Testicular cancer is a special type of malignant tumor that develops in the testicles (male gonads). This disease differs from many other oncological diseases in its rapid growth and active metastasis. Every man, having heard a similar diagnosis, wants to know whether it is possible to overcome the disease and how to do it.
Testicular cancer: statistics
By the frequency of occurrence, this type of oncology is far from the first place. Of all the cases of cancer in men, a testicular tumor is approximately 0.5%. Most of all patients with this diagnosis are young men aged 15 to 45 years. At an older age, the risk of developing testicular cancer is somewhat reduced.
It was noted that in men of European appearance this disease occurs 10 times more often than in dark-skinned and Asians.
Today, doctors are talking about the increasing incidence of this disease. According to statistics, over the past 5 years, the increase in incidence increased by 30%. In general, this is associated with a deterioration of the environmental situation and a large number of bad habits.
Causes of the disease
Leading scientists and oncologists in many countries regularly conduct research in this area, but so far they have not been able to find out why testicular cancer develops in men. No one can name exactly the reasons, but there are factors that, according to doctors, can be the impetus for the appearance of pathological (cancerous) cells in the body:
- Various diseases of the male genital organs. Among them: testicular torsion, cryptorchidism, underdevelopment of the testicles and many others.
- Injury to the scrotum, as well as its regular overheating.
- Pathology of the endocrine system.
- AIDS virus.
- Harmful production, including prolonged contact with heavy metals.
- The effect of radiation.
- Bad habits, including drug addiction, smoking and alcohol abuse.
Risk factors
Risk factors were also identified. In the presence of one or another factor (or their combination), representatives of the stronger sex should be extremely careful about their health.
Cryptorchidism is a pathology in which the testicle does not descend into the scrotum. According to medical statistics, the presence of cryptorchidism in a man 5 times increases the risk of developing malignant neoplasms of the testis. Bilateral cryptorchidism increases the risk by 10 times.
The effect of estrogen. Men living in areas with high environmental pollution are much more likely to suffer from this type of oncology.
Heredity. Studies have shown that a genetic predisposition plays an important role in increasing risk. For fathers and sons, the risk increases 4 times, and for brothers - almost 10 times.
The presence of Klinefelter syndrome and Down syndrome.
Types of testicular oncology
All existing types of testicular tumors are divided into several varieties. This characteristic allows you to determine the peculiarity of the development of the disease, find the most effective method of treatment and give the most realistic prognosis. The main criterion for difference is the localization of pathological cells.
1. Non-germinogenic types of tumors. This term refers to those types of tumors that grow from the stroma. The frequency of their appearance is quite low - only about 5% of all cases of testicular cancer. Such varieties include:
- leydigoma;
- sarcoma;
- dysgerminoma;
- sertolioma.
2. Germ cell types of the tumor. These cells infect the tissues of the seminal epithelium. They are diagnosed much more often - their number reaches 95% of all types of testicular tumors. This category includes:
- seminoma (almost 35% of cases);
- embryonic testicular cancer;
- chorioncacinoma;
- appendage cancer;
- teratoma;
- yolk sac cancer;
- teratoblastoma.
3. Mixed species. In this case, cells of both types of tumor will be present.
Stages of the disease
The course of the disease is divided into stages, this helps doctors describe the complete picture of the disease as accurately as possible. So, according to the international TNM system, the following stages of testicular cancer development exist:
- T-1 - at this stage, the tumor is quite small and is located within the protein coat.
- T-2 - the tumor is still limited to the protein coat, however, a small deformation is already present in the scrotum.
- T-3 - malignant cells germinate through the protein membrane and pass to the adnexal organs.
- T-4 - at this stage of the development of the disease, the spermatic cord or scrotum tissue is involved in the process.
- N-1 is the initial stage of metastasis, in which pathological cells are found in the nearest lymph nodes.
- N-2 - lymph nodes at this time are significantly enlarged and painful, easily palpated during palpation.
- N-3 - distant metastases to organs (liver, lungs, kidneys, brain and bone tissue) are detected.
There is another classification of the stages of development of testicular cancer in men. Symptoms and signs in this case belong to one of three stages or substages. When making a diagnosis, doctors also consider the degree of metastasis and tumor marker.
Stage 1
The tumor in this case is characterized by small size and a clear localization within the testicle. At this stage in the development of the disease, men do not report any symptoms. Detection of oncology at this stage is rare, usually during routine diagnosis. With such signs of testicular cancer in men, the prognosis of treatment is optimistic - patient survival is 98%.
2 stage
The stage of the disease in which cancer cells infect the inguinal lymph nodes. The chances of recovery are 50%.
3A stage
Metastases spread to the lymph nodes located between the lungs or in the lungs.
3B stage
The tumor goes to distant lymph nodes, possibly lung damage. Marker level is average.
3C stage
The last stage of the development of the disease. At this time, cancer cells appear in many organs. Most often, the liver, lungs, kidneys, and brain are affected. The marker level is characterized as high.
Clinical picture
At the earliest stage of the disease, the characteristic symptoms and signs of testicular cancer are practically absent. This is due to the small size of the tumor. The first manifestations of the disease most often occur from the second stage.
- An increase in the size of the testicle, asymmetry of the scrotum. Many patients go to the clinic for this reason. Men are concerned about the enlargement of the testicle, especially in cases where this was not preceded by an injury. In this case, pain is not always present.
