For years, awareness of testicular cancer has been poor, yet every year, many men in their reproductive age group are diagnosed with this cancer. The testis as we know is the male sex organ responsible for the production of sperm cells and testosterone (male sex hormone). Testicular cancer is seen exclusively in men, but it’s important that both men and women are aware of this dreaded disease because such knowledge can help in reducing the incidence in our husbands, sons and uncles.
Testicular cancer occurs in the testes, but the abnormal cells can spread to other organs of the body, especially the bones, lungs and the liver. The good news is that Testicular cancer is treatable if treatment is commenced early in the course of the disease. Death is increased in advance stage testicular cancer from the spread to other vital organs.
Causes/ Risk factors
As with any other cancers, the exact cause of testicular cancer is unknown, but certain risk factors have been associated with it. They include:
· Age: age is the major risk factor for testicular cancer. It occurs frequently in the 2nd to 4th decade of life. It rarely occurs during childhood. Also, it is frequently seen from the 6th decade of life.
· Gender: testicular cancer occurs exclusively in men. However, it is important to note that female hermaphrodites with underdeveloped testis stand a higher risk of developing testicular cancer.
· Family history: the risk of developing testicular cancer increases with a first degree male relative having the cancer.
· Race: from available studies, Scandinavians men have the highest risk of developing testicular cancer when compared to other races
· Marital status: funny to say, the risk of developing testicular cancer is higher in unmarried men. The reason is however not clear to physicians and scientists.
· Undescended testis: undescended testis occurs when the testis is located outside of the scrotum. The scrotum helps in maintaining the optimal temperature for the formation of sperm cells. The risk of developing testicular cancer is higher with an undescended testis
· Exposure to ionizing radiation e.g. X-rays, industrial/ Occupational exposure
· Exposure to drugs like chemotherapy and radiotherapy used in the treatment of other cancers in the body
· Exposure to heavy metals, hydrocarbons, arsenic compounds, phenols, herbicides and pesticides
· Smoking and excessive consumption of alcohol increases the risk of developing testicular cancer
Clinical features
· The first symptom of testicular cancer is usually a non-painful scrotal mass which can be felt on Testicular Self Examination. The mass grows steadily over time to involve the entire testes
· Another important early symptom is the accumulation of fluid within the scrotum. This is referred to as ‘hydrocele’
· If you experience bloody urine, then you should check your doctor.
· Anorexia, nausea, loss of appetite and weight loss are constitutional symptoms of testicular cancer
· Spread of testicular cancer to the lungs leads to chest pain, cough and difficulty in breathing.
· Spread to the bones (especially bones of the back and waist) causes low back pain from compression of nerves or irritation or the muscles around the groin
· Testicular cancer can also obstruct the lymph vessels that drain the legs. This leads to swelling of the legs, which can affect one or both legs.
· Spread to the liver (hepatomegaly) can occur, leading to the disruption of the functions of the liver. This is followed with the accumulation of fluid within the abdomen.
Treatment options
Several treatment options are available for testicular cancer, but it depends on the stage and grade of the disease, presence of other disease conditions and the medical expertise of the hospital, which includes the available equipment and skilled personnel. Treatment options include surgery, chemotherapy and radiation therapy.
· Surgery: this is the primary treatment option for testicular cancer. Here, the affected testis, the cancer and the surrounding lymph nodes are removed
· Chemotherapy: this involves the use of drugs to kill the cancer cells. This is frequently used in advanced stage disease to kill metastatic cells
· Radiation Therapy: this is the use of a high powered external beam to kill the cancer cells. It is frequently used alongside surgery in the treatment of testicular cancer.
Testicular Self Examination (TSE)
Testicular Self Examination (TSE)
The key of the prevention and early diagnosis of testicular cancer is Testicular Self-Examination (TSE). Every man above the age of 20 should be educated on TSE. I will now walk you through the steps of performing a TSE.
· TSE is best done in the morning after a hot bath because the scrotal skin is moist and relaxed, making the testicles easy to feel
· Also, it should be performed every month. A suitable day is fixed and a strict monthly schedule is used. A calendar or a reminder should be used.
· With regular examination of the testes, you will get accustomed to the consistency and feel of your testes. This will make the detection of any testicular swelling easier.
· It is advisable that you stand in front of a mirror whenever you want to carry out a TSE
· The first step is to cup one testis at a time using both hands. Then slowly roll your fingers over your testis to feel for any swellings or lumps. Note the surface and the consistency of your testis. However, there is always a slight swelling at the upper pole of your testes. This is a normal swelling with no cause for alarm.
· The steps should be repeated on the other testis
· Note: one testis is usually bigger that the other, and there is a soft coiled structure that is felt during examination. This is the epididymis that stores and transports sperm cells
· All unusual findings during TSE should be reported to the doctor, who will perform a detailed medical evaluation of the swelling/ mass
Testicular cancer is relatively a rare cancer with little or no awareness. It is important that we educate ourselves about this disease, because it is the key to early diagnosis and prompt treatment. If you are experiencing any of the symptoms discussed above or you notice any usual swelling of the scrotum and testes, then it is important that you consult your physician for further evaluation and treatment.
Image credits:
healthandmindcare.com
laparoboticsurgery.com
testicularcancerawarenessfoundation.org
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