The testicles are paired organs of the male reproductive system. The testicles are known as the testes & a single testicle is called a testis. These two organs are enclosed in a skin sac known as the scrotum. The scrotum hangs just below the penis base. Testes have to synthesize male hormones or androgens like testosterone and produce sperm, that is the male cells (sperm) which fertilize a female egg cell (ovum) to initiate the pregnancy.
What are testicular cancers ?
Testicular Cancers are basically tumours of the Testicles. The testicles are made up of various different cells, each of which if affected by cancer, leads to a different type of cancer.
What are the risk factors for testicular cancer ?
The known risk factors for testicular cancer include:
- Cryptorchidism or an undescended testicle(s)- This condition is when either only a single testis or both testes fail to move down from the abdomen into the scrotum prior to birth. Affected males are more likely to get testicular cancer than those with normal descent of testicles.
- A family history of testicular cancer.
- Having AIDS or HIV infection.
- An earlier benign, non-invasive cancer or carcinoma in situ of the testicle.
- A prior history of testicular cancer.
What are the types of testicular cancers ?
There are several types of cancer that can initiate in the testicles.
- Germ cell tumours: A majority of testicular cancers develop in specialized cells called the germ cells. The germ cells are the cells that make sperm. The two basic types of germ cell tumours (GCTs) in men include seminomas & non-seminomas. Non-seminomas are again either the embryonal carcinoma, the yolk sac carcinoma, the choriocarcinoma, and/or the teratoma.
- Carcinoma in situ of the testicle: Testicular germ cell cancers can have a benign, non-invasive cancer called carcinoma in situ (CIS). In this cancer, the cells are atypical, however they are yet to extend beyond the walls of the seminiferous tubules (the site where the sperm cells are produced). Carcinoma in situ does not necessarily progress to invasive cancer.
- Stromal tumours: Tumours arise in the hormone-producing and supporting connective tissues, or stroma, of the testicles. The two basic types of Stromal Tumours are the Leydig cell tumours or the Sertoli cell tumours.
- Secondary testicular cancers: Cancers that initiate in other organs and then spread to the testes are secondary testicular cancers. These cancers are not primary testicular cancers – they are treated based on their original site. Lymphoma is by far, the commonest secondary testicular cancer.
What are the clinical features of testicular cancers ?
Testicular cancer will first begin to show as a lump or swelling on the testicle. Some of the tumours might be painful, but most of the time they are painless. Men with testicular cancer may have heaviness or an aching feel in the lower abdominal area or scrotum. Advanced cancers might have low back pain, chest pain or abdominal pain.
How are testicular cancers diagnosed ?
- A complete physical examination of the body is mandatory.
- Ultrasound of the Testes- This is the first test to be done in the diagnostic line-up for testicular cancers.
- Tumour Markers in Blood- Many testicular cancers secrete proteins or tumour markers, like alpha-fetoprotein (AFP) as well as human chorionic gonadotropin (HCG). When blood levels of these tumour markers are elevated, there may be a possibility of a testicular tumour.
- Biopsy– Removed tissue examined under a microscope by a pathologist is confirmative for testicular cancer.
- Imaging Tests
To determine the exact extent of disease, additional tests may need to be performed so doctors can view, assess and judge the cancer and determine how far it has progressed or spread. These tests may include the following such as X- rays, CT Scan, MRI Scan, PET Scans or bone scans.
How are testicular cancers staged ?
Grade and Stage describe the tumour, helping to provide guidance for the urologist in choosing the best treatment options. Staging helps to find out the extent of the cancer. Staging will define whether the cancer has invaded adjacent structures, whether the disease has spread, and if so, to what parts of the body. The advanced the stage the more the cancer has grown away from its primary site in the testicles. Grade refers to what the cancer cells resemble and how fast the cells are multiplying. The higher the grade, the more uneven the cells are and the more the cells are multiplying.
How are testicular cancers treated ?
The treatments for Testicular Cancers have been progressing over the last few decades. Treatment options depend on the type of cancer, staging of the cancer, and its location.
The standard treatments for Testicular Cancer include:
- Surgery : Surgical treatments for Testicular Cancers include Radical Inguinal Orchiectomy wherein complete excision of the testicle from the scrotum is done. Affected lymph nodes also have to be removed in a surgery called Retroperitoneal lymph node dissection (RPLND).
- Radiation Therapy: A cancer treatment that utilizes high-energy x-rays or basically radiation to eradicate cancer cells. The two main types of radiation therapy used to treat testicular cancer are external beam therapy and internal radiation therapy, also known as brachytherapy.
- Chemotherapy : Another kind of cancer treatment that uses either drugs or chemical substances (hence the name chemotherapy) to kill cancer cells and prevent them from dividing.
- High-dose Chemotherapy and Stem Cell Transplant : Testicular cancers usually respond well to chemotherapy (chemo), but not all the cancers can be cured. Even if higher doses of chemotherapy are more effective, they are not administered as they damage the bone marrow severely, the factory of new blood cells.High dose chemo leads to severe infections, bleeding, and other life threatening problems because of decreased or low blood cell counts. So, a stem cell transplant allows oncologists to use higher doses of chemotherapy, by reforming blood cells in the damaged marrow, after the chemotherapy.
What is the care to be taken after the treatment of testicular cancer ?
Metastatic diagnostic workup and monitoring post-treatment has to include imaging and scanning of the limbs, thorax, chest, retroperitoneum, and abdomen with radiography, MRI or CT scans. Adjuvant chemotherapy or radiotherapy may be required in cases wherein excision cannot be done completely.
How to find and reach cancer specialists for testicular cancer treatment ?
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Find, reach and choose a cancer specialist for testicular cancer treatment on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
