Testicular cancer is a malignant tumor or cancer that can develop in a man’s testicle from the germ cells. Clear causes leading to testicular cancer have not yet been scientifically proven. Testicular cancer can mostly be treated very well nowadays.
What is testicular cancer?
Schematic diagram showing the anatomy of the testis in testicular cancer. Click to enlarge. Testicular cancer is a malignant tumor that affects the male testicles. This develops from the same germ cells of the testicle from which sperm originate. About 95 percent of these tumors are malignant, but testicular cancer is quite a rare form of cancer in men. Only about two percent of cancers in men involve testicular cancer. Between the ages of 20 and 40, this disease occurs most frequently, with European men being affected significantly more often than men from Africa, for example. Why this is so, however, is not yet clearly understood. Typical of testicular cancer is a hard swelling of the testicles, which is usually painless. This can be easily felt by the patient. In most cases, it also enlarges; however, the process takes a long time. At this first, but clear sign, a doctor should always be consulted to rule out the disease. Other symptoms can also occur with testicular cancer, for example a reduced sexual desire, an enlargement of the male breast or the accumulation of a watery fluid around the testicle. If the disease is more advanced, problems such as back pain or shortness of breath may develop.
Causes
The causes of testicular cancer are still largely unexplained scientifically. Although testicular cancer is not hereditary, it can still be assumed that it is genetically predisposed. Testicular cancer also occurs more frequently in people who suffer from the so-called undescended testis. Normally, the testicle migrates from the abdominal cavity to the scrotum already at embryonic age. However, this can be disturbed by certain factors and the testicle remains in the abdomen or groin area – this condition is then called undescended testis and should be treated in surgery. Although this condition is easily curable, affected men have a significantly increased risk of developing testicular cancer. Testicular cancer usually affects only one testicle. Men who have already had testicular cancer on one side are naturally at risk of getting it on the other side of the testicle.
Symptoms, complaints and signs
For testicular cancer, there are a number of signs and symptoms that are important to know. The most common symptom is a nodule-like swelling or induration on the testicle that can be felt externally and usually does not cause pain. In most cases, this symptom occurs only on one side and not on both testicles at the same time. In addition, however, there may be other symptoms associated with testicular cancer. For example, many patients experience a vague feeling of heaviness in the testicle. As the disease progresses, pain may also occur, which is felt as a pulling sensation on one side and often radiates to the groin area. Furthermore, there may be an accumulation of fluid on the testicles. Because testicular cancer affects the production of the sex hormone testosterone, hormonal symptoms such as infertility or a decrease in libido, i.e. sexual desire, can also be signs. Unilateral or bilateral breast enlargement and pain in the mammary glands are also among these signs. In the advanced stages of testicular cancer, metastases may cause other nonspecific symptoms, such as shortness of breath or back pain, depending on the affected areas of the body.
Disease progression
If testicular cancer is detected in time, the course of the cancer is mostly favorable, since surgery or therapy almost always leads to a cure. However, if the disease is detected late and metastases may have already formed, the chance of cure decreases considerably. Nevertheless, the chance of survival is quite high due to chemotherapy and radiotherapy. In most cases, testicular cancer develops on one side. Only rarely are both halves of the testicle affected. Only if both testicles are affected and have to be removed with surgery, the patient is no longer capable of procreation.If only one testicle is affected, nothing will continue to stand in the way of the affected person’s desire to have children.
Complications
With early detection and appropriate treatment, the chances of cure are very high. On the other hand, if testicular cancer remains untreated, it leads to death. Especially in advanced stages, the disease can lead to complications. Symptoms worsen and pain becomes more severe. In addition, the therapy can cause side effects. As with any tumor, metastases can form, daughter tumors that spread to adjacent organs. These are usually associated with back pain and swelling of the lymph nodes in the adjacent region of the body. Further complications arise depending on the type of treatment. For example, if both testicles have to be removed, the male sex hormone has to be supplied artificially by means of medication. This is not the case if one side is removed, as it is still produced in sufficient quantities. In addition, chemotherapy can have a stressful effect on the entire body. In addition to hair loss, possible side effects include increased susceptibility to infections and emotional disturbances. Furthermore, impotence can occur if sperm production is impaired by chemotherapy. In many cases, the ability to conceive is only reduced for a certain period of time, but in some circumstances it may remain. The doctor will advise on any risks that may occur and how to prevent them before treatment.
When should you go to the doctor?
