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Testicular Cancer

The two oval-shaped glands inside the scrotum that produce testosterone and sperm are called testicles, and they can be affected by testicular cancer, a relatively uncommon type of cancer. Testicular cancer is the most prevalent cancer in men aged 15 to 40, despite its rarity. The good news is that, with early diagnosis and treatment, it is very curable, even at advanced stages.

Since many young men are not aware of the risk, symptoms, or significance of self-examination, it is imperative that awareness regarding testicular cancer be increased.

Types of Testicular Cancer

Testicular cancers are classified primarily into two categories based on the type of cells involved:

  • Germ cell tumours (GCTs) – These account for over 90% of all testicular cancers. They are further divided into:
    • Seminomas – Generally grow slowly and respond well to treatment.
    • Non-seminomas – Often more aggressive, including subtypes like embryonal carcinoma, yolk sac tumour, choriocarcinoma, and teratoma.
    • Non-germ cell tumours – These include rare types such as Leydig or Sertoli cell tumours.

Knowing the exact type aids in choosing the best course of action and forecasting how the cancer will behave.

Who Is at Risk?

While testicular cancer can affect anyone with testicles, certain risk factors may increase susceptibility:

  • Undescended testicle (cryptorchidism) – Even if corrected surgically
  • Family history – Having a brother or father with testicular cancer
  • Previous historyof testicular cancer in the other testis
  • HIV infection
  • Abnormal testicular development (e.g., Klinefelter syndrome)

However, many patients have no identifiable risk factors. Lifestyle or diet is not known to play a major role.

Signs and Symptoms

The most common symptom of testicular cancer is a painless lump or swelling in the testicle. Other warning signs may include:

  • A feeling of heaviness in the scrotum
  • Dull ache in the lower abdomen, back, or groin
  • Pain or discomfort in the testicle or scrotum
  • Fluid buildup in the scrotum
  • Enlargement or tenderness of the breasts (due to hormonal changes)
  • In advanced cases, symptoms may include fatigue, weight loss, cough, or breathlessness due to spread to lungs or lymph nodes

Because it often causes no pain, many men ignore early signs. That’s why monthly self-examination is strongly recommended.

How Is It Diagnosed?

When a man notices any unusual change in the testicles, he should see a healthcare provider without delay. Diagnosis involves:

  • Physical examination – To assess lumps or irregularities
  • Scrotal ultrasound – Non-invasive imaging to differentiate solid from fluid-filled masses
  • Tumour markers in blood – These include:
    • AFP (alpha-fetoprotein)
    • β-hCG (beta-human chorionic gonadotropin)
    • LDH (lactate dehydrogenase)

An orchidectomy, or removal of the testicle, is a diagnostic and therapeutic procedure when a tumor is suspected. Because of the possibility of cancer cells spreading, biopsies are typically avoided.

CT scans of the chest, abdomen, and pelvis are used for staging in order to look for spread, particularly to the lymph nodes or lungs.

Staging and Spread

The three stages of testicular cancer are Stage I (confined to the testicle) and Stage III (spread to distant organs like the liver or lungs). Thankfully, the majority of cases are identified early and have excellent treatment outcomes.

Treatment Options

The type (seminoma vs. non-seminoma), stage, tumor markers, and patient fertility objectives all influence the course of treatment. The best results come from a multidisciplinary approach.

1. Surgery

  • Radical inguinal orchidectomy –Groin incision to remove the afflicted testicle. Almost always, this is the first step.
  • • Retroperitoneal lymph node dissection (RPLND) –May be required for certain non-seminomatous tumors that involve lymph nodes.

2. Chemotherapy

Used for patients with high-risk characteristics or advanced disease. BEP (Bleomycin, Etoposide, Cisplatin) is a common regimen. The majority of patients can achieve long-term remission and tolerate chemotherapy well.

3. Radiation Therapy

Mostly applied to seminomas, which are extremely sensitive to radiation. Because there are now more effective chemotherapy alternatives, it is less common in practice.

4. Surveillance

After surgery, in low-risk Stage I cases, active surveillance with routine blood tests and scans may be preferred over immediate chemotherapy or radiation.

Fertility and Psychological Impact

Young men who receive a cancer diagnosis may experience physical and emotional difficulties, particularly in relation to masculinity and fertility. It's critical to understand:

  • The remaining testicle typically continues to produce sperm and hormones normally.
  • Sperm bankingbefore chemotherapy is strongly advised if future fertility is a concern.
  • Testosterone replacement may be needed in rare cases.

Patients can manage treatment and recuperation with the assistance of fertility specialists, counselors, and oncologists.

Prognosis and Survival

Testicular cancer is one of the most curable solid cancers.

  • Stage I survival rates exceed 98%
  • Even Stage III cancers have survival rates of over 70–80% with appropriate treatment

Most patients return to normal life, careers, and fatherhood after completing therapy.

Self-Examination: A Simple Life-Saving Habit

All men, especially between ages 15 and 40, should perform a monthly testicular self-exam:

  • Best done after a warm shower
  • Gently roll each testicle between the fingers
  • Look for lumps, swelling, or changes in shape or firmness

Early detection can mean simpler treatment and complete cure.

When to See a Specialist

A doctor should be consulted right away if there is any change, pain, or lump in the testicles. Complex treatments and more advanced disease can result from a delay in evaluation.

Testicular cancers are diagnosed and treated by medical oncologist Dr. Amit Badola, who specializes in long-term surveillance and chemotherapy management. His interdisciplinary approach guarantees that every patient receives customized care that takes into account their mental and physical health.