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What is testicular cancer? -

Testicular cancer is when cancer cells develop in the tissues of one or both (less common) testicles.

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Types of testicular cancer -

The vast majority of testicular cancer is created by germ cells that clump together and form a mass. Germ cells develop into reproductive cells, or sperm.

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Types of testicular cancer: seminoma -

This type of cancer grows slowly and has become more common in the last couple of decades. It is divided into two types: classical seminoma, which usually affects men between 25 and 45, and spermatocytic seminoma, which typically affects older men.

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Types of testicular cancer: non-seminomas -

This type of cancer grows more quickly than seminomas, and usually affects males from their late teens to early thirties. Non-seminomas are divided into four types, according to the type of germ cell that makes up the tumor. These can be embryonal carcinoma, yolk sac carcinoma, choriocarcinoma, or teratoma.

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How common is testicular cancer? -

Overall, testicular cancer is quite rare when compared to other types of cancer. It is, however, the most common cancer among males aged 15 to 35.

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Signs and symptoms -

A lump or swelling in a testicle is one of the most common signs. Fluid buildup in the scrotum is also a sign.

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Signs and symptoms -

A feeling of heaviness, discomfort, or pain in a testicle or scrotum can also be a symptom. As can a dull ache in the lower abdomen or groin, as well as testicular atrophy.

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What causes testicular cancer? -

The causes of most testicular cancers are unknown. There are some changes to the DNA of testicle cells, but it’s not known what causes these changes.

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Risk factors: age -

One of the risk factors is age. While testicular cancer can affect males of any age, as previously mentioned, it mostly affects those aged between 15 and 35.

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Risk factors: undescended testicles -

Testicles form in the abdomen and then drop into the scrotum before a male is born. Those with a history of cryptorchidism, or undescended testicles, are more at risk of developing testicular cancer later in life.

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Risk factors: race and ethnicity -

White males are more likely to get testicular cancer. The risk of developing this type of cancer is higher for men living in North America and Europe when compared to those living in Africa or Asia. The reason for this is unknown.

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Risk factors: family history -

Some genetic conditions, such as Klinefelter syndrome, may increase the risk. And so does having a father or brother who has had testicular cancer. Though the majority of men who develop the disease do not have a family history of testicular cancer.

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Risk factors: HIV -

Males infected with the human immunodeficiency virus (HIV), especially those who develop AIDS, are at higher risk of testicular cancer.

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Diagnosis: physical exam -

Many times, a lump is detected through a physical exam, either by the person or during a routine medical check.

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Diagnosis: ultrasound -

If something is detected through a physical exam, then the next step is usually an ultrasound of the testicles.

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Diagnosis: inguinal orchiectomy and biopsy -

If the ultrasound confirms the existence of a possible cancer, then a surgical procedure called inguinal orchiectomy is done next. This involves removing the testicle(s) through the groin and examining it. A biopsy of the mass is then performed.

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Diagnosis: serum tumor marker test -

Other tests may also be performed, including a serum tumor marker test, which is done using a blood sample.

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Diagnosis: other medical imaging tests -

CT scans, X-rays, and MRIs can also be performed if there are suspicions of testicular cancer. These are mostly done to detect if the cancer has spread to other parts of the body.

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Stages of testicular cancer -

Cancer staging is a way to classify the characteristics of the cancer and treat it accordingly.

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Stage 0 -

Stage 0, also known as germ cell neoplasia in situ (GCNIS), is when abnormal cells have developed but are still inside the testicles where sperm cells develop. It's essentially a precursor to the formation of a tumor.

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Stage I -

Stage I is when cancer is confirmed to exist, but it remains confined to the testicle, so it hasn’t spread to any other part of the body.

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Stage II and III -

Stage II is when the cancer has spread to the lymph nodes in the back of the abdomen. In the presence of elevated tumor markers, or when the cancer has spread to other lymph nodes or an organ, then this is considered Stage III.

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Treatment -

Treatment will depend on a number of factors, namely the type and stage of the cancer. One possible treatment is surgery. There are two types of surgery usually performed: radical inguinal orchiectomy, and retroperitoneal lymph node dissection (RPLND). Of course, if the cancer has spread to other parts of the body, then doctors may choose to perform further surgeries to remove it.

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Treatment: radical inguinal orchiectomy -

This is when the testicle is removed through an incision in the groin. This procedure is used to treat both seminoma and non-seminoma cancers.

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Treatment: retroperitoneal lymph node dissection (RPLND) -

This procedure involves removing the lymph nodes behind the abdominal organs. This approach is used more often to treat non-seminoma testicular cancers.

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Treatment: radiation therapy -

Radiotherapy consists of using X-rays to kill cancer cells. This is sometimes performed after surgery, to prevent the cancer from returning. Semiomas in particular tend to respond well to radiation therapy.

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Treatment: chemotherapy -

Chemo is a tried and tested cancer treatment. Sometimes chemotherapy is enough to kill the cancer and avoid surgery. This works for both seminomas and non-seminomas.

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Prevention: testicular self-exam -

Testicular cancer as such isn’t preventable, but regular testicular self-exams should be performed. If you notice any lump, hardness, discomfort, or change in size, then talk to your doctor about it.

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Outlook -

The prognosis for testicular cancer patients is actually pretty good. The vast majority are successfully treated and cured, especially when the cancer is detected early. And while this type of cancer can be fatal, the risk is very low.

See also: The biggest health risks for men

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