Testicular cancer is the most common cancer in young men. What are the symptoms?

Testicular cancer is the most common cancer that affects men between the ages of 15 and 35. The most common symptom to look out for is a painless lump in the testicle. An early diagnosis of testicular cancer drastically increases the chances of a cure. How well a patient responds to treatment will depend on the type of cancer cells, whether the disease has spread, and on the overall health of the patient. For the early detection of testicular cancer, men are encouraged to familiarize themselves with the early symptoms, learn to test their testicles themselves, and speak to a doctor if a suspicious lump, swelling, or pain develops in the testicular area.

1. Testicular cancer affects young men, most often between the ages of 20-30
2. A typical symptom of developing disease is a lump in the testicle
3. The best preventive method is a systematic self-examination of the testicles. Early detection of changes allows for effective treatment
4. You can find more such stories on the TvoiLokony home page

What are the testicles?

The testicles are part of the male reproductive system and, in the case of adult males, are only slightly smaller than golf balls. They are in a skin sac called the scrotum. The scrotum is located under the base of the penis.

The kernels have two main functions:

1. produce male hormones (androgens) such as testosterone.
2. they produce sperm, the male cells needed to fertilize a female egg.

Sperm are produced in long, threadlike tubes inside the testicles, called the seminal tubules. They are then stored in a small coiled tube behind each testicle, called the epididymis, where they mature.

During ejaculation, sperm is carried from the epididymis through the vas deferens to the seminal vesicles. There they mix with the fluids produced by the follicles, prostate and other glands to form semen. This fluid then enters the urethra, the tube in the center of the penis through which both urine and semen leave the body.

See also: Premature ejaculation – facts and myths

Testicular cancer – types

It is estimated that almost 90 percent. of all tumors of the testicle arise from germ cells (germinal or germ cell tumors), which are responsible for the production of sperm. Two types of testicular cancer arise from such cells – seminomas and non-seminomas.

Seminomatous tumors of the testicles

Semiform tumors usually grow and spread more slowly than non-seminomatous tumors. The two main subtypes of these tumors are classical seminomas and spermatocytic tumors.

1. Classic seminoma. Over 95 percent seminomas are classic seminomas. They usually occur in men between the ages of 25 and 45.
2. Spermatocytic seminoma. This rare type of seminoma usually occurs in older men (average age is around 65). Spermatocytic tumors tend to grow more slowly and are less likely to spread to other parts of the body than classical seminomas.

Some seminomas can increase the level of a protein called human chorionic gonadotrophin (HCG) in the blood. HCG levels can be checked with a simple blood test and is considered a tumor marker for certain types of testicular cancer. It can be used to diagnose and see how a patient responds to treatment.

Non-seminomatous tumors of the testicles

These tumors are most commonly seen in men between late teens and early 30s. Within this group, a distinction is made between germ cell cancer, orchidoblastoma, chorionic carcinoma and teratoma. Most tumors are a mixture of different types (sometimes with seminoma cells as well), but this does not change the treatment of most non-seminoma tumors.

Testicular germ cell carcinoma

It is assumed that 40 percent of the cells responsible for embryonic cancer are found. of all testicular tumors, but only 3% of pure germ cell carcinomas are present. up to 4 percent cases. Under the microscope, these tumors can appear like tissues of very early embryos. These tumors tend to grow rapidly and spread beyond the testicle. They can increase the blood levels of a tumor marker protein called alpha-fetoprotein (AFP), as well as human chorionic gonadotropin (HCG).

Testicular yolk sac carcinoma

These necklaces resemble the yolk sac of an early human embryo. It is the most common form of testicular cancer in children (especially in infants), but pure cancers of the yolk sac (tumors not found in other types of non-seminoma tumor cells) are rare in adults. When they appear in children, these tumors are usually treated successfully. However, they are more disturbing when they occur in adults, especially if they are clean. This form of testicular cancer responds very well to chemotherapy, even if it has metastasized. Usually yolk sac cancer has the level of AFP (alpha-fetoprotein) in the blood.

Testicular chorion carcinoma

A very rare and rapidly growing type of testicular cancer in adults. Pure chorionic cancer is likely to spread quickly to other parts of the body, including the lungs, bones, and brain. More commonly, chorionic cancer cells are seen with other types of non-seminoma tumor cells in a mixed tumor from germ cells. These mixed tumors tend to have a slightly better prognosis than pure chorionic carcinomas, although the presence of chorionic carcinoma is always a worrying finding. This type of tumor increases the level of HCG (human chorionic gonadotropin) in the blood.

