The testicles are an egg-shaped pair of organs located just below the penis in men and covered with skin called the scrotum. Its job is to produce sperm and testosterone. Testicular cancer, on the other hand, is a type of cancer that originates from testicular reproductive cells and is seen in the testicle. Testicular cancer is most common in adult males. Its incidence in the community is 3 per 100,000 people.
Rarely, the disease can be seen in pre-adolescents. The cause is not known exactly. However, there are some risk factors. Failure to correct undescended testicles until the age of 10 in childhood may lead to testicular cancer. When there is cancer in one testicle, the risk increases in the other testicle. The risk is higher in men with testicular cancer in their father or brother than in the normal population. Those who have had orchitis, ie testicular inflammation, are at risk of developing testicular cancer. It has been reported in some publications that HIV infection can also lead to testicular cancer. Apart from the primary tumor of the testicle, different cancer types can metastasize to the testicle.
Symptoms of testicular cancer
The most common symptom is a generally painless swelling felt inside the testicle. The swelling is hard. There may be a feeling of heaviness in the scrotum. Sudden collection of fluid in the scrotum may also be another symptom. Occasionally, the mass may be painful. If the cancer has spread to the lymph nodes, there may be pain in the groin and back. Testicular cancer most often spreads to the lungs. In this case; chest pain, shortness of breath and cough may occur. It can cause lumps to form in different parts of the body. There are benign conditions other than cancer that causes swelling in the testicles. These; hernia, scrotum fluid (hydrocele), varicocele and spermotocele.
Early diagnosis in testicular cancer
Early diagnosis in testicular cancer can be made by examining himself intermittently and immediately consulting a doctor in case of abnormality. There is no need to check the testicles almost every day. When the scrotum is loose after a shower once a week, the consistency of the testicles can be checked with the help of two fingers. In case of asymmetry, mass and pain, a doctor should be consulted immediately.
Testicular cancer diagnosis
Noticing an abnormality in the testicle, the patient should go to a urologist. The urologist conducts a detailed physical examination and takes the history. The physician will first ask the patient for ultrasonography and tumor markers. If the disease is thought to have spread, chest radiography, abdominal and lung tomography may be requested. If the testicle needs to be removed with an operation, a biopsy is performed and sent for pathological examination. If spine or brain involvement is suspected, MRI may be requested.
Testicular tumors come in two types, seminoma and nonseminoma. Seminoma tumors have a better prognosis and respond well to radiotherapy and chemotherapy. Nonseminoma tumors (choriocarcinoma, embryonal carcinoma, yolk sac tumor, teratoma) behave differently according to the stages of the disease.
Stages of testicular cancer
Stage 1: The tumor is only in the testicle.
Stage 2: The cancer has spread to the lymph nodes in the abdominal area.
Stage 3: The cancer has spread to lymph nodes and lungs in distant regions, except for the lymph nodes in the abdomen.
Treatment in testicular cancer
Surgery, chemotherapy and radiotherapy treatments are applied according to the stage of the disease in testicular cancer. The recovery rate in testicular cancer is high. A prosthesis can be placed in patients whose testis is removed to correct the appearance impairment.
Testicular tumors can recur despite treatment. The probability of recurrence is highest in the first 2 years. Follow-up of the patient is done closely for at least 5 years. Since the risk of cancer in the intact testicle increases, the patient should examine himself well intermittently.
Removing one of the testicles does not affect the reproductive potential of the patient. However, reproductive functions may deteriorate after chemotherapy. The patient’s ability to discharge semen may be impaired.