'Cancer' is a word which attracts instant attention enlaced with confusion and scare, and when it is
associated with testes, it has to garner interest and attention for every man out there! Let us understand
more on how a disease like 'cancercan associate with our reproductive organ and disrupt peace and reproduction
of our happiness.
'Testes' or 'Testicles' are actually glands that form a
functional part of the male reproductive system, that
are placed just outside the body in scrotum. The two
main functions of the testes are.
1.Spermatogenesis (Production of sperms)
2. Production of androgens (Testosterone and
Dihydrotestosterone)
Testes play an important role in normal development and maintenance of male reproductive
organs along with development of male characteristics. The normal functioning of testes is
under control of gonadotropic hormones produced by pituitary, namely, follicle. stimulating
hormone (FSH) and luteinising hormone (LH). FSH controls the process of spermatogenesis and
LH controls the production of testosterone by the testes.
Apart from playing an important role during puberty of a man into adulthood, testosterone is also responsible
for development of secondary sexual characteristics such as:
Facial and body hair
Deep voice
Bone density
Muscle development (strength and mass)
Getting an erection
Libido (sex drive)
Testes also produce a hormone called 'inhibin', which regulates the levels of FSH and LH in conjunction
with testosterone.
Testicular Cancer and Its Types
Testicular cancer is an uncontrolled and abnormal growth of one or more types of healthy cells in the
testes forming a 'tumour'. Most common (95% of the cases) type of testicular cancer is known as 'germ
cell testicular cancer', that develops into germ cells that help in production of sperms. The two main
subtypes of germ cell testicular cancer are!
1. Seminomas : Account for around 40-45% of all germ cell testicular cancers
2. Non-seminomas : Account for around 40-45% of all germ cell testicular cancers
Although both seminomas and non-seminomas tend to respond well to chemotherapy treatment, nonseminomas
usually tend to be more dangerous than seminomas due to their quick growth and tendency to spread. A few
types of non-seminoma cancers include teratoma, embryonal carcinoma, choriocarcinoma and yolk sae tumours.
Less common types of testicular cancer are Leydig cell tumours (account for around 13% of the cases),
Sertoli cell tumours (1% of the cases). Lymphoma (4% of the cases) and carcinoma of the rete testis
(a part of the testes).
Statistics of Testicular Cancer
The occurrence of testicular cancer is relatively rare and uncommon. It usually accounts for about 1% of
cancers that affect men. It is unusual in its fact that it generally targets younger men and is actually
the most common cancer that affects men in the age group of 15-49 .
Symptoms of Testicular Cancer
A lot of men wouldn't even have a clue, what to look for if asked to check their testes. Being aware is
the key to catching this menace before it turns out to be devastating. Following are a few symptoms to
watch for:
- Painless lump or swelling in a part of the testicle
- Discomfort, dull ache or sharp pain in the testicle or scrotum, may be intermittent
- Change in shape and size of the testes
- Gynecomastia (enlargement and/or tenderness of the breasts in men, rare and usually occurs in later stages of cancer)
- Sudden buildup of fluid in the scrotum (Hydrocoele)
Risk factors for Testicular Cancer
Although, there are no definite causes or risk factors directly associated with testicular cancer, a few
factors do increase your risk of developing it; they are:
Undescended testicles
It is one of the most significant risk factors associated with the development of testicular cancer. Testes are
formed in the abdomen and descend into the scrotum just before birth or during the first year of its life. However,
in some babies the testicle or testes fail to descend and has to be surgically moved down into the scrotum. Research
has found that patients who undergo this surgery are at an increased risk of developing testicular cancer.
Familial
history People who have had other close members in their family tree diagnosed with testicular cancer are predisposed
to the risk of developing it. If your father has suffered with it, you are 6 times more likely to develop this cancer
than a person with no familial history.
Fertility issues fertility problems in men have been associated with an
increased risk of testicular cancer. Although not entirely known, it is thought to be the case due
to the common risk factors shared between them.
Age
Although it can occur at any age, teens and younger men in the age group of 20 to 35 are at an increased
risk of developing testicular cancer.
Inguinal hernia Patients with inguinal hernia (a condition where a
portion of small intestine or a soft tissue enters the inguinal canal) are more prone to develop testicular
cancer
Congenital abnormalities
Being born with defective abnormalities of kidneys, penis or testes raises an individuals risk of testicular
cancer. Also, some genetic disorders or abnormalities that lead to defective development of testes may increase
a person's risk.
Smoking
Research suggests that long-term smokers are twice as likely to develop testicular cancer
as compared to nonsmoker's.
HIV and AIDS Men suffering with HIV or AIDS have an increased risk of developing
testicular cancer.
