Testicular Cancer

Testicular Cancer

Testicles

The testicles are located inside the scrotum, a pouch beneath the penis. There are two testicles, which are part of the male reproductive system. The testicles produce both sperm and the hormone testosterone, which is essential for sexual development and maintaining male characteristics.

What is Testicular Cancer?

Testicular cancer starts in the germ cells, which are responsible for producing sperm. Hence, these cancers are referred to as germ cell tumors. Germ cell tumors can also develop in other areas such as:

• Testicles – the most common site

• Retroperitoneum – near the spine

• Mediastinum – between the lungs

• Lower spine and pineal gland (in children)

Testicular cancer, if detected early, can be completely cured.

Types of Testicular Cancer

1. Seminoma

2. Non-Seminoma

• Choriocarcinoma

• Embryonal carcinoma

• Yolk sac tumor

• Teratoma

Non-seminoma cancers grow and spread more aggressively. For a cancer to be classified as seminoma, it must be 100% seminoma without any other tumor types mixed.

Statistics

• India: Annually, 4,681 new cases of testicular cancer are diagnosed.

• Ranking: Testicular cancer ranks 31st among all cancers in India.

• Deaths: 1,252 deaths are reported annually due to testicular cancer.

Survival Rate

• In the United States, the 5-year survival rate for testicular cancer is 95%.

• If detected at Stage I, the survival rate rises to 99%.

Risk Factors

Several factors increase the risk of developing testicular cancer:

• Age: Most cases are diagnosed in men aged 20 to 45, but it can occur at any age.

• Cryptorchidism: A condition where one or both testicles fail to descend into the scrotum.

• Family History: Having close relatives (like brothers) with testicular cancer increases the risk.

• Personal History: If a person has had cancer in one testicle, they are more likely to develop it in the other.

• Race: More common in white men compared to other races.

• HIV/AIDS: People with HIV have a higher chance of developing seminoma.

Symptoms of Testicular Cancer

• Painless lump or swelling in one or both testicles

• Pain or discomfort in the testicles or scrotum

• Change in size or feel of a testicle

• Lower abdominal or groin pain

• Sudden fluid buildup in the scrotum

• Breast pain or swelling

Advanced Symptoms:

• Back pain

• Shortness of breath

• Chest pain or coughing blood

• DVT (Deep Vein Thrombosis)

Diagnosis

1. Physical Examination:

• A doctor examines the testicles and other parts of the body (abdomen, lymph nodes, chest) for abnormalities.

2. Blood Tests:

• AFP (Alpha-fetoprotein) – elevated in non-seminoma cancers

• Beta-hCG – elevated in both seminoma and non-seminoma

• LDH, PLAP – additional tests to confirm diagnosis

3. Radical Inguinal Orchiectomy:

• The entire testicle is removed surgically to examine it under a microscope for cancer.

4. Imaging Tests:

• Ultrasound

• X-ray

• CT Scan / MRI / PET-CT

Treatment Options for Testicular Cancer

1. Surgery

• Radical Inguinal Orchiectomy:

• Involves removal of the entire testicle.

Even after removing one testicle, the other healthy testicle typically continues to produce enough testosterone and sperm. If testosterone levels drop, symptoms such as depression, fatigue, and low sex drive may occur.

A prosthetic testicle can be surgically placed to maintain the appearance of the scrotum.

2. Chemotherapy

Chemotherapy uses drugs to kill cancer cells. Testicular cancer treatment typically involves 1 to 4 cycles of chemotherapy.

Common Chemotherapy Drugs:

• Bleomycin

• Carboplatin

• Cisplatin

• Etoposide

• Gemcitabine

• Ifosfamide

• Oxaliplatin

• Paclitaxel

• Vinblastine

Side Effects:

• Fatigue

• Nausea and vomiting

• Hair loss

• Numbness in hands and feet

• Tinnitus (ringing in the ears)

• Increased risk of infections

3. Radiation Therapy

Radiation therapy uses high-energy radiation to destroy cancer cells. It is typically directed at the abdominal lymph nodes to prevent the spread of cancer.

Side Effects:

• Redness and itching of the skin

• Fatigue

• Diarrhea

• Peptic ulcers

Follow-Up Care

After completing treatment, regular follow-up tests are essential to monitor for cancer recurrence and manage side effects. Follow-up care includes:

• Physical examinations

• Blood tests

• Imaging tests such as CT scans or PET-CT

Testicular cancer is highly treatable, especially when detected early. Advances in surgery, chemotherapy, and radiation therapy have significantly improved outcomes. Regular self-examination of the testicles and timely consultation with a healthcare provider are crucial for early detection and successful treatment.

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