Testicular teratoma

A tumor whose areas under the microscope look like each of the 3 layers of a developing embryo: the endoderm (innermost layer), mesoderm (middle layer), and ectoderm (outer layer). Pure testicular teratomas are rare and do not increase AFP (alpha fetoprotein) or HCG (human chorionic gonadotrophin) levels. Most often, teratomas are seen as parts of mixed germ cell tumors.

There are two main types of teratomas:

1. mature teratomas are tumors made up of cells that are very similar to the cells of adult tissue. They rarely spread. They can usually be treated surgically, but some come back after treatment.
2. immature teratomas are less developed tumors with cells that look like cells from an early embryo. In this case, it is more likely that adjacent tissues will be invaded, metastatic outside the testicle, and relapsed years after treatment.

Also check: Testicular cancer kills instantly

The causes of testicular cancer

It is not clear what causes testicular cancer in most cases. Doctors know that testicular cancer occurs when the healthy cells in the testicle are changed. Healthy cells grow and divide in an orderly manner to keep the body functioning normally. However, sometimes some cells develop abnormalities, causing growth to go out of control, these cancer cells continue to divide even when new cells are not needed. The accumulating cells form a mass in the nucleus.

Almost all testicular cancers start in germ cells, which are the cells of the testicles that produce immature sperm. It is not known what causes the reproductive cells to become abnormal and turn into cancer.

Testicular cancer risk factors

Factors that may increase your risk of testicular cancer include:

1. undescended core (cryptorchidism). The testicles form in the abdominal area during fetal development and usually descend into the scrotum before birth. Men who have testicles that have never descended are more likely to develop testicular cancer than men whose testicles have never descended normally. The risk remains elevated even if the testicle has been surgically moved into the scrotum. Still, most men who develop testicular cancer do not have a history of undescended testicles.
2. abnormal testicular development. Conditions that cause the testes to develop abnormally, such as Klinefelter’s syndrome, can increase the risk of testicular cancer.
3. family history. If family members have had testicular cancer, a man may be more likely to develop this cancer.
4. age. Testicular cancer affects adolescents and younger men, especially between the ages of 15 and 35. However, this cancer can occur at any age.
5. infertility. Some of the same factors that cause infertility may also be linked to the development of testicular cancer. In this case, however, more research is needed to understand the relationship.
6. rasa. Testicular cancer is more common in white men than in black men.
7. HIV i AIDS. There is evidence that people with HIV (Human Immunodeficiency Virus) and AIDS (Acquired Immunodeficiency Syndrome) have an increased risk of developing testicular cancer.

Testicular cancer – symptoms

The most common symptom of testicular cancer is a painless lump in the testicle. Other symptoms may include changes in the appearance of the testicles and pain.

1. Swelling or a sudden build-up of fluid in the scrotum.
2. Lump or swelling in both testicles.
3. A feeling of heaviness in the scrotum.
4. Dull pain in the groin or lower abdomen.
5. Pain or discomfort in the scrotum or testicle.
6. Shrinking testicle (testicular atrophy).

However, it should be added that these symptoms can also occur in other conditions, so if you notice them, do not panic. Instead, see a doctor for a diagnosis. Very few men with testicular cancer felt pain at first.

The doctor (urologist) will want to check if the cancer is developing or if there is any other problem, such as:

1. epididymitis. Edema of the epididymis, often treated with antibiotics.
2. Testicular torsion. Often treated surgically.
3. inguinal hernia. When part of the intestine pierces the weak part of the abdominal muscles near the groin. Often treated surgically.
4. testicular hydrocele. When fluid builds up in the scrotum. The condition often passes without treatment.

Testicular cancer – stage

The stage of testicular cancer provides important information that will guide treatment decisions, such as the size of the tumor and whether the tumor is spreading.

1. Step 0. The abnormal cells have developed but are still in the testicles where sperm starts to grow. Stage 0 is also called IGCN.
2. Stadium I. The cancer is confined to the nucleus, which may involve nearby blood or lymph vessels. Tumor markers may or may not be elevated.
3. Stadium II. The cancer has spread to lymph nodes in the back of the abdomen (also called the retroperitoneal space) but nowhere else. If a patient has cancer in the lymph nodes along with moderate or very elevated tumor markers, they are stage III, not stage II.
4. Etap III. The cancer has spread to lymph nodes outside the abdomen or to an organ.

Also read: Tumors that kill fastest

Testicular cancer – diagnosis

A doctor can diagnose testicular cancer after examining a lump or other lesion in the testicle that the patient found during self-examination. Sometimes testicular cancer is diagnosed during a routine physical examination.

