Cancer Treatment
Here are the 3 main treatments at each stage that are performed while treating testicular cancer treatment:
- Radiation Therapy
Let’s have a look at the surgery options available:
Radical Inguinal Orchiectomy
Radical inguinal orchiectomy is the medical term for the procedure that removes a testicle that has cancer. Just above the pubic region, an incision (cut) is made, and the testicle is carefully extracted from the scrotum through the opening created by the incision. After that, the doctor will remove the affected testicle along with the tumor, as well as the spermatic cord. Testicular cancer has the potential to spread to other parts of the body through blood and lymph vessels that are located in the spermatic cord. Additionally, the spermatic cord contains a portion of the vas deferens. These vessels are secured at an early stage of the operation in order to reduce the likelihood of this occurring. This type of surgery is often effective in treating all forms of testicular cancer, including those that have spread.
Retroperitoneal Lymph Node Dissection (RPLND)
The lymph nodes around the big blood vessels (the aorta and inferior vena cava) at the back of the abdomen (belly) may be removed at the same time as the orchiectomy or during a second operation. This depends on the type and stage of your cancer. Because the removal of lymph nodes is not necessary for everyone who has testicular cancer, it is essential to explore this topic (as well as alternatives to it) with your physician.
This is a laborious process that takes a long time. When removing lymph nodes, a broad incision (cut) is typically made through the center of the belly. This is done in almost all cases. A skilled surgeon who performs RPLND procedures regularly is recommended. Experience counts.
Utilizing a laparoscope and many other long and slender surgical instruments, the surgeon may be able to extract lymph nodes from the abdomen through very small skin incisions in certain instances. A laparoscope is a thin, illuminated tube that has a little camera attached to the end so that a physician may view the interior of the abdomen. During this particular kind of operation, the hands of the surgeon are not required to enter the body of the patient.
After you have been put to sleep for laparoscopic surgery, you will be positioned on your side for the procedure. On your abdomen, a number of very small incisions will be made. In order to remove the lymph nodes, a laparoscope and several surgical instruments are inserted via the incisions. After that, the incisions are stitched up, and you will be awakened.
Patients heal far faster from this operation compared to the conventional open treatment, and they are able to walk shortly after surgery. In most cases, patients experience less pain, and they can begin eating sooner.
Laparoscopic surgery seems to be a lot easier for the patient, but doctors aren’t sure if it’s as safe and effective as the usual “open” surgery in removing all of the lymph nodes that could contain cancer. Open surgery is the more common type of surgery. If cancer is identified in the lymph nodes, doctors are more likely to suggest chemotherapy as a treatment option after laparoscopic surgery due to the inherent unpredictability of the situation.
Patients with early-stage non-seminomas are the ones who most frequently undergo this treatment to determine whether or not their lymph nodes contain malignancy. This is a complex operation, and the only way it should be performed is if the surgeon performing it has a great deal of previous expertise with similar cases.
#2 Radiation Therapy
High-energy rays (such as x-rays or gamma rays) or particles that are used in radiation treatment to kill cancer cells or inhibit the growth of cancerous tumors. Radiation therapy is the primary method utilized in the treatment of testicular cancer. The primary goal of this therapy is to eradicate cancer cells that have progressed to lymph nodes.
Radiation therapy, also known as external beam radiation, is a form of radiation treatment in which radiation is delivered to a particular area of the body by a machine. The therapy is quite similar to having an x-ray taken, however, the radiation dose is higher. Radiation does not cause any pain. Before beginning your treatments, the medical staff will conduct precise measurements to ascertain the ideal angles at which the radiation beams should be aimed as well as the quantity of radiation that should be administered. Only a few minutes are spent on each treatment; however, the time spent getting you into position for treatment (the “set-up period”) typically lasts longer.
Patients diagnosed with seminoma, a kind of cancer that is highly radiosensitive, constitute the majority of those treated with radiation treatment. In some cases, it is administered following an orchiectomy (the surgical removal of the testicles) and is aimed at the lymph nodes located at the very bottom of the belly (the retroperitoneal lymph nodes). This is done in order to eradicate any microscopic cancer cells that may be hiding in those lymph nodes and which cannot be seen. Additionally, it can be utilized in the treatment of insignificant amounts of seminoma that have progressed to the lymph nodes (based on changes seen on CT and PET scans).
Additionally, radiation therapy may be utilized in the treatment of testicular cancer (both seminoma and non-seminoma) that has metastasized to other organs in the body (like the brain).
The use of medications in the treatment of cancer is known as chemotherapy (often abbreviated as chemo). Pills of the medication can be taken orally, although it is also possible to inject it directly into a vein or muscle using a needle. Drugs are typically administered by intravenous route in the treatment of testicular cancer (IV). Chemotherapy is a form of systemic treatment. This indicates that the medication moves throughout the body to get to the cancer cells and kills them when it does. Chemotherapy is administered to patients in order to eradicate any cancer cells that have separated from the primary tumor and spread to lymph nodes or other parts of the body.
When chemotherapy is used to treat testicular cancer, it is typically done so because the disease has gone beyond the testicle. Additionally, it is utilized to assist in lowering the possibility of cancer returning after the testicle has been removed. It is not utilized in the treatment of cancer that is localized solely in the testicles.
Drugs Used During The Treatment
Chemotherapy is administered in cycles, with each treatment session being followed by a period of rest to provide the body with the opportunity to recuperate. In most cases, a chemotherapy cycle will last between three and four weeks. The following list contains the primary medicinal treatments for testicular cancer:
- Etoposide (VP-16)
- Ifosfamide (Ifex®)
- Paclitaxel (Taxol®)
Combining two or more chemotherapy medications is frequently more effective than using any one agent on its own. The following chemotherapy regimens are those that are most frequently used as the initial treatment for testicular cancer:
- BEP is an acronym for Bleomycin, Etoposide, and Cisplatin
- Cisplatin and Etoposide are abbreviated as EP
- VIP: VP-16 (etoposide) or vinblastine along with ifosfamide and cisplatin
Patients who have an illness that has a high risk may be treated with more intensive treatments by some physicians, who may also advise a different chemotherapy medication combination or even a stem cell transplant.
Testicular Cancer Chance Of Recovery
The likelihood of acquiring testicular cancer is approximately one in 270. The testicular cancer survival rate is, thankfully, quite high (greater than 95% for all men with testis cancer). Only about 400 men each year succumb to testicular cancer and die.
Is Testicular Cancer Life Threatening?
Even when it is in an advanced stage, testicular cancer is one of the cancers that are easiest to treat. It does not frequently endanger one’s life. You still have a very good chance of surviving the disease in the long run, even if it has progressed to surrounding organs.
How Long Do You Survive With Testicular Cancer?
Testicular cancer is one of the forms of cancer that may be treated the most effectively, and its prognosis is one of the best among cancers. Almost all males globally (99%) survive for at least a year after being diagnosed with testicular cancer, and almost all men (98 %) survive for at least 5 years after being diagnosed with testicular cancer.
We must remember that testicular cancer is a deadly disease. In this article, we have discussed everything about testicular cancer in detail. So, if you think that you or someone you know may have testicular cancer, please seek professional medical help immediately. Remember to get regular screenings and to talk to your doctor about any changes in your health!