What Are the Symptoms and Treatment Methods of Testicular Cancer?

Testicles are essential organs of the male reproductive system, located in a skin sac called the scrotum behind the penis. They produce and store sperm and produce the main sex hormone, testosterone. Testicular cancer occurs due to uncontrolled growth and proliferation of cells within the testicles, forming tumors. It is one of the most common reproductive system cancers in men. Although it can progress without symptoms for a long time, it has one of the highest treatment success rates, making early diagnosis crucial.

What is Testicular Cancer?

Testicular cancer is a type of cancer commonly seen in males aged 15-35. It constitutes approximately 1% of all cancers in males. The testicles are made up of multiple cell types, and testicular cancers usually arise from the cancerous transformation of one of these cell types called germ cells. Testicular cancer can occur in both testicles, but it is most commonly found in the right testicle. One of the major risk factors is an undescended testicle.

Testicular cancers are classified into three types based on the type of cancerous cells: Type I, Type II, and Type III. Type I testicular germ cell tumors are seen in newborn male babies and children. Type II testicular cancer is generally seen in males aged 20-40. Type III testicular cancer, known as spermatocytic seminomas, arises from the uncontrolled growth and proliferation of type B spermatogonia cells and usually affects males over 50 years old.

In the past 50 years, there has been a significant increase in the incidence of testicular cancer. Particularly affecting young and middle-aged men, about 80% of testicular cancers can be easily treated with chemotherapy or surgical interventions compared to other cancers. If detected at an early stage, the success rate of treatment can reach up to 100%.

What are the Symptoms of Testicular Cancer?

Testicular cancer often does not show symptoms in the early stages. Common symptoms that may appear in later stages include:

• A feeling of discomfort similar to a pulling sensation in the scrotum
• Changes in testicle size
• Unexplained pain in the lower abdomen and groin
• Swelling and edema in the legs
• Shortness of breath, lung embolism, weight and appetite loss due to metastasis to other tissues and organs
• Breast enlargement similar to gynecomastia
• Persistent, unexplained infection in the epididymis or testicle
• Abnormal fluid accumulation in the scrotum
• Aching pain in the scrotum

What Causes Testicular Cancer?

The exact causes of testicular cancer are not clearly understood. However, several risk factors are thought to contribute to the development of the disease. These risk factors include:

• Undescended Testicle: This condition, particularly in male children, where the testicles do not descend into the scrotum, is a well-defined and significant risk factor, increasing the risk of testicular cancer by about 4 to 8 times.
• Family History: Individuals with family members who have had testicular cancer are at a 3 to 10 times higher risk.
• Atrophic Testis: This condition involves the testicle being smaller than normal. While not definitively linked to cancer, some studies suggest a high cancer risk, particularly when combined with undescended testicles.
• Hormonal Factors: Testicular cancers often appear during the peak of sexual activity and hormone release, suggesting a possible hormonal influence. Studies also indicate higher cancer risks in male children of mothers who underwent estrogen treatment.
• Exposure to Chemicals: Exposure to agricultural chemicals and related toxicities is also considered a risk factor.

Stages of Testicular Cancer

Determining the stage of testicular cancer is crucial for both accurate diagnosis and effective treatment planning. This staging helps exclude ineffective treatments, thus saving the patient valuable time. The stages of testicular cancer are as follows:

• Stage 1: Cancer cells are localized within the testicle and have not spread. Tumor markers in blood tests are elevated.
• Stage 2: Cancer cells have spread outside the testicle, particularly to the abdominal lymph nodes. Tumor markers are moderately elevated.
• Stage 3: Cancer cells have metastasized beyond the abdomen to areas like the lungs. Imaging tests can confirm this stage, with tumor markers highly elevated in blood tests.

How is Testicular Cancer Diagnosed?

Both imaging and invasive methods are used for diagnosing testicular cancer. Diagnostic methods include:

• Physical Examination: Detects palpable masses in the testicles, usually painless unless manipulated.
• Ultrasonography: Uses sound waves to produce images, providing information on lesion size and location.
• Computed Tomography (CT): Uses X-rays for detailed staging of testicular cancer.
• Magnetic Resonance Imaging (MRI): Offers detailed images using magnetic fields, more specific than ultrasonography but costlier.
• Serum Markers: Elevated levels of Alpha Fetoprotein (AFP), β-hCG, and lactate dehydrogenase (LDH) in blood help in diagnosis and monitoring.
• Biopsy: Involves surgical removal (orchiectomy) and biopsy of the testicle, essential for confirming the diagnosis and determining the cancer type and stage.

How is Testicular Cancer Treated?

The treatment for testicular cancer depends on the stage of the disease and its spread within the body. The main goal is to eliminate uncontrolled growing cells and prevent further spread. If the cancer cells are localized in the testis and have not spread, a procedure called radical orchiectomy, where the testicle is removed, is performed. After orchiectomy, radiotherapy and chemotherapy might be considered depending on the case.

If the cancer has not spread significantly or has spread to nearby areas like the abdomen, radiotherapy is an option. For stage II cancer, chemotherapy, which involves using drugs to kill cancer cells, is preferred. Chemotherapy is also used for stage III cancer, though the process is more prolonged.

Testicular cancer often progresses without initial symptoms, making early detection crucial. Early diagnosis significantly increases the chances of successful treatment. Regular check-ups and tests at the nearest health facilities can help determine if you are at risk.