Testicular Cancer

Cancer that occurs to either of the testicles is called Testicular Cancer. This is not a very common condition but can happen at any age of a man. Good news is, testicular cancer is treatable irrespective of the stage it is in.

Symptoms of testicular cancer

1. The tumor like lumps form on the testicles. You can touch and feel them when you touch the scrotum.
2. A feeling of heaviness in the scrotum.
3. Mild pain in the abdomen or groin area.
4. A sudden collection of fluids in the scrotum
5. Back pain
6. Enlargement or tenderness of the breasts.

What causes testicular cancer?

The exact reason for testicular cancer is not known. However, the experts have different opinions on what causes testicular cancer.  ‘Germ Cells’ are cells in the testicles that produce immature sperms. When these cells are developing, some abnormalities occur in them and they turn cancerous. Once they turn cancerous, they continue multiplying without stopping and cause lumps.  Healthy cells stop their growth when the body has enough of them but cancerous cells don’t stop their growth, anywhere in the body.  The reason what makes a cell cancerous is not known so far.

Factors that increases chances of testicular cancer:

1. Undescended testicle(s) – When a male baby is born, the two testicles descend from the abdominal area into the scrotum. (happens before birth itself). In some cases, this doesn’t happen. The testicle(s) descend after birth or in some cases; they have to be moved down surgically into the scrotum. Some experts believe that such a situation can pose risk of developing testicular cancer at a later stage. However, there is no concrete evidence to prove the same because, most men with testicular cancer didn’t have the problem of undescended testicle(s).
2. Abnormal development of testicle –Klinefelter syndrome (a problem happens due to genetic errors) is one such condition which leads to abnormal development of testicles. Such conditions also lead to testicular cancer.
3. Family History – If anyone in the family tree had testicular cancer, there is a chance that their children or grand children can develop the same.
4. Age – In fact, this can affect men of any age but majority of the cases lie between 15 to 35 years of age.
5. The problem varies depending on the race of a person. In the US, white men are at higher risk than black men in developing testicular cancer.

Diagnosis of testicular cancer

If you happen to figure that there is a lump on your testicle, contact your sexologist immediately. Or, if your general physician suspects lumps during your regular annual health check up, he/she will advise you to see a good sexologist for further diagnosis and treatment.  Sexologist will then do some tests to determine if the tumors or lumps or cancerous, if so, he/she will try to figure out the location.

1. Ultrasound imaging – A gel will be applied to your scrotum and using a hand held ultrasound device, your doctor will look for the lumps on the testicles. This will help the doctor determine if the lumps are solid or fluid filled and if they are present inside the testicles or on them.
2. Blood tests will be performed to determine the tumor markets in the blood.
3. Radical Inguinal Orchiectomy – Removal of testicle. If your doctor confirms that the lumps on the testicle are cancerous, the testicle may be removed. It will then be sent for testing to understand the nature of cancer and at what stage it is in.

Types of testicular cancer

In cases when the testicle is removed and sent for testing, the testicular cancer can belong to one of the following types:

1. Seminoma – This occurs in all age groups, especially, if an aged man develops testicular cancer, it will be mostly Seminoma.
2. Non Seminoma – They occur in younger age. They are aggressive, meaning, they grow and spread very rapidly in the body. Different types of Non Seminoma cancers include Choriocarcinoma, Embryonal Carcinoma, Teratoma and Yolk Sac Tumor.

Stage of your cancer

After knowing the type of cancer, it is important to know in what stage it is.  To determine if the testicular cancer has spread to other parts of your body, further tests may be done such as:

1. CT (Computerized Tomography) Scan – This takes a series of images of pelvis, abdomen, chest regions to look for spread of cancer.
2. Blood Test – Elevated tumor markers indicate if the cancer possibility still exist in the body.

Based on what stage your cancer is, appropriate treatment is proposed.

Treating testicular cancer

As said, determining the type and stage of cancer will decide the type of treatment that will be adopted.

Surgery

1. 1. Surgery to remove the testicle – Radical Inguinal Orchiectomy. This is done for cancers of all types and stages. A small incision will be made in the groin area and the testicle will be extracted. If required (by you), a prosthetic, saline-filled testicle will be implanted in it’s place.  If the cancer is in preliminary stage, extraction of testicle will suffice.  For cancers that have evolved to later stages and has spread to other parts of the body, further examinations and treatment will be required.
   2. Surgery to remove lymph nodes – Retroperitoneal Lymph Node Dissection – This is done by making an incision in the abdomen. This is a more risky procedure because, in some cases, the nerves surrounding the lymph nodes may be damaged and that can result in infertility. However, erections of penis will still happen

Radiation therapy

High powered energy beams are used to kill cancer cells.  In men suffering from ‘Seminoma’ type of cancer, radiation therapy may be advised.  Radiation therapy will also be performed even after the testicle is removed if the doctor determines that the cancer has spread to other regions.

Chemotherapy

In this therapy, drugs will be used to kill cancer cells in the body.  The medicine will travel throughout the body to kill cancer cells at the origin and in the places where it might have spread to.  Side effects of chemo include fatigue, nausea, hair loss etc.  Chemotherapy can lead to infertility in some men.  It is always advisable to go for ‘cryopreservation of sperms’ before undergoing chemotherapy for any reason.