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Testicular Cancer — Rare and Highly Curable

HIGHLIGHTS:

  • Testicular cancer is more frequently found in men between the ages of 15 and 35 years. Men with genetic infertility also have a higher than normal chance of developing testicular cancer.
  • Monthly testicular self-exams are an important screening method that can play a part in catching this disease in its earliest stages, especially for those with risk factors.
  • There may be some side effects to treatment for testicular cancer, particularly in patients who regularly smoke or drink alcohol, or in those with certain diseases, such as diabetes, high blood pressure or dyslipidemia, as well as in the elderly.

Testicular cancer — its mere mention is just as frightening as any other type of cancer. Fortunately however, it is not one of the 10 most common cancers found in Thai men. Rather, it is, in fact, quite rare, accounting for approximately only 2% of all cancers.

Testicular cancer is also classified as a less severe type of cancer and is known to be highly treatable, even when the cancer has spread beyond the testicles and into the bloodstream. Of course, this also depends on the type of cancer cells, the tumor size, age and overall health of the patient.

Testicular cancer has the same chance of occurrence in either the left, right or both testicles. However, it most often occurs in just one side. The highest incidence rates for the disease are found in those within the 15-35 year age range. Because of this, patients are often concerned about its effect on sexual functions, making it a cancer that has a huge emotional and mental impact on young men in particular.

Symptoms

  • Lump in either testicle
  • Non-painful swelling or enlargement of a testicle
  • Dull ache in the abdomen or groin
  • Unexplained feeling of heaviness or swelling of a testicle, as if filled with fluid
  • Pain or discomfort in a testicle or in the scrotum
  • Feeling of fluid accumulation in the scrotum
  • Decreased sex drive

If the testicular cancer has spread to other organs in the body, there may also be other symptoms:

  • Abdominal or lower back pain
  • Headaches or confusion
  • Pain, numbness or weakness in the thighs
  • Shortness of breath, coughing and chest pain

Testicular self-examination

Monthly testicular self-exams for men of reproductive age are important in order to notice changes in one’s testicles. A simple self-exam can play a part in catching this disease in its earliest stages. It’s best to do a self-exam when the testicles are in a relaxed state, such as just after a warm shower or bath.

Firstly, hold your penis out of the way. Then, examine one testicle at a time using both hands. Roll it between your thumb and fingers to see if there is any lump present or not.

Be aware, however, that it is considered normal for one testicle to be a different size or shape than the other or for one to hang lower than the other. There is also a soft, cordlike structure behind each testicle that collects and carries sperm. This is also normal and should not be mistaken for a suspicious lump.

Causes and risk factors

Currently, there are still no clear, known causes for a number of different cancers, and testicular cancer is no exception to this. However, studies have found that there are a variety of possible risk factors, as follows:

  • For males with undescended testes, there is approximately a 10-40% probability of testicular cancer
  • Chromosome 1 or 12 abnormalities
  • Atrophic (underdeveloped) testicles
  • Previous injury or inflammation of the testes due to various causes
  • An immune deficiency, for example due to HIV infection or AIDS
  • Men with genetic infertility also have a higher than normal chance of developing testicular cancer

Diagnosis

  • History and symptom taking
  • Physical exam, including an examination of both testicles
  • Testicular ultrasound test

Pathological examination for clear diagnosis of possible cancer and stage of the disease

In the diagnosis of testicular cancer, no biopsy will be performed. To do so, an incision must be made through the scrotum, and there is a small risk that this could cause cancer cells to spread to this area as well, which would result in treatment becoming more challenging and complicated.

Stages of testicular cancer

Testicular cancer can be divided into three stages. Determining the stage of the cancer allows the physician to make the best possible treatment plan that will deliver the best possible results:

Stage 1: The cancer is only in the testicle and has not spread to the lymph nodes or other organs. There is a 90–100% cure rate for this stage.

Stage 2: The cancer has spread to the retroperitoneal lymph nodes in the back of the abdomen. This stage has an 80–90% cure rate.

Stage 3: The cancer has spread to the retroperitoneal lymph nodes, as well as in high levels into the blood. There is still a 50–70% cure rate for this stage of the cancer.

In rare cases, if the patient is chemotherapy- or radiation-resistant, this can result in a cure rate as low as 5-10%.

Treatment

  • Surgery to remove the testicle affected by the disease, for which the physician will make a thorough evaluation of the cancer cells and cancer stage, as well as the patient’s overall health, in order to provide ongoing treatment and follow-up.
  • Radiation therapy, whereby radiation may be directed at the retroperitoneal lymph nodes, the chest or other areas to which the cancer has spread.
  • Chemotherapy: After surgery, your doctor may consider the use of chemotherapy for continued treatment, either on its own or in conjunction with radiation therapy.

Possible side effects of treatment

There may be some side effects to treatment for testicular cancer, particularly in patients who regularly smoke or drink alcohol, or in those with certain diseases, such as diabetes, high blood pressure  or dyslipidemia, as well as in the elderly. Possible side effects can include:

  • Surgery side effects: Loss of one or more testicle, wound infection or reaction to anesthesia
  • Radiation therapy side effects: There may be some side effects to the skin or tissues surrounding the affected area
  • Chemotherapy side effects: Common side effects include hair loss, nausea, vomiting and reduced platelet count

Currently, there are no known methods for preventing or screening for testicular cancer before symptoms or signs have developed. Because of this, the best method is to perform regular self-examinations. If any lumps or abnormalities are found, you should immediately see a doctor for proper diagnosis and treatment. Taking good care of your health can also help reduce risk factors.

While testicular cancer is quite rare and is highly treatable compared to other types of cancers, any abnormalities of the male sexual organs can have a greater emotional impact than a physical effect.


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