What is Testicular Cancer ?
Testicular cancer is one of the cancers that heals best, since the cure rate approaches 100% (less than 1% mortality). This testicular cancer is a relatively rare cancer, but it is the most common form of cancer in young men and adolescents, between puberty and 45 years, with a mean age of diagnosis of 37 years. It affects about 1 in 20,000 men. This cancer is increasing steadily, by 2.5% per year between 1980 and 2005 in France. In Canada, the incidence rate of this testicular cancer has increased by about 80% in the last 25 years
Testicular cancers are classified into two broad categories: seminomas and non-seminons (which include all other forms). Seminomas are more common among older men, while non-seminomas are more common among young men. The only way to confirm the type of cancer is to remove the testicle by surgery to analyze it. This operation is called total orchiectomy . It is done by an incision in the groin.
In almost all cases, only one testicle is reached. Very often, it is the discovery of a suspicious mass during the palpation of the testicles that sounds the alarm. The testicular cancer is a cancer that responds well to treatment (95% of men heal). However, treatments, whether by surgery, radiotherapy or chemotherapy, carry risks of infertility.
When to consult
If a man feels a lump or swelling , usually painless and gradually enlarging on one of his testicles, a doctor should be consulted. A small percentage of testicular cancer is likely to lead to early pain. Benign tumors of the testis are rare, and that is why it is necessary to consult quickly.
Symptoms of Testicular cancer:
- A ball or mass in a testicle, discovered by the man on palpation. The ball is usually hard to the touch, but painless.
- A feeling of discomfort or heaviness in the scrotum (skin containing the testicles);
- The appearance of liquid in the purses;
- A pain in the purses is much rarer;
- Swelling and tenderness of the breasts is very rarely an observed sign;
- Infertility. It is sometimes during a checkup for male infertility that testicular cancer is detected.
Some factors increase the risk of testicular cancer.
- Have had an undescended testicle in infancy (ectopic testicle or cryptorchidism) where the testicle remains in the stomach instead of falling normally in the purses. The risk of testicular cancer is multiplied by 35. The operation to lower the test is in the purses does not entirely protect against the risk of cancer.
- The decrease in size of the testis, for example after mumps (testicular atrophy), or after trauma increases the risk of testicular cancer
- Men who are HIV-positive for AIDS have a higher risk of testicular cancer.
- Men who have had testicular cancer on one side have an increased risk of having cancer on the other side. They must therefore regularly feel the other testicle for screening.
- Presence of testicular cancer in the father or in a brother.
- Be between 15 and 35 years old.
- Endocrine disrupting chemical pollutants are suspected to be involved in the occurrence of testicular cancer.
Since not enough preventable causes are known for testicular cancer , measures cannot be taken to prevent their occurrence. On the other hand, monthly testicular self- examination is recommended throughout life, especially in young boys with a testicle that did not spontaneously descend, in boys or men with unusually small testicles, HIV-positive men, because they are at high risk and more globally among all young men. Because more testicular cancer is discovered quickly, the better the chances of healing with the least possible sequelae.
|Testes self examination
This exam is easier to do if the scrotal skin is relaxed, such as after a hot bath or shower.
Examine each testicle with both hands, gently rolling the testicle between your thumb and fingers. A testicle is often – and normally – a little bigger than the other. A man can normally feel the presence of the epididymis , a small cord on the top of the testicle that connects him to the urethra. By regularly performing such a self-examination, a man becomes familiar with the shape of his testicles.
Surgery of Testicular cancer
The removal of the testicle achieved by inguinal surgery cancer is almost always the first and often the only treatment needed. It does not usually interfere with fertility or erection ability, since the remaining testis is sufficient to produce the necessary hormones and sperm. A testicular prosthesis is put in place during the operation to reduce the psychological and aesthetic impact of orchiectomy (removal of a testicle), but it is not mandatory.
Surgery is systematically associated with sperm preservation. Indeed, even if fertility is preserved, if a chemo or radiotherapy treatment is necessary or if the other testicle is affected by cancer, it is still possible to have children. Sometimes some lymph nodes are also surgically removed in addition to the affected testicle.
Once the testicle is removed , some patients will have to undergo regular blood tests and radiological examinations for a few years. This monitoring is essential in order to avoid the use of radiotherapy or chemotherapy when all is well (disease localized to the testis), or to start them quickly if we notice a change in the radiological image or the blood test ( disease outside the testicle).
Radiotherapy can be used as a supplement after surgery to prevent the spread of cancer cells to the lymph nodes of the abdomen. Radiation therapy is performed when the cancer is a seminoma, a type of tumor that is very sensitive to radiation.
It can cause temporary or permanent infertility , but usually does not affect erection ability.
It is also often used in addition to surgery with removal of the testicle. Indeed, testicular tumors are very sensitive to certain chemotherapies. After the operation, to prevent some cancer cells from remaining active, preventive chemotherapy can be performed, depending on the type of cancer and the extent of the tumor.
Chemotherapy can cause several side effects, such as fatigue, nausea, hair loss, infertility and increase the risk of infection.
The medical team routinely suggests that a neat man preserve his fragile fertility before potentially toxic treatments. Sperm preservation can be performed before removal of the testicle , which provides a better chance of obtaining good quality spermatozoa after thawing. Once cured, one has the choice to use or not the frozen sperm flakes for years.