Common procedures and tests to help diagnose testicular cancer include:

1. physical examination and medical history. Your doctor will ask about your symptoms and carefully examine you to look for signs of testicular cancer. The specialist will examine the testicles for nodules and check the lymph nodes for signs of cancer spreading.
2. ultrasound examination. The doctor may also order an ultrasound. Ultrasound is a painless medical procedure that uses high-energy sound waves to create images of the tissue inside the body.
3. inguinal orchidectomy and biopsy. If the ultrasound shows signs of cancer, your doctor will remove the affected testicle through an incision in your groin. A specialist will examine the tissue (taken from the testicle) through a microscope to check for cancer cells.

Other tests may include:

1. examination of a tumor marker in the serum. This procedure tests a blood sample to measure the amount of certain substances associated with certain types of cancer. These substances are called tumor markers. Tumor markers that are often elevated in testicular cancer are alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG or beta-HCG), and lactate dehydrogenase (LDH). Different types of tumors raise different markers. For example, seminomas sometimes raise HCG but not AFP. Non-seminomas can increase AFP but not HCG. Elevated LDH levels may indicate cancer is spreading.
2. computed tomography, x-rays and MRI. Computed tomography uses X-rays to create images of the inside of the body. Your doctor may do a CT scan of your abdomen and pelvis to see if the cancer has spread to the abdominal organs. He may also order a CT scan or a standard X-ray to see if the cancer has spread to the lungs. If your doctor suspects that the cancer has spread to the central nervous system (the brain and spinal cord), he or she may perform an magnetic resonance imaging (MRI). MRI uses magnets and radio waves to create images of the inside of the body.

Testicular cancer and testicular self-examination

According to many physicians, self-examination of the testicles should be performed immediately after a warm bath or shower, while standing, while the scrotum is relaxed. It is not difficult and only takes a few minutes. In order to self-test your testicles, you need to follow the few steps below.

1. Check every testicle. Gently but firmly roll each testicle between thumb and forefingers. Try to check the entire surface of the testicles. The firmness of the testicles should be the same everywhere. Don’t worry if one testicle is slightly larger than the other, that’s normal.
2. Find the epididymides and the vas deferens. They are soft, tubular structures above and behind the nucleus. These tubes collect and carry sperm. Check their condition.
3. Look for lumps, swelling, or anything that seems abnormal. The lumps or bumps are not normal (even if they aren’t causing you pain). Pain is also not normal.
4. Perform a self-examination of the testicles at least once a month. Always look for changes in the size, shape or texture of the testicles.

If we notice a lump or any change over time, we should seek medical attention. It may be nothing, but if it’s testicular cancer it can spread very quickly. Testicular cancer diagnosed early is curable. If you have any questions or concerns, talk to your urologist.

See also: Every man should have his testicles checked once a week. Doctors show

Testicular cancer – treatment

Treatment depends on several factors, including the patient’s health, stage of cancer, and type of tumor. For example, seminomas tend to grow slower and respond better to radiotherapy than non-seminomas. In turn, both types of testicular cancer tumors respond well to chemotherapy. In the event that testicular cancer includes seminoma and non-seminoma neoplasms equally, a specialist will treat it as a non-seminoma.

Testicular cancer – surgical treatment

Surgery to remove a cancerous testicle is the most common treatment for testicular cancer, regardless of the stage of the cancer or the type of tumor. In some cases, a doctor may also remove a patient’s lymph nodes.

1. Radical orchidectomy. This is nothing but the removal of the testicle to treat both seminoma and testicular cancer. During the procedure, an incision is made in the groin to remove the testicle with the tumor. In addition, blood vessels and lymph tissue are also closed to prevent the cancer from spreading from the tumor site to the rest of the body.
2. Retroperitoneal lymph node dissection (RPLND) removal. The procedure is performed depending on the stage of the cancer and the type of tumor. RPLND is more common in non-seminoma testicular cancers. During the procedure, the doctor makes an incision in the abdomen and removes the lymph nodes behind the abdominal organs. RPLND can be used to treat cancer as well as staging cancer.

The doctor may also perform surgery to remove any tumors that have spread to the patient’s lungs or liver.

Testicular cancer – radiation therapy

Radiotherapy uses high doses of X-rays to kill cancer cells. During radiotherapy, the patient is on a table with a large machine moving around him, which directs energy beams to precise points on his body.

Radiation may be applied after surgery to prevent the tumor from returning. Usually, radiation is limited to treating seminomas.

Unfortunately, there are some side effects associated with radiation therapy, which can include nausea and fatigue, as well as redness and irritation of the skin around the abdomen and groin. Radiotherapy may also temporarily reduce sperm count and may affect fertility in some men.

