Testicular cancer is the most common cancer that occurs in males between 20–40 years old and it accounts for approximately 1–1.5% of all cancers in men.
Testicular cancer develops in the testicles and includes several types of cancer, such as germ cell tumors (GCT), sex cord-gonadal stromal tumors and secondary testicular tumors.
The incidence, prevalence and death or morbidity rates change considerably in different geographical areas: the rates are highest in Northern and Western Europe, Northern America and Australia, while lowest rates have been found in South Europe, Central America and, lastly, in Asia and Africa.
In Malaysia, testicular cancer is the 9th and 10th most frequent cancer in males aged 0-14 years old and 14-49 years old. Majority of them were of Malay ethnicity. The average age at presentation was 33.7 years.
Testicular cancer would present themselves like
- A lump or enlargement in either testicle
- A feeling of heaviness in the scrotum
- A dull ache in the abdomen or groin
- A sudden collection of fluid in the scrotum
- Pain or discomfort in a testicle or the scrotum
- Enlargement or tenderness of the breasts
- Back pain
Causes of Testicular Cancer
The cause of testicular cancer in most cases is idiopathic (unknown despite investigations done). Testicular cancer occurs when healthy cells in a testicle become altered.
Nearly all testicular cancers begin in the germ cells — the cells in the testicles that produce immature sperm. What causes germ cells to become abnormal and develop into cancer isn’t known.
Factors that may increase your risk of testicular cancer include:
- An undescended testicle (cryptorchidism)- The testes form in the abdominal area during fetal development and usually descend into the scrotum before birth. Men who have a testicle that never descended are at greater risk of testicular cancer than are men whose testicles descended normally. The risk remains elevated even if the testicle has been surgically relocated to the scrotum.
- Abnormal testicle development- such as Klinefelter syndrome, may increase your risk of testicular cancer.
- Family history- If family members have had testicular cancer, especially first degree relatives.
- Age-Testicular cancer affects teens and younger men, particularly those between ages 15 and 35. However, it can occur at any age.
- Race- Testicular cancer is more common in white men compared to Asian men.
Prevention of Testicular Cancer
Regular testicle self-examinations is paramount to identifying testicular cancer at its earliest stage.
In some cases men discover testicular cancer themselves, either unintentionally or while doing a testicular self-examination to check for lumps. In other cases, your doctor may detect a lump during a routine physical exam.
To determine whether a lump is testicular cancer
- You may have to do a Ultrasound
- Blood tests- tumour markers like alpha feto protein, lactate dehydrogenase and Human chorionic gonadotropin
- Computerized tomography (CT) scan
- Biopsy- using a needle , a small piece of tissue is taken and sent to the lab for analysis, to determine it is cancer.
- MRI – Magnetic resonance imaging.
- PET Scan- A positron emission tomography scan is a type of imaging test. It uses a radioactive substance called a tracer to look for disease in the body.
Treatment of Testicular Cancer
How is Testicular Cancer Treated?
The need for further treatment depends on:
• Type of cancer
• The stage of the cancer
• The prognosis
Treatment options depends on the age of the patient, condition of patient and the patient liking:
It may be:
• Surgery to remove your testicle (radical inguinal orchiectomy) , Surgery to remove nearby lymph nodes (retroperitoneal lymph node dissection.
• Chemotherapy treatment uses drugs to kill cancer cells.
• Radiation therapy uses high-powered energy beams, such as X-rays, to kill cancer cells.