Diagnosis of Testicular Cancer
Diagnosis of any cancer forms a crucial step towards
treating it . Earlier the diagnosis, better are the chances of a complete recovery
There are a few options available to diagnose testicular cancer at its early stages. A
clinician may opt for a test taking into consideration the age of the patient, medical
condition, signs and symptoms presented.
Physical examination
It is the first step
towards diagnosing this type of cancer, where the physician may examine the testes
for any signs of swelling, fluid buildup, tenderness or hardening. The doctor may
also examine for any enlarged lymph nodes in other areas of the body.
Ultrasound
Ultrasound is the modality which employs sound waves to create an image by bouncing
them off the internal tissues/organs. These images help the physician to detect any
abnormal growth or lump in the tissue.
blood tests in Testicular cancers
If any abnormalities are detected,
the blood of the individual is examined for any 'biomarkers' produced by the tumours.
These tumour markers' are proteins that are produced at abnormally high levels in the
affected person's blood. Different cancer types produce different markers, however there
might be a few biomarkers that overlap in more than one cancer type. The following markers
are commonly used for testicular cancers
>> Alpha-fetoprotein (AFP)
>> Human Chorionic Gonadotropin (Beta hCG)
>> Lactate dehydrogenase (LDH).
Not all the cancers produce all the markers and a few cancers may not even produce any of the above
biomarkers. In some cases, it is quite possible to have high level of these markers without having cancer.
Biopsy
A biopsy may be performed to diagnose if the tumour is cancerous or not. In this, a small tissue sample
of the suspected tumour is excised and examined for 'malignancy' ability to be cancerous and spread to the
other parts of the body).
Once the cancer is found, more advanced imaging technologies could be used for
diagnosis of the level of the spread to distant organs, which may include X- rays, CT scan, MRI and PET-CT
combined with biopsy.
Treatment of Testicular cancer
Stages of the cancer decide the treatment modality to be used. The common treatment options available for testicular
cancer are surgery, radiation therapy and chemotherapy
- Surgery is usually referred to as 'orchiectomy', which refers to removal of testicle to prevent the
tumour from spreading to other parts of the body.
- Radiation therapy involves use of high-energy X
rays targeted towards killing the cancer cells by
destroying their DNA and their capability to divide.
- Chemotherapy entails usage of chemicals, gener
ally medications aimed at preventing cancer cells from dividing and reproducing, and is generally
used for advanced stages of cancer
Nowadays a multidisciplinary approach is followed for cancer treatments, which uses a combination of either
of the treatment modalities mentioned above, and generally yields better recovery from the disease.
There are certain side-effects of radiation and chemotherapy such as nausea, hair loss, loss of appetite, tiredness,
rashes, muscle and joint stiffness, vomiting, sores, etc., that depend on various factors including cancer's stage,
overall health of the individual, length of the treatment and the dosages used. Side-effects could range from mild
to severe, but they can be managed and controlled very well today
With medical science touching new frontiers and new drugs being discovered, clinical trials are held to test
their efficacy and pharmacokinetics. Some doctors may advise the patients to participate in some clinical trials
that are a part of such cancer research, where new cancer drugs are tested for their suitability.
Coping with Testicular Cancer
Testicular cancer or for that matter any cancer may have effects that transcend the physical barrier, affecting
the social and emotional side-effects. Coming to terms with such a dreadful menace itself can be difficult, but
every individual may deal with the ensuing emotional challenges in their own way. Feelings of being scared and
anxious of the future may never leave oneself, but acceptance of the same and having a plan to
Make yourself aware
Read about testicular cancer, its diagnosis and treatment options available, and discuss them with your
clinician.
Take good care of yourself
Making healthy choices in food and lifestyle, avoiding smoking or unnecessary stress and good rest does
help in preparing for the 'bout'.
Talk to your family and friends
Strong support from your family and friends and acknowledging that you are not alone in this fight makes a
huge difference to your approach in fighting and healing from testicular cancer: '
Counselling (Medical and Psychological)
Talk to your medical professional to evaluate appropriate treatment options available for you. Understand
the side-effects and dealing with them from experienced professionals. Talking to testicular cancer survivors
can be very encour aging and tips from them may help you in dealing with various aspects of this disease.'deal with
it positively can go a long way in one's fight with cancer
Infertility may be inevitable in many cases, that may affect one's chances to father a child. Sperm banking before
treatment can eliminate this challenge. Lower libido after treatment can be another challenge, but hormone replacement
therapies for testosterone or testosterone patches have become a norm and revive your libido.
Remember, that most of the testicular cancer cases are curable, so be positive when dealing with it. Being
optimistic is the key and needless to say 'It does take 'balls' to survive testicular cancer.
