Testicular cancer 👨‍⚕️ how to recognize the symptoms!
Testicular cancer 👨‍⚕️ how to recognize the symptoms!

Testicular cancer is a rare, malignant disease of the male sex organ. Since there are no preventive medical check-ups, regular testing of the testicles plays an important role in detecting the tumor. How can you palpate testicular cancer and what other symptoms can occur? What are the therapy options, is the fertility impaired by an operation and what are the chances of survival? You can read that and more here.

What is testicular cancer?

Testicular cancer – also testicular tumor or testicular carcinoma – is a malignant (malignant) change in the testicles (scrotum). This can be distinguished from benign changes, such as inflammation of the epididymis (epididymitis) or accumulation of fluid in the testicles (hydrocele testis).

In the case of malignant testicular tumors, a distinction is made between seminoma and the group of non-seminomas. Seminomas develop from the sperm-producing germ cells (spermatogonia) in men. In the case of non-semiomas, further forms are subdivided. Depending on their origin (yolk sac tumor, teratoma, choriocarcinoma, stromal tumor or embryonic cell carcinoma). The distinction between the two forms of testicular cancer is made by examining the affected tissue under the microscope. The classification is particularly relevant because the forms differ in terms of therapy and prognosis.

How common are testicular tumors?

Hardly more than 4,000 men were diagnosed with testicular cancer in Germany in 2018. In the same year, on the other hand, more than 35,000 men were diagnosed with lung cancer. This comparison is intended to illustrate the rarity of the disease.

At what age do you get testicular cancer?

Testicular cancer mainly occurs between the ages of 25 and 45. Which is relatively early compared to other types of cancer. In addition, there is a second frequency peak from the age of 70.

However, testicular cancer can also occur in infancy. For example, yolk sac tumor, a subtype of non-seminomas. Is the most common testicular tumor in children under the age of three.

Causes

There are certain risk factors that can increase the likelihood of developing testicular cancer. These include:

undescended testicles (maldescensus testis)

Testicular cancer in the family (especially in the parents or siblings)

previous testicular cancer on the other testicle

Undescended testicles are characterized by the fact that the testicles are not in the scrotum. But outside of it, for example in the inguinal canal (groin testicles) or even in the abdomen (abdominal testicles). The wrong position of the testicles is caused by the fact that they usually migrate. From the abdomen to their final position in the scrotum before birth. If the scrotum is still empty after birth, the affected testicle often moves into its natural position. On its own over the course of the first year.

However, if the process is not yet complete by the end of the first year of life. Then surgery is usually used to help. The increased temperature in the abdomen. Compared to the cooler temperatures in the scrotum increases the risk of malignant degeneration of the tissue and can therefore be a cause of testicular cancer. However, a smaller but still increased risk of testicular cancer remains even after corrective surgery.

According to current research, carrying a mobile phone in your pocket does not appear to be a risk factor for the development of testicular cancer.

Symptoms

Although testicular cancer is a rare disease, regular examination of the testicles plays a crucial role in detecting changes at an early stage, especially if one or more of the risk factors mentioned above are present.

Testicular cancer symptoms:

Appearance: Testicular cancer often causes unilateral enlargement of the testicle.

Pain: This enlargement is usually painless, but there can also be accompanying testicular pain.

Palpable Hardening: The testicle may feel hardened in testicular cancer. A hard lump inside the scrotum can also be an indication.

Pulling and heaviness: Occasionally there may be a feeling of tightness and heaviness in a testicle or groin.

However, the signs mentioned are not specific to testicular cancer, they can also occur with benign changes in the testicles. These can only be clearly distinguished from malignant tumors by special examinations.

Excessive hormone production can also cause unilateral or bilateral breast enlargement (gynaecomastia).

Occasionally, the testicular tumor can only be noticed through the symptoms caused by the secondary tumors (metastases). These symptoms can include, for example, back pain caused by metastases in the spine.

How do you know if you have testicular cancer?