A visit to the doctor is advisable if there is pain or swelling in the testicle. If the testicle enlarges without an understandable reason, there is cause for concern. A doctor should be consulted before painkillers are taken. In case of sexual dysfunction, conspicuousness when touched or basically an unpleasant feeling in the scrotum, a check-up visit to a doctor should be made. If there is discoloration of the skin or other changes in the skin in the intimate area, it is advisable to consult a doctor. In case of behavioral abnormalities of the affected person, a feeling of illness, anxiety or panic attacks, a visit to the doctor is necessary. If existing complaints spread or increase in intensity, a medical examination should be initiated as soon as possible. Drawing pains in the abdomen, back pain or shortness of breath are warning signs that the disease is progressing. Since the patient’s premature demise is imminent without medical treatment, a physician should be consulted immediately. If there are unusual sensations in the intimate area during locomotion or if the affected person suffers from a feeling of tightness, a physician is needed to clarify the perceptions. If there are feelings of shame and disgust, as well as sudden partner conflicts, a doctor should be consulted.
Treatment and therapy
A variety of treatment options are available to treat testicular cancer. Surgery as well as radiation therapy or chemotherapy may be considered. The choice of appropriate treatment depends on the type of cancer or the stage in which the disease is located. In most cases, the affected testicle is removed during surgery. However, this removal of the testicle together with the epididymis and spermatic cord does not affect fertility and sexuality. Once this operation has been performed, the so-called surveillance strategy is applied and it is waited whether the cancer could be defeated. If this is not the case, radiation or chemotherapy may follow.
Outlook and prognosis
The outlook and prognosis for existing testicular cancer depends very much on the time of diagnosis. The earlier testicular cancer is detected, the better the chances of a complete cure. Those who opt for appropriate treatment at an early stage significantly increase their chances of recovery. In most cases, however, chemotherapy is essential. Overall, testicular cancer can be cured and treated very well. The survival rate is 96%, although medical treatment is essential. Otherwise, the chances of a complete cure decrease drastically. In the worst case, death is even imminent if the affected person completely forgoes medical treatment. If left untreated, the metastases multiply within a very short time, so that subsequent therapy is almost ineffective. In the further course, severe pain occurs, which can only be alleviated with appropriate medication.Generally, in case of testicular cancer, medical and drug treatment is mandatory. Without such treatment, testicular cancer disease cannot be cured.
Prevention
Preventive measures against testicular cancer are not known up to the present state of research. It is only important to see a doctor at the first signs, because the earlier testicular cancer is detected, the better the chances of cure. In the early stages, the chance of cure is almost 100 percent. However, even if the cancer is more advanced, the chances of cure are usually quite good for this type of cancer. As the only preventive measure, men should regularly palpate their testicles for any changes. This is especially true for men between the ages of 15 and 40, as this is the age when testicular cancer most commonly occurs. Scientifically could not be proven a prevention by frequent sexual intercourse or masturbation.
Aftercare
After therapy has been completed, close follow-up care is essential for testicular cancer. The treating physician will determine an individually coordinated procedure for this. As a rule, follow-up examinations take place at fixed intervals. In the first two years after completion of the therapy, the examinations take place every three months. In the following year, the frequency is extended to four months, and in the fourth and fifth years to half a year. Close monitoring is particularly important during the so-called “wait-to-see” therapy in the early tumor stage. Regular checks ensure that possible new tumor formations are detected early and other secondary diseases can be ruled out. Five years after the end of therapy, follow-up examinations at longer intervals are sufficient. Here, too, the attending physician decides on the individual case. Decisive factors here are the individual situation and the course of the disease. The stage of the tumor at the time of diagnosis should also not be neglected. The most important examinations after the end of therapy include general, comprehensive physical examinations. The tumor marker in the blood is also determined regularly. In order to detect possible neoplasms at an early stage, ultrasound examinations of the scrotum and X-rays of the lungs are standard. Computer tomography or magnetic resonance imaging of the abdomen is also recommended. The patient himself can equally help to detect possible complications in advance by regular palpation.
What you can do yourself
Testicular cancer always requires medical treatment. The chances of cure are very good here, although these can be additionally improved by the assistance of the affected patients. Thus, men should regularly palpate their testicles for changes. This improves the chances of detecting testicular cancer at an early stage, with a high chance of keeping the testicles fully functional even after treatment. Since the risk of testicular cancer is highest in cases of early testicular undescendancy or familial predisposition, self-examination should take place especially in these cases. This involves palpating the testicles for lumps and swellings while showering or bathing. If there is also a feeling of heaviness or pulling, as well as painful mammary glands, a doctor should be consulted urgently. If treated early, the cancer can be completely cured up to 95 percent of the time. However, if the doctor is consulted too late, it is possible that one or even both testicles may need to be removed. If family planning has not yet been completed, the semen can be frozen in a sperm bank prior to chemotherapy and radiation, in consultation with the doctor, so that it can be used again later for artificial insemination. Furthermore, condoms should be used for sexual intercourse during radiation and chemotherapy to prevent the chemotherapeutic agents from entering the partner’s cervix.
