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Testicular cancer

The testicles are paired organs of the male genital system. They produce male sex hormones and sperm for reproduction.

Testicular cancer usually occurs in young men between the ages of 15 and 35. It is the most common cause of cancer in young male patients. It is important to note that testicular cancer has a great potential for cure.

Symptoms

Most are usually detected by an induration in one of the testicles. As it is usually painless and without inflammatory reaction, patients do not prioritize the consultation. Some of the most common symptoms are

  • Lump or enlargement in either testicle.
  • Feeling of heaviness in the scrotum.
  • Pain in the abdomen or groin.
  • Sudden accumulation of fluid in the scrotum.
  • Pain or discomfort in a testicle or in the scrotum.
  • Breast enlargement or tenderness.
  • Back pain

Causes

Testicular cancer occurs when healthy cells in a testicle become altered. Healthy cells grow and divide in an orderly way to keep the body functioning normally. Sometimes, some cells have abnormalities and this causes this growth to get out of control, generating cancerous cells that form a mass in the testicle.Risk Factors – Abnormal testicular development: for example, undescended testicles (when the testicles have not descended normally into the scrotum), among other testicular anomalies.

  • Previous testicular cancer.
  • Family history.
  • Age.

Diagnosis

Usually the physical examination confirms the diagnosis, additionally the urologist will request a testicular ultrasound, perform blood tests, may indicate chest X-ray and computed axial tomography of the abdomen and pelvis with contrast, or magnetic resonance imaging to confirm the diagnosis. Treatment Generally, surgery is necessary, the urologist will decide at that time if an intraoperative biopsy is necessary before deciding to remove the testicle. The surgery consists in the removal of the entire testicle, epididymis and spermatic cord in order to send everything for analysis.

A testicular prosthesis can be placed at that time for aesthetic purposes.

The pathologist will establish what type of tumor it is. In most cases the histological type is called seminomatous tumors, the other tumors are called non-seminomatous. This result will be analyzed with the urologist to determine the post-surgical treatment. This treatment varies according to the type of tumor and stage of the tumor. The options are:

  • Control or surveillance: Periodic controls will be performed with tumor markers and imaging studies with computed tomography or magnetic resonance imaging.
  • Retroperitoneal lymphadenectomy: In some cases, especially in non-seminomatous tumors, removal of the lymph nodes located in the retroperitoneum may be indicated. This technique can be performed to stage the disease or for curative purposes.
  • Chemotherapy.
  • Retroperitoