All about testicular cancer

Although this type of cancer can occur at any age, it is more prevalent in young adult men, especially between the ages of 18 and 35

BENGALURU: Testicles are an important part of the male reproductive system and are located inside a sac called the scrotum. They make the hormones such as testosterone and sperms fertilise a female egg cell to start a pregnancy. It starts in the cells of the testicles (testes). The most common (more than 90 per cent) type of testicular cancer is called germ cell tumour. 

Testicular cancer in young adults

Although testicular cancer can occur at any age, it is more prevalent in young adult men (especially between ages 18 to 35 years) and constitutes less than one per cent of all adult cancers. Testicular cancer is not talked about as it is not very common. In India, it constitutes 0.3 per cent of all cancers and ranks 31 among all cancers. 

Watch out for 

• A lump in either testicle
• Heaviness in the scrotum
• Pain in the abdomen
• Pain in the testicle or the scrotum
• Enlargement of the breasts. It may rarely cause symptoms like breast enlargement due to the release of hormones. 
• In advanced stages, patients can present with back pain, cough and breathlessness due to spread to the lungs. 

Risk Factors

There are not many known risk factors leading to testicular cancer. Some risk factors include the history of undescended testis at birth, abnormal testicle development, family history of testicular cancer, and some rare inherited diseases. Prior injury to the testicles, though blamed many times, is not a proven risk factor.

Diagnosis

Sometimes, testicular cancer is self-detected by men either unintentionally or through testicular self-examination. In other cases, it is usually detected by your doctor during a routine physical exam. Testicular cancer typically presents in young males with a lump or swelling in the testicles. To confirm if the lump is testicular cancer, your doctor may order a testicular ultrasound test, and certain blood tests to detect the presence and levels of tumour markers in your blood. Checking blood for tumour markers like alpha-fetoprotein (AFP), beta HCG and LDH help in the diagnosis and staging.

Medical Treatment

The treatment of testicular cancers involves surgery and removal of the affected testis. If the lump on your testicle is diagnosed to be cancerous, a surgery called radical inguinal orchiectomy may be performed to remove the cancer affected testicle. In some cases, nearby lymph nodes are also removed using a procedure called retroperitoneal lymph node dissection. Alternative treatments such as radiation therapy, or chemotherapy may be recommended before or after surgery. The cure rates after appropriate treatment in testicular cancers are very good.

Usually, testicular cancer affects one testicle, and the other testicle can produce enough male hormone, testosterone, for a future normal healthy life. But in some patients, infertility can be a side effect due to cancer or its treatment, and this should always be discussed while planning treatment. 

Importance of self-examination

It is not clear if testicular cancer is preventable. However, it can be detected in its early stages by doing regular testicle self-examinations. You can discuss with your doctor how testicular self-examination is performed. It is a simple and painless test and takes just a minute. 

Doing the testicular self-examination in front of the mirror may be helpful. Since testicular cancer is relatively rare, in case you find a lump, don’t panic. Consult your doctor for a prompt diagnosis.

• Check your testicles one at a time. 
• Using fingers and thumb, gently roll the testicle and feel for lumps or swelling. 
• Also, look for any changes in the testicular shape and size. 

(The writer is HOD and consultant - medical oncology, Manipal Hospital Old Airport Road)