About Testicular Cancer

Testicles or testes are two egg-shaped glands located in the scrotum and form a part of the male reproductive system. When the cells in the testes show abnormal growth and multiplication, it gives rise it testicular cancer. Though it can occur at any age, testicular cancer is more common in men between 15 and 49 years. It is a less common cancer but the early stages of testicular cancer can be cured. There are two major subtypes of testicular cancer – seminomas and non-seminomas, based on the type of cells it begins in. Testicular cancer life expectancy five years after diagnosis is 95%, and it has a cure rate of 90%, making it one of the most curable cancers. Though the exact cause of testicular cancer is unknown, some factors that can increase your risk of developing the condition include: Family history Infections (Human Papilloma Virus(HPV), Cytomegalovirus (CMV), HIV and the Epstein-Barr Virus (EBV)) Testicular trauma High maternal oestrogen level

Symptoms

The most common symptom of testicular cancer is a painless lump or growth in the testicles. Other symptoms that you may experience include:

  • One testicle appears bigger than the other.
  • A feeling of heaviness in the scrotum.
  • A dull ache or discomfort in the scrotum.
  • Sudden fluid build-up in the scrotum.
  • Pain the lower back region.
  • The difference in the texture of the affected testicle.

If you experience any of the above symptoms or find an unusual lump in your testes, visit your doctor immediately. Pain is usually not the first symptom of testicular cancer.

Diagnosis

After assessing your symptoms, medical and family history, they may recommend the following tests to confirm the diagnosis and determine how to treat testicular cancer:

  • Physical examination of the testes

Your doctor will look for any lumps, growth or changes in the texture of your testicles.

  • Blood test

A tumour marker test may be performed to check for tumour markers (proteins released by tumour cells). Raised HCG and AFP levels can help your doctor determine the type of testicular cancer you may have. It is important to note that the presence of a tumour marker does not confirm a cancer diagnosis.

  • Scrotal ultrasound

This procedure uses high-frequency sound waves to create an image of the inside of your testicle. This helps your doctor determine whether the lump in your testicle is cancerous or not.

  • Imaging tests

Tests like x-rays, CT scans, MRI and PET scans may be performed to assess testicular cancer’s location, extent, and spread.

  • Biopsy

Your doctor may collect a tissue sample from the lump in the testicle to confirm if it is cancerous or not. The tissue sample is also further analysed to determine the stage and grade of your testicular cancer.

After evaluating your symptoms and studying the diagnostic test results, your doctor and multidisciplinary healthcare team will determine how to treat testicular cancer.

Treatment

The standard testicular cancer treatment options available today are:

  • Surgery

This is the primary treatment for testicular cancer. You may require surveillance, chemotherapy, or radiation therapy after surgery.

  • Surveillance or monitoring

If you have stage 1 testicular cancer that can be removed entirely with surgery, you may not need additional treatment. However, you will be required to undergo regular tests to monitor if your cancer shows any sign of recurrence.

  • Radiation therapy

External radiation therapy is routinely used to treat seminoma (a type of testicular cancer) that may have spread to lymph nodes in your abdomen.

  • Chemotherapy

This treatment uses anti-cancer drugs to kill testicular cancer cells. Chemotherapy is used in stage 3 and stage 4 testicular cancer cases with other therapies or when there is a high chance of cancer recurrence.

  • High-dose of chemotherapy with stem-cell transplant

High-dose chemotherapy and testicular cancer may damage the bone marrow. In these cases, chemotherapy is often followed by a stem cell transplant.

Since treatments like radiation therapy and chemotherapy may affect your fertility, sperm banking is usually recommended before beginning treatment. Newer treatment options are being studied in clinical trials.  Any treatment option like radiation or chemotherapy for testicular cancer has benefits and side effects. Your doctor and healthcare team will determine the best plan to treat your testicular cancer.

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