Although testicular cancer is an uncommon type of cancer, it has become a type of cancer with an increasing incidence in men between the ages of 20 and 35. However, thanks to the technological developments in treatment methods, the situation can be completely treated in most of the cases. One of the main factors that increase the risk of this condition is cryptorchidism, known as undescended testis. In addition to this situation that increases the risk of cancer, testicular tumors in first-degree family members, infertility and Klinefelter syndrome, which is a genetic disorder, are among other risk factors.
The testicles are an important part of the male reproductive system and are two oval glands located under the penis within the skin sac called the scrotum. Sperm production and storage are carried out by these glands. In addition to this function, the testicles produce testosterone, which is important for libido in men.
This type of cancer is a tumoral formation that starts in the testicles and in some cases can spread to other areas of the body. This formation occurs with the development of malignant cells in the tissues of the testis. The incidence of testicular cancer in the right testis is 52.3%, and the incidence in the left testis is 47.7. Although rare, cancerous cell development can be seen in both testicles.
“What causes testicular cancer?” The question is one of the most asked questions. As with most types of cancers, testicular cancer does not have a definite cause, but there are some risk factors. These:
- Undescended testis
- HIV infection
- Testicular inflammation
- Abnormal development of testis
Age is one of the most important factors causing testicular cancer, and this type of cancer is commonly seen in men aged 15-35 years. Another factor, cryptorchidism, is one of the conditions that come to the fore with age and creates a risk for the person. Cryptorchidism, known as undescended testis syndrome, is a birth defect where one or both testicles remain undescended. Hereditary factors, one of the conditions that increase the risk, are also valid for people with a history of testicular cancer in first-degree family members.
Testicular cancers, 90% to 95% of which consist of germ cells required for sperm production, have 2 different types as seminoma and non-seminoma. So what is a seminoma? Seminoma tumors develop slowly and usually appear between the ages of 25-45. Non-seminoma tumors develop rapidly and are usually seen in late adolescence and early 30s. In some cases, testicular cancer may appear as a combination of non-seminoma cells. Such tumors are also called mixed tumors.
Testicular cancer stages play an important role in determining the appropriate treatment method for cancer.
Stage 0: This stage originates from the germ cells and the cancerous cells have not spread to the tissues. In this stage, which generally does not cause symptoms in the person, cancer is usually detected by chance.
Stage I: At this stage, cancerous cells are only in the testis. Diagnosing cells that have not spread to any tissue or organ at this stage may facilitate treatment.
Stage II: Cancerous cells spread to the lower abdominal region at this stage.
Stage III: In this stage, which is also called the advanced stage, the cells have spread. It passes to the surrounding tissues and organs, especially to the lymph nodes.
Testicular cancer symptoms are generally in the form of a hard lump in the testicle or a swollen testicle. Other symptoms seen are as follows:
- Fluid accumulation in the scrotum
- Experiencing a pulling or discomfort sensation in the scrotum
- Experiencing pain in the lower abdomen and groin area
- Testicle larger than normal
- Back pain
- Swelling / blood clot in one or both legs
- Shortness of breath
- Weight loss
- Testicular infection
- Breast enlargement and tenderness
Physical examination, blood tests and testicular ultrasound are required for the diagnosis of mass in the testicles. In addition to these, tomography and chest X-ray are also requested from the person against the risk of cancer spreading. As in many types of cancer, early diagnosis is of great importance in testicular cancer. If a palpable mass is detected in the physical examination, if the tests do not prove otherwise, this mass is considered a tumor and the treatment process is planned accordingly. For diagnosis, certain blood tests are done to measure the levels of tumor marker proteins. These tests are:
- Beta-human chorionic gonadotropin
- Lactic dehydrogenase
- Placental alkaline phosphatase
As a result of all these tests and pathological evaluation, the stage of the disease is determined and according to the results obtained, it is determined whether the person needs radiotherapy or chemotherapy.
The treatment to be applied to the patient is determined according to the area where the cancerous cells have spread, its type and the general health status of the person. In stage 1, the cancer is only in the testis. In stage 2, the cancer has spread to lymph nodes in the pelvis or abdomen. In stage 3, the cancer has spread beyond the lymph nodes to other parts of the body. When evaluated in this respect, the surgical method is used in cancer diagnosed at an early stage. However, if the cancerous cell has spread beyond the testis, radiotherapy and/or chemotherapy is applied to the patient.
Surgery: This procedure, which is applied to remove the affected testis in testicular cancer, is called orchidectomy. Surgery is the main treatment method for the early stage. However, if the cancer is advanced, other additional surgical interventions are added to the treatment.
Chemotherapy: Chemotherapy is used in the treatment of cancer that recurs after surgery and spreads beyond the testicles. Even in cases where the cancer has not spread, with chemotherapy it is expected to reduce the possibility of cancer recurrence in the future.
Radiotherapy: Radiotherapy method is used in the treatment of seminoma type cancer. In addition, it is preferred in patients who have undergone surgery to prevent cancer recurrence.
What is the incidence of testicular tumors?
This type of cancer, which is seen in men between the ages of 20 and 34, is actually a rare health problem.
How to perform testicular examination at home?
In order to diagnose testicular tumor at an early stage, the person should examine himself every month. This examination should be done after a hot shower. This relaxes the scrotal skin. Before the manual examination, the person should observe whether there is a difference in appearance. Then, each testis should be slid between the thumb and the other fingers to check for mass formation. If a suspicious situation is detected in this examination, a urologist should be consulted.
Is it possible to have children after testicular cancer?
After the removal of a single testis with surgery, the person does not experience erection problems or infertility. The other testicle starts producing more testosterone and sperm to complete the missing testicle. However, with radiotherapy and chemotherapy applications, a decrease in the fertility of the person can be observed.
Can testicular cancer be prevented?
This type of cancer cannot be prevented, but it can be diagnosed and treated at an early stage. For this reason, men should definitely examine themselves once a month and consult a doctor if they see any difference in their testicles.
What is the success rate of testicular tumor treatments?
High success can be achieved in the treatment of those who are diagnosed with cancer at an early stage, undergo chemotherapy for testicular cancer, or receive one or more of these treatments.