TESTICULAR CANCER

diagram-of-testicular-cancerOverview

The testicles are a part of male reproductive system. These two egg shaped organs in adult males, are contained within a sac of skin called the scrotum, which hangs beneath the base of the penis.

The testicles manufacture the male hormones, most of which is testosterone. They also produce sperm. Sperm cells are carried from the testicles by the vas deferens to the seminal vesicles, where they are mixed with fluid produced by the prostate glands. During ejaculation, sperm cells, seminal vesicle fluid, and prostate fluid enter the urethra, the tube in the centre of the penis through which both urine and semen are passed.

Almost all testicular cancers start in the germ cells. The two main types of testicular germ cell tumors are seminomas and non-seminomas. These 2 types grow and spread differently and are treated differently. Non-seminomas tend to grow and spread more quickly than seminomas.

Testicular cancer is more common in men 25 to 35 years old.

Risk factors

Having had an Un-descended testicle.

Having had abnormal development of the testicle.

Having Klinefelter’s syndrome (a genetic disorder in males caused by having an extra X-chromosome). Males with this disorder may have larger than normal breasts, a lack of facial and body hair, and small testicles.

Age.

Signs and symptoms

A painful lump or swelling in either testicle.

A change in how the testicle feels.

A dull ache in the lower abdomen or groin.

A sudden built up of fluid in the scrotum.

Pain or discomfort in a testicle or in the scrotum.

Diagnosis as per modern science

Physical exam and history – An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. The testicles will be examined to check for lumps, swelling, or pain. A history of the patient’s health habits and past illnesses and treatments will also be taken.

Ultrasound – Procedures in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.

Serum tumor marker test- A procedure in which a sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumor markers.

The following 3 tumor markers are used to detect testicular cancer:

  • Alpha-fetoprotein (AFP).
  • Beta-human chorionic gonadotropin
  • Lactate dehydrogenase (LDH).

Radical inguinal orchiectomy and biopsy –A procedure to remove the entire testicle through an incision in the groin. A tissue sample from the testicle is then viewed under a microscope to check for cancer cells. The surgeon does not cut through the scrotum into the testicle to remove a sample of tissue for biopsy, because if cancer is present, this procedure could cause it to spread into the scrotum and lymph nodes.

Staging

Stage 0 – (Carcinoma in situ) Preinvasive germ cell cancer.

Stage I – No spread to lymph nodes or distant organs, and blood tests are normal.

Stage II – Cancer has spread to regional lymph nodes but not to lymph nodes in other parts of the body or to distant organs.

Nonbulky stage II – Spread to lymph nodes behind the abdominal cavity (retroperitoneal lymph nodes), and lymph nodes are not larger than 5cms.

Bulky stage II – Cancer has spread to 1 or more retroperitoneal lymph nodes, and they are larger than 5cms.

Stage III – Cancer has spread to distant lymph nodes and/or to distant organs, such as the lungs or liver.

Non-bulky stage III – Metastasis are limited to lymph nodes and lungs, and no mass is larger than 2 cms.

Bulky Stage III – There are large metastasis and lymph node metastases are larger than 2 cm. and/or cancer has spread to other organs, such as the liver or brain.


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