Testicular cancer – chemotherapy

Chemotherapy uses drugs such as cisplatin, bleomycin, and etoposide to kill cancer cells.

Depending on the cancer, you may receive chemotherapy instead of surgery. Chemotherapy can be used before RPLND surgery or after radical orchiectomy. Chemotherapy can also be used to treat cancer recurrences.

As with radiotherapy, chemotherapy also has some side effects that depend on the specific medications used. Common side effects include fatigue, nausea, hair loss, and an increased risk of infection. It should be added that medications and treatments are available that reduce some of the side effects of chemotherapy. Chemotherapy can also lead to infertility in some men, which in some cases may be permanent.

Treatment of testicular cancer in children

In the case of testicular tumors in children, early detection and treatment are successful. Unfortunately, tumors detected after they have spread are more difficult to heal. As with men, testicular cancer often begins as a painless lump. The most common type in young boys are yolk sac tumors and teratomas. Detected types of cancer cells in children.

1. Tumors of the yolk sac. When these tumors grow in adults, they are more dangerous.
2. Teratomas. These germ cells grow in an unpredictable manner and do not respond to chemotherapy. They can be treated surgically.
3. Gonadal stromal tumors. They are more prone to spread and require a chest x-ray if found.
4. Germ germ cell and dysgerminoma are rare. They happen in babies with testicles that did not grow normally before birth. Speaking of germ cell tumors, these tumors are usually benign (in 50% of cases they can become cancer).

The most common treatments for children are:

1. exploration of the inguinal canal. In this operation, an incision is made in the skin fold just above the pubic bone and the testicle is drawn out of the scrotum. The surgeon then looks at the gland to decide what to do next. The procedure is recommended for every child with a testicular tumor.
2. kernel sparing operation. The method is suitable for benign tumors. The doctor makes decisions based on the appearance of the tumor and the correct tumor markers. In this case, only the tumor tissue is removed, which is then sent for examination by a pathologist.
3. radical orchidectomy. Surgery to remove the testicle is necessary if the biopsy shows cancer. This method is also used in the case of high tumor marker scores, a large tumor and if a tumor is found after puberty.

If the cancer is more aggressive, RLND, radiotherapy or chemotherapy are also used.

After treatment, children are checked for at least two years to make sure everything is okay. Physical exams, tests for tumor markers, and chest x-rays are common follow-up examinations. Most often, boys do not look any different after the testicle has been removed. The scrotum is not cut and the other testicle is still growing. If your child feels uncomfortable with the removal of the testicle, a testicular prosthesis may be used (this is usually done after adolescence).

Most boys who have been treated for testicular cancer will be healthy and will be able to have children by the time they grow up.

See also: Testicular cancer attacks young men

Testicular cancer – management after treatment

It is estimated that it may take from two weeks to two months for complete recovery from an orchiectomy. In such cases, it is not advisable to lift weights over 5 kg for the first two weeks or have sex until the patient recovers. In addition, it is advisable to avoid physical activity such as exercise, sports and jogging for about four weeks after surgery.

Also check: Lifting weights helps rheumatism

Testicular cancer – relapse of the disease

The risk of testicular cancer recurrence depends on the stage of diagnosis, but is small (5% or less). There is also a very small (around 2%) risk of developing cancer in the other testicle.

However, you must learn to examine the testicles yourself. Regular check-ups with your urologist will also be important. How often and how long further care is needed depends on the individual case. If the cancer returns, your doctor will want to find and treat it quickly. Additional treatment depends on the type and location of the tumor.

Testicular cancer, sex life and fertility

Removal of one testicle should not affect the patient’s sexual life or fertility. While most men do not have erection problems after surgery, they still have a higher risk of infertility and low testosterone levels than others. Sometimes a short decrease in sperm growth is also observed.

Additionally, if lymph nodes are removed, it may be more difficult to ejaculate. However, this problem can be solved through the use of appropriate medications. Before undergoing testicular cancer treatment, it’s important to think about a sperm bank.

Over time, a healthy testicle and lymph nodes will produce enough testosterone to help the man return to normal. Your doctor may check your hormone levels annually as part of a checkup.

Also check: Men think it is too small and not working properly. What does the urologist say?

Testicular cancer and the risk of heart disease

Patients who have undergone radiation therapy and / or chemotherapy should pay attention to their heart health. Their risk of cardiovascular disease increases after treatment. Simple lifestyle changes can prevent problems. For example, you may find it helpful to exercise regularly, eat less processed foods, and quit smoking.

Also, be sure to check regularly to check your blood pressure, lipid and glucose levels.

See also: A blood test will show you if you are at risk of having a heart attack or stroke within four years. Important discovery