Testicular Cancer: Causes, Symptoms, Diagnosis, and Treatment

Testicular cancer is one of the most common cancers affecting men, especially those between the ages of 15 and 35. Though relatively rare compared to other types of cancer, its incidence has been increasing in recent years. Despite this, testicular cancer is highly treatable, especially when detected early. In this blog, we will explore the causes, symptoms, diagnosis, and treatment options available for testicular cancer.

What is Testicular Cancer?

Testicular cancer occurs when abnormal cells in one or both of the testicles grow uncontrollably, forming a tumour. The testicles are part of the male reproductive system and are responsible for producing sperm and testosterone. When cancer develops, it typically originates in the germ cells, which are responsible for producing sperm.

There are two main types of testicular cancer:

1. Seminomas: These are the most common type, accounting for about 50% of all testicular cancers. They tend to grow slowly and are more likely to be diagnosed in men aged 30 to 40.
2. Non-Seminomas: These are less common but tend to grow more quickly. Non-seminomas usually affect younger men, particularly those between the ages of 15 and 35. They include several subtypes, including embryonal carcinoma, teratoma, choriocarcinoma, and yolk sac tumours.

Although rare, testicular cancer is one of the most curable types of cancer, especially when diagnosed early.

Causes and Risk Factors of Testicular Cancer

The exact cause of testicular cancer is not known, but certain risk factors have been identified that can increase the likelihood of developing the condition. Some of the main risk factors include:

1. Undescended Testicles (Cryptorchidism): Men who had an undescended testicle at birth, which did not descend into the scrotum, are at higher risk of developing testicular cancer. Even if the condition is corrected surgically, the risk remains elevated.
2. Family History: If a man has a family history of testicular cancer, he is at an increased risk of developing the disease.
3. Age: Testicular cancer is most common in young men, especially those between the ages of 15 and 35.
4. Previous Testicular Cancer: Men who have had testicular cancer in one testicle have an increased risk of developing cancer in the other testicle.
5. HIV Infection: Some studies have shown that men who are HIV positive have a higher risk of developing testicular cancer.

While these risk factors can increase the likelihood of developing testicular cancer, many men with the disease have no known risk factors.

Symptoms of Testicular Cancer

Testicular cancer often does not cause any noticeable symptoms in its early stages, which is why it is important for men to regularly perform self-exams to detect any changes in the testicles. However, as the cancer grows, several symptoms may develop. Common signs of testicular cancer include:

1. A Lump or Swelling in the Testicle: The most common symptom of testicular cancer is the discovery of a lump or swelling in one of the testicles. This lump may be painless, although some men may experience discomfort or tenderness.
2. Pain or Discomfort: Men with testicular cancer may experience pain or a dull ache in the testicle or lower abdomen. This pain can also radiate to the groin or back.
3. Changes in Testicular Size or Shape: One testicle may become larger or feel different from the other.
4. Pain in the Scrotum or Groin Area: A heavy or aching feeling in the scrotum may indicate the presence of cancer.
5. Back Pain: In some cases, back pain may develop due to the spread of cancer to the lymph nodes in the abdomen or pelvis.
6. Breast Tenderness or Growth: In rare cases, testicular cancer may produce hormones that lead to breast enlargement or tenderness (gynecomastia).

It is important to note that these symptoms can also be caused by conditions other than testicular cancer, such as infections or trauma. However, if any of these symptoms persist or worsen, it is essential to seek medical attention for an accurate diagnosis.

Diagnosis of Testicular Cancer

If a man experiences symptoms of testicular cancer or notices any changes in his testicles, he should visit a healthcare provider for an evaluation. The doctor will typically begin with a physical examination of the testicles and may perform the following tests to confirm the diagnosis:

1. Ultrasound: An ultrasound of the testicle is the most common imaging test used to identify the presence of a tumour. It uses sound waves to create detailed images of the inside of the testicle.
2. Blood Tests: Blood tests may be used to measure specific tumour markers, such as alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and lactate dehydrogenase (LDH). Elevated levels of these markers can indicate the presence of testicular cancer.
3. CT Scan: A CT scan of the abdomen and chest may be recommended to check for the spread of cancer to lymph nodes or other organs.
4. Biopsy: A biopsy is rarely performed in testicular cancer, as the diagnosis is typically confirmed through ultrasound and blood tests. However, in certain cases, a biopsy may be necessary to confirm the diagnosis.

Once testicular cancer is diagnosed, staging is important to determine the extent of the cancer and guide treatment decisions. Staging may involve additional tests to check for the spread of cancer to other parts of the body.

Treatment Options for Testicular Cancer

Testicular cancer is highly treatable, and the prognosis is generally very good, even if the cancer has spread beyond the testicle. The treatment plan will depend on the type, stage, and overall health of the patient. Common treatment options for testicular cancer include:

1. Surgery (Orchiectomy): The first line of treatment for testicular cancer is usually surgery to remove the affected testicle, a procedure called orchiectomy. In some cases, the remaining testicle may also be removed if there is a high risk of cancer in that testicle.
2. Chemotherapy: Chemotherapy is often used for more advanced cases of testicular cancer or when the cancer has spread to other parts of the body. It involves the use of drugs to kill cancer cells or stop their growth.
3. Radiation Therapy: Radiation therapy may be used in some cases of seminomas, which are more sensitive to radiation. It involves using high-energy rays to target and destroy cancer cells.
4. Stem Cell or Bone Marrow Transplant: In rare cases, a stem cell or bone marrow transplant may be used to treat testicular cancer, particularly if the cancer has returned after initial treatment.

After treatment, regular follow-up appointments are necessary to monitor for any recurrence of cancer. These may include physical exams, blood tests, and imaging tests.

Conclusion

Testicular cancer is a relatively rare but highly treatable form of cancer. Early detection is key to successful treatment, and self-examinations of the testicles can help identify changes that may indicate cancer. Men who experience symptoms such as lumps or pain in the testicles should seek medical attention promptly. With proper treatment, most men diagnosed with testicular cancer can go on to live healthy, fulfilling lives.

If you are concerned about testicular cancer or have any questions, don't hesitate to consult with Dr. Aditya Sharma. Early detection and intervention can save lives.