Testicular cancer

The Function of the Testes and Complications Associated with Testicular Cancer

The testes (also called testicles) are the male reproductive glands found inside the scrotum. Their main jobs are to make sperm, which helps in reproduction, and to produce testosterone, the hormone responsible for male fertility, muscle growth, and other male traits. Any condition that affects the testes can disturb hormone balance, sperm production, and overall reproductive health.

Testicular cancer mostly affects men between 18 and 40 years of age. It is one of the most curable cancers when found early. If not treated in time, it can lead to infertility, hormone problems, and in serious cases, spread to organs like the lungs, brain, or abdomen. It can also affect emotional and mental health, especially in younger men. Regular self-exams and check-ups play a big role in early detection and successful treatment.

Types of Testicular Tumours

Testicular tumours can be primary (start in the testes) or secondary (spread from another organ).

• Primary Testicular Cancer: Begins in the testicular tissue and includes:
  • Germ Cell Tumours (GCTs): The most common, making up over 90% of testicular cancers.
  • Seminomas: Grow slowly and often occur in men aged 25–45.
  • Non-Seminomas: Faster-growing types, including embryonal carcinoma, yolk sac tumour, choriocarcinoma, and teratoma.
  • Non-Germ Cell Tumours: Include Leydig cell and Sertoli cell tumours (rare).
  • Lymphoma: The most common testicular cancer in men over 60.
• Secondary (Metastatic) Testicular Cancer: Rarely, cancers from other organs such as the prostate, kidney, or lymph nodes can spread to the testes.

Risk Factors

• Undescended testicle (cryptorchidism)
• Family or personal history of testicular cancer
• Infertility
• Klinefelter’s syndrome
• HIV infection
• Caucasian ethnicity (higher risk)
• Exposure to environmental chemicals or endocrine disruptors

Common Symptoms of Testicular Cancer

Testicular cancer is often discovered by men themselves during self-examination. Watch for these signs:

• A painless lump or swelling in either testicle
• Heaviness or ache in the lower abdomen or scrotum
• Sudden fluid buildup in the scrotum
• Pain or discomfort in a testicle
• Breast tenderness or swelling (gynecomastia)
• Lower back pain (if the cancer has spread)
• Shortness of breath or chest pain (if spread to lungs)

Early stages often cause no symptoms, which is why regular self-checks are important.

Diagnosis of Testicular Cancer

Doctors follow several steps to confirm and understand the stage of cancer:

• Clinical Examination: The doctor checks the testicles and abdomen for any lumps or pain.
• Blood Tests: Certain tumour markers help in diagnosis:
  • Alpha-fetoprotein (AFP)
  • Beta-human chorionic gonadotropin (β-hCG)
  • Lactate dehydrogenase (LDH)
• Imaging Tests:
  • Scrotal Ultrasound: First test to identify any mass inside the testicle.
  • CT Scan: Helps to check for spread in chest, abdomen, or pelvis.
  • MRI: Used for detailed imaging if needed.
• Surgery (Radical Inguinal Orchiectomy): The affected testicle is removed for accurate diagnosis and treatment.
• Staging: Cancer is classified from Stage I to III based on tumour size, lymph node involvement, and spread.

Treatment Options for Testicular Cancer

Testicular cancer treatment is usually very successful. The choice of treatment depends on the type and stage of the tumour.

A. Standard Treatments

• Radical Inguinal Orchiectomy: Surgical removal of the affected testicle.
• Retroperitoneal Lymph Node Dissection (RPLND): Removes lymph nodes in the abdomen if cancer has spread.
• Radiation Therapy: Mostly used for seminomas, which respond well to radiation. Common side effects include tiredness and nausea.
• Chemotherapy: A mix of drugs like cisplatin, etoposide, and bleomycin (BEP regimen). It works well for most advanced cases.

B. Advanced and Modern Treatments

• Laparoscopic RPLND: A minimally invasive surgery with faster recovery.
• High-Dose Chemotherapy with Stem Cell Transplant: Used for relapse or resistant cases to improve survival.
• Targeted Therapy: Still under research but may help in advanced, hard-to-treat cases.
• Immunotherapy: New drugs that boost the immune system are being studied for resistant testicular cancers.

Prevention and Healthy Lifestyle

• Perform monthly self-exams to detect lumps early
• See a doctor for any swelling or pain in the testicles
• Have regular health check-ups
• Avoid exposure to harmful chemicals
• Consider sperm banking before chemotherapy or radiation
• Stay informed and raise awareness among young men

Prognosis and Survival Rate

Testicular cancer has one of the best survival rates among all cancers. The 5-year survival rate is over 95%, and in early stages, it can be nearly 100%. Even in advanced stages, most men recover well with proper treatment. Regular follow-up is important to prevent recurrence.

Conclusion

Testicular cancer mainly affects young and middle-aged men, but it is highly treatable when detected early. Awareness, self-examination, and timely medical care are key. Modern treatments, including surgery and chemotherapy, have made recovery and long-term survival very likely. By staying informed and taking care of your health, you can reduce risks and maintain both physical and emotional well-being.