- Pain. At first, pain is present during palpation of the scrotum, however, with the development of the tumor, cancer patients complain of frequent attacks of pain even at rest. Pain can be felt in the lower abdomen.
- Signs of gynecomastia (breast enlargement). This is one of the common symptoms of testicular cancer. The reason for this is the defeat of the appendages, which entails hormonal changes. In cases of the development of such a pathology in boys, early puberty is observed (rapid hair growth on the body and face).
- Sensation of pressure and heaviness in the scrotum.
- A noticeable increase and soreness of the lymph nodes in the inguinal region.
- A sharp decrease in libido (sexual desire).
- Low sensitivity in the genital area.
- At later stages, outflow of urine is impaired.
If, for all these symptoms, treatment of testicular cancer in men has not been started, new signs appear that accompany all oncological diseases:
- fast fatiguability;
- loss of appetite;
- a sharp decrease in body weight;
- apathy;
- the appearance of irritation.
It is very important to understand that the speed and accuracy of diagnosis is important for successful treatment. At the last stage of the disease, the five-year survival rate of patients reaches no more than 10%. That is why doctors recommend going to the clinic at the first suspicion of an illness.
Diagnostic procedures
Symptoms of some diseases (testicular tuberculosis and hydrocele) are very similar to the symptoms and signs of testicular cancer. When diagnosing, the doctor must correctly differentiate the disease, because the effectiveness of treatment depends on this. There is a special protocol for diagnosis, including a number of laboratory tests and hardware examinations.
1. Initial reception and examination of the patient. In this case, the doctor will ask a number of questions to identify increased risk factors, listen to patient complaints. At the initial examination, examination and palpation of the scrotum, inguinal lymph nodes and mammary glands are mandatory.
2. Blood test. Such a laboratory test helps to detect the presence in the blood of tumor markers AFP, hCG and LDH. Their presence in the body of a man makes it possible to diagnose a tumor even at a stage when there are no characteristic symptoms yet.
3. Ultrasound. Ultrasound examination of the testis is one of the most accurate ways to diagnose cancer. Effective in 98-100% of cases.
4. CT, MRI, PET. These types of hardware diagnostics provide accurate data on the location, size and shape of the tumor. To detect metastases in the soft tissues, these procedures are very reliable.
5. Bone scintigraphy. This type of diagnosis is used to detect bone metastases.
6. Biopsy. This analysis allows you to determine the nature of the tumor (benign or malignant). Spend it as follows. A tissue sample is removed from the tumor tissue, which is subsequently subjected to a thorough histological examination.
Treatment features
Each case requires an individual approach and the development of a special course of treatment for testicular cancer. Causes, symptoms, type of tumor, stage of cancer, the absence or presence of metastases, the size of the neoplasm, the age of the patient - all this affects the selection of methods to combat the disease.
Most often, a set of measures is prescribed:
- surgical intervention;
- chemotherapy;
- radiotherapy;
- taking hormonal drugs;
- a course of vitamins and immunostimulants.
Surgical Tumor Removal
Surgery is a radical method of treatment, however, in most cases this is the approach that gives the maximum effect. During surgery, the doctor performs an orchectomy (removal of the affected testicle). Most often, inguinal lymph nodes in which metastases are present are also removed during the operation.
The operation as the only independent treatment is almost never used - usually it is supplemented with a course of chemotherapy and radiation therapy. This allows you to eliminate all pathological cells remaining in the patient's body after surgery. The result is a significant reduction in the risk of relapse (re-appearance of the tumor).
As for the cosmetic defect (after removal of the testicle), modern medicine solves this problem very effectively. There is a special testicular prosthesis that is implanted in place of a removed organ.
Radiation therapy
With this approach, the tumor is exposed to ionizing radiation. This therapy is based on the increased sensitivity of cancer cells to radioactive rays. Under their action, the structure of the pathological cell breaks up, and it loses the ability to further growth and development. The treatment is carried out in several approaches, the doctor selects the number and dose of radiation individually in each case.
Such procedures can be prescribed before surgery to significantly reduce the size of the tumor. Quite often, radiotherapy is also carried out after surgery to eliminate all pathological cells that have not been removed by the surgeon.
In some cases, radiation therapy acts as the main treatment if the tumor is inoperable for one reason or another.
Chemotherapy
This method of combating oncology is one of the main ones. Its essence lies in the use of potent drugs that enter the cancer cells and disrupt their work. The form of drugs can be different, they are available in the form of tablets or injections for intravenous administration.
In total, several courses are held intermittently. The duration, dose and type of drug is chosen by the attending physician. Medications are taken under strict medical supervision, since all the medications presented have numerous side effects.
Additional measures
The patient is experiencing very difficult treatment of testicular cancer, both psychologically and taking into account the general deterioration. Chemotherapy and radiotherapy cause nausea and bouts of vomiting, dizziness, lack of appetite, loss of strength. There is also a sharp drop in immunity, in connection with which cancer patients are at risk of contracting respiratory diseases.
To restore the condition, patients are prescribed vitamin complexes and immunomodulators. This helps the body restore its natural strength.
Given all of the above, we can emphasize: today a testicular tumor is effectively treated. However, for a good result, timely diagnosis and proper treatment are necessary. To protect themselves as much as possible, men should not wait for the progression of testicular cancer - with the first symptoms and signs, you should immediately consult a doctor.