Overview – What is it?
Testicular cancer is a type of cancer that begins in the tissue of one or both testicles. Testicles (also known as the testes) are two egg-shaped glands, inside a sac-like pouch (scrotum) which is part of the male reproductive system. Sperm and testosterone are produced in these glands.
Testicular cancer can be caused by abnormal development of the testicles, undescended testicles and family history, among other factors.
Some of the symptoms of this cancer are a lump in the testicle, back pain and enlargement and tenderness of the breasts.
It can be diagnosed through blood tests, imaging tests and by carrying out a biopsy. The treatment for this cancer can be done by the use of surgery, radiotherapy and chemotherapy, among other treatment options.
Causes – What causes it?
Testicular cancer occurs when normal healthy cells in the testicles become altered, causing them to grow rapidly and uncontrollably which leads to the formation of a mass in one or both testicles. In most cases, testicular cancer begins in the germ cells which produce immature sperm. The common types of germ cell testicular cancer are:
- Seminoma which is a slow-growing form of testicular cancer that can spread to the lymph nodes near the testicles and is very sensitive to radiation therapy.
- Non-seminoma tumours which, grow and spread faster than seminomas.
The risk factors for this cancer are:
- Cryptorchidism: This occurs when testicles do not descend into the scrotum before birth. This puts a man at a higher risk of developing testicular cancer, even if the testicles have been relocated surgically.
- Abnormal development of testicles: Conditions such as Klinefelter Syndrome, cause the testicles to develop abnormally which can increase the risk of testicular cancer.
- Personal history with testicular cancer: A man who has had this cancer is at an increased risk of having the cancer again.
- Family history: If you have a close family member who has had testicular cancer, your risk of developing the same cancer is increased.
- Certain health conditions: People with some health conditions such a HIV/AIDs are at increased risk of this condition due to their compromised immunity. Mumps orchitis (a condition that causes inflammation of the testicles) also increases testicular cancer risk. Having a hernia in the groin also increases testicular cancer risk.
- Age: Men between 15-44 years are at an increased risk of this cancer, however, older men can also get testicular cancer.
Symptoms – What do you feel?
This cancer may not cause any symptoms in its early stage and in most cases, men find the cancer themselves or it is found during a routine physical exam. Some of the symptoms that you should look out for are:
- Painless lump or swelling in the testicles,
- Discomfort in the testicles or scrotum,
- Pain in the testicle or scrotum,
- Feeling a heaviness in the scrotum,
- Enlargement or tenderness of the breasts,
- Sudden accumulation of fluid in the scrotum,
- Dull ache in the lower back, abdomen or groin, and
- Unexplained fatigue.
In rare cases, when testicular cancer travels to other parts of the body, a person can experience:
- Breathing difficulties,
- Difficulty swallowing,
- Coughing, and
- Chest swelling.
Diagnosis – How do you diagnose it?
If you notice any abnormalities in your testes, it is advisable to see a doctor as soon as possible. The different ways through which testicular cancer can be diagnosed include:
- Physical exam: This is done during the initial consultation when the doctor finds out your symptoms, your medical history as well as that of your family. This examination involves examining the testicles to feel for any abnormalities such as swelling or the presence of a lump. A small light or torch can be held near the scrotum to determine whether light passes through it, because when fluid collects in the scrotum, it allows light to pass through it.
- Imaging tests: These include CT (computerised tomography), MRI (magnetic resonance imaging) scans and ultrasound which are used to give images of the inside of the scrotum and testicles which help in identifying any abnormalities such as a lump in the testicle. A chest x-ray can be done to check whether the cancer has spread to the chest or a full body scan can be done to check whether it has spread to other parts of the body as well.
- Blood tests: These are done to determine the level of tumour markers in your blood. Having a higher level of tumour markers can indicate the presence of cancer although it might not necessarily indicate that you have cancer.
- Biopsy: The tumour in the testicle is removed and examined under a microscope for cancer cells.
- Orchiectomy: This involves the removal of the entire testicle, after which the lump inside the testicle is examined to determine whether it is cancerous and if it is, it can be determined what type testicular of cancer you have.
Treatment – How do you treat it?
The various treatments that can be done for testicular cancer include:
- Surgery: This involves removal of the tumour or the entire testicle and it is the most common treatment for this cancer. The types of surgeries done for testicular cancer are:
- Biopsy to remove the tumour in the testicle,
- Radical inguinal orchiectomy to remove the entire testicle that is affected by the cancer, and
- Retroperitoneal lymph node dissection which involves removing nearby lymph nodes and at the same time avoiding damage to the surrounding nerves.
- Chemotherapy: The use of anti-cancer drugs to kill cancer cells.
- Radiation therapy: This treatment involves administering high energy-beams to the affected area to destroy the cancer cells, preventing them from growing further.
- Fertility treatment: As a result of the treatment of testicular cancer, some men are unable to produce sperm. Therefore, sperm can be harvested from the patient before treatment and stored in a sperm bank to enable them have children even after the treatment.
Prevention – How do you prevent it?
There is no specific way to prevent testicular cancer, however you can reduce your risk factors by:
- Getting regular check-up or doing a testicular self-exam,
- Avoiding exposure to chemical toxins,
- Eating a healthy, well-balanced diet rich in vegetables and fruits,
- Exercising regularly,
- Taking nutritional supplements like medicinal mushrooms,
- Reducing stress, and
- Detoxifying and protecting your liver.