The testicles are two male reproductive glands located inside the scrotum, a loose pouch of skin that hangs below the penis. The testicles produce male sex hormones, such as testosterone, and sperm.
Testicular cancer can affect reproductive health and, in some cases, can cause infertility. It is important to note that most lumps in the testicles are not cancerous, but it is essential to consult a doctor for an accurate diagnosis.
Testicular cancer develops when cells in one or both testicles grow abnormally and uncontrollably, forming a tumor. Testicular cancer, if left untreated, can spread to other parts of the body. Therefore, early detection and timely treatment are essential for a better prognosis.
Symptoms of testicular cancer
It is important to note that these symptoms can vary in their presentation and not all men with testicular cancer experience them. Among the most frequent symptoms and signs are:
A lump or swelling in either testicle:
this is the most common symptom. The lump may be painless or cause a feeling of heaviness.
Dull pain in the abdomen or groin:
this may be a sign that the cancer has spread to nearby lymph nodes.
Sensation of heaviness in the scrotum.
Pain or discomfort in a testicle or in the scrotum:
the pain can be sharp or dull and can vary in intensity.
Breast enlargement or tenderness:
in some cases, testicular cancer can produce hormones that cause changes in the breasts.
Lower back pain:
this may be a sign that the cancer has spread to other parts of the body.
Classification of testicular cancer
Testicular cancer originates in germ cells, which are the cells in the testicles that produce sperm. There are different types of testicular cancer, and classifying them is essential for determining the most appropriate treatment and the prognosis of the disease. The main types of testicular cancer are seminomas and non-seminomas.
Seminomas: they are the most common type of testicular cancer, accounting for about 50% of cases. They tend to grow slowly and are highly sensitive to radiotherapy and chemotherapy.
Non-seminomas: this group encompasses several subtypes of testicular cancer, which tend to grow and spread more rapidly than seminomas. Some of the most common subtypes are:
Embryonal carcinoma: it is the most common subtype of non-seminoma. This is an aggressive type of testicular cancer that often occurs in combination with other non-seminoma subtypes.
Teratoma: this tumor is composed of different types of tissues, such as hair, muscle, and bone. It can be benign or malignant.
Choriocarcinoma: it is a rare but fast-growing and highly malignant type of testicular cancer.
Yolk sac tumor: it is the most common type of testicular cancer in children, but it can also occur in adults.
Accurate classification of the type of testicular cancer and its stage is crucial for determining the most effective treatment plan.
Causes of testicular cancer
The exact causes of testicular cancer are not fully known. However, certain factors have been identified that can increase the risk of developing the disease.
There are certain factors that can increase the risk of developing this disease. It is important to note that the presence of these factors does not necessarily mean that a person will develop testicular cancer, but rather that they have a higher probability compared to the general population. Some of the most known risk factors are:
Cryptorchidism (undescended testicle): it is a condition in which one or both testicles do not descend into the scrotum during fetal development. This factor significantly increases the risk of testicular cancer, especially in the affected testicle. Surgical correction of cryptorchidism is recommended, ideally in childhood, to reduce this risk.
Family history of testicular cancer: having a father or brother with testicular cancer increases the risk of developing the disease. If there is a family history, it is essential to perform regular testicular self-examinations and consult a doctor if any abnormality is detected.
Klinefelter syndrome: this genetic syndrome is characterized by the presence of an extra X chromosome in men. Men with Klinefelter syndrome often have smaller testicles and reduced testosterone production, which increases their risk of testicular cancer and other health problems.
White race: testicular cancer is more common in white men than in men of other races. The exact reasons for this racial disparity are unknown, but genetic and environmental factors are being investigated as possible contributors.
It is important to note that most men diagnosed with testicular cancer have no identifiable risk factors. However, knowing these risk factors can help people make informed decisions about their health and seek early medical attention if they experience any symptoms or abnormalities in the testicles.
Complications of testicular cancer
Without proper treatment, testicular cancer can lead to a number of complications that affect the patient’s health and quality of life.
If left untreated, testicular cancer can spread (metastasize) to other parts of the body, such as the lymph nodes, lungs, liver, and brain.
Infertility can also be a complication of testicular cancer treatment. It is crucial to seek medical attention if the disease is suspected in order to avoid complications.
Diagnosis of testicular cancer
Diagnosing testicular cancer involves a series of tests and procedures to confirm the presence of the disease and determine its stage.
Physical examination: the doctor will feel the testicles to detect any lumps, swelling, or other abnormalities.
Testicular ultrasound: it is an imaging test that uses sound waves to visualize the inside of the scrotum and testicles, allowing for the presence of tumors to be identified.
Blood tests: blood tests are performed to measure levels of tumor markers, such as alpha-fetoprotein (AFP), beta human chorionic gonadotropin (β-hCG), and lactate dehydrogenase (LDH), which may be elevated in the presence of testicular cancer.
Biopsy: in some cases, a biopsy may be performed to remove a tissue sample from the testicle and examine it under a microscope to confirm the diagnosis. The biopsy is performed through a small incision in the scrotum or via laparoscopy.
Once the diagnosis is confirmed, additional tests are performed to determine the stage (extent) of the cancer. These tests may include computed tomography (CT) scans of the chest, abdomen, and pelvis, as well as a bone scan.
Testicular cancer treatment
The treatment of testicular cancer depends on the type and stage of the disease, as well as the patient’s overall health. Treatment options include:
Active surveillance: in some cases, especially in early stages, active surveillance may be chosen, which involves regular follow-up with physical examinations, blood tests, and imaging tests to monitor the progression of the disease.
Chemotherapy: it uses medications to destroy cancer cells. It can be administered before or after surgery, depending on the stage and type of cancer.
Radiotherapy: it uses high-energy radiation to destroy cancer cells. It can be used to treat testicular cancer that has spread to the lymph nodes.
Radical inguinal orchiectomy: it is the surgical removal of the affected testicle and spermatic cord through an incision in the groin. It is the most common initial treatment for testicular cancer.
Remember that this article is for informational purposes only and does not replace professional medical advice. If you suspect you have testicular cancer, consult a specialist to obtain an accurate diagnosis and a treatment plan tailored to your needs.
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