The signs already explained are best recognized by regular palpation of both testicles. This allows you to feel the testicular cancer in yourself in some cases. If any abnormalities occur during scanning, it is advisable to consult a urologist as soon as possible.

Unlike, for example, colon, skin or prostate cancer, there is no special check-up for this type of cancer. Self-examination is therefore the most important precaution.

How fast does testicular cancer grow?

Malignant testicular tumors have a tumor doubling time of 10 to 30 days. This means that the tumors can double in size within this time. Testicular tumors grow very quickly compared to many other types of cancer. This also explains why a change in appearance or abnormal tactile findings should promptly be examined by a doctor.

Testicular cancer is divided into different stages. In the current “Lugano classification” one speaks of stage 1 if all lymph nodes are cancer-free. If lymph nodes are already affected, this is stage 2. Stage 3 is when metastases affect not only the lymph nodes in the area, but also more distant lymph nodes, other organs or the bone.

However, there are other classifications that can be used to determine the stage of the cancer somewhat differently.

Diagnosis and tests

If you go to a urological practice with a change in the testicles. The affected testicles are first inspected and palpated.

An ultrasound examination of the testicles can be carried out as further diagnostics. In addition, special tumor markers (α1-fetoprotein (AFP) and human chorionic gonadotropin (β-HCG)) can be determined with the help of a blood test.

Tissue removed during the operation can be examined under the microscope. To confirm the presence of testicular cancer and to plan further surgical procedures. This procedure is referred to as a “quick cut”. In further examinations under the microscope, the type of tumor (seminoma or non-seminoma) can also be determined. Imaging methods such as magnetic resonance imaging (MRI), computed tomography (CT) and X-rays also help in the search for possible metastases.

Testicular cancer treatment

Malignant testicular tumors should usually be surgically removed. Surgery usually involves unilateral removal of the testicles (orchiectomy).

If certain risk factors are present (small testicles, malposition of the testicles, functional impairment of the testicles or age under 40), tissue (biopsy) of the unaffected testicle can also be taken in some cases to examine it for malignant cells.

Even if the removal of a testicle does not necessarily result in infertility. Freezing sperm (sperm conservation) before treatment is recommended if you later want to have children. In addition, after the testicles have been removed, a so-called “testicle prosthesis”. Can also be used, which, however, fulfills a purely optical function.

Depending on the type of tumor and the stage of the tumor in which the affected person is. There are various additional treatment methods that must be decided on individually in each case:

In some cases, so-called “active surveillance” is recommended, in which regular check-ups are carried out. But no further treatment measures are initially initiated. This option is suitable, for example, depending on the tumor size and the extent of the tumor in stage 1 (according to the Lugano classification).

Complementary chemotherapy can also be carried out.

A third option is to treat testicular cancer with radiation (radiation therapy).

What are the chances of surviving testicular cancer?

Fortunately, testicular cancer is one of those cancers that have a relatively good prognosis. However, the individual chance of survival with this cancer depends on the stage one is in and what type of tumor shows up under the microscope (seminoma or non-seminoma). In non-seminomas, metastases are often already present at the time of diagnosis, so they have a worse overall prognosis than seminomas. The occurrence of metastases can also significantly reduce life expectancy without treatment.

In the early stages of the disease without distant metastases, the 5-year survival rate is 90 to 97 percent. The prognosis has greatly improved, particularly with the introduction of chemotherapy as a treatment option.

The chances of recovery worsen when distant metastases are present. This term refers to secondary tumors that are not in the vicinity of the tumor or in its surrounding lymph nodes, but further away, for example in the spine or abdominal organs. The lungs are particularly frequently affected by metastases, but in the case of testicular cancer, lung metastases do not significantly worsen the prognosis.

The 5-year survival rate for distant metastases outside the lungs is 50 to 80 percent, depending on the type of tumor. This means that even in these tumor stages, up to 80 percent of those affected survive the first five years after diagnosis.

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Vogue Health Team

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