Testicular cancer develops in the testicles, which is a part of the male reproductive system. It is most common in men aged between 18 and 35 years and effects approximately 1 in 500 men between the ages of 15 and 50. Whilst incidence rates for testicular cancer have risen since the 1970s, the mortality rates have fallen. When caught at an early stage,
treatment for testicular cancer might involve only
surgery to the diseased testicle. However in over thirty percent of cases, by the time of
diagnosis the cancer has already spread. In spite of this over 95% of patients can be cured, using treatments such as
chemotherapy and
radiation therapy.
Causes
Whilst the specific causes of testicular cancer are not known, certain factors might indicate a higher level of risk. For example an undescended testicle, infertility problems or a family history of the condition. Such men should take particular care and visit health professionals for regular examinations.
Symptoms
The early signs of testicular cancer can be detected by simple regular
self examination. However surveys indicate that only 5% of men do this, whilst many men are either unaware or prefer to ignore the issue. Medical experts recommend that men carry out a testicular self-examination each month. This is best done following a bath or hot shower, as the scrotum will then be looser. Each testicle should be examined for pea-shaped lumps or the hardening of a testicle. Normally a testicle should be smooth. Ridges could indicate enlarged blood vessels or a tumor and the whole testicle could feel hard and lumpy. Other symptoms which men should be aware of include, unusual sensitivity, reduction in sex drive, change in size of a testis, tiredness, a dull pain in the groin or lower abdomen or blood in semen. There are sensible steps that men can follow, such as reporting pain in the lower back, pelvis or scrotum to a health professional. It is during such examinations that most testicular cancer cases are found.
Scrotal ultrasound can be used to evaluate any testicular mass. This can determine the size, location and characteristics of the lump, such as whether it is cystic or solid, uniform or heterogeneous and poorly defined or sharply circumscribed. Metastases are located using CT scans, which evaluate the extent of the disease. Tumor markers specific to testicular cancer can be identified using blood tests and pathologists can examine surgically excised testis and attached structures. Biopsy risks allowing the cancer to spread and should not therefore be used.
The three basic types of treatment for testicular cancer are Surgery, Chemotherapy and Radiotherapy. That chosen will depend upon the type of cancer and whether it has spread.
The first treatment for either seminoma or teratoma is usually orchidectomy or surgical removal of the testicle. This also enables doctors to make an exact diagnosis. It is rare for cancer to affect both testicles, though in a small percentage of men this can happen. Consequently a small biopsy might be suggested in which a thin needle is used to take cells from the other testicle. If any signs of cancer are found it should be possible to treat it with a low dose of radiotherapy. After surgery it is important to visit a doctor regularly for blood tests, CT scans and x-rays. It is possible that cancer might return, requiring further treatment. In the minority of cases where cancer does return, further treatment is generally successful. However if the cancer was removed completely with the orchidectomy and has not spread, no more treatment might be required after the surgery.
Radiotherapy uses ionizing radiation as part of the cancer treatment, and should not be confused with radiology which uses radiation in imaging and diagnosis. The aim is to destroy cancer cells, whilst causing minimal damage to normal tissue such as skin and other organs, through which the radiation passes. Radiotherapy is generally used to treat seminoma rather than teratoma and is used to prevent recurrence or when cancer has spread to glands at the back of the abdomen. It is usually a very effective form of treatment, curing most men affected by this form of cancer.
Side effects
Possible side effects of Radiotherapy include tiredness, sickness and diarrhoea. They are mostly mild, can be treated with drugs and should gradually go after treatment is completed. During the treatment period it is important to maintain a healthy diet, drink lots of fluids and get sufficient rest. You will not become radioactive and it is perfectly safe to be around other people throughout the period of Radiation Therapy.
In the treatment of cancer, chemotherapy involves the use of anti-cancer drugs to kill cancer cells. They disrupt the growth of cancer cells, circulate in the blood and can be used to prevent cancer returning or to treat cancer that has spread to other parts of the body. Sometimes chemotherapy is used to shrink a cancer before surgery, to make it easier to remove. Possible side effects of chemotherapy include nausea and vomiting, loss of appetite and hair loss. There is the possibility of an increased risk of infection and if necessary infections can be treated with antibiotics. Below a certain level of white blood cells, drugs can be given to stimulate bone marrow. Regular blood tests will monitor this and the functioning of kidneys which can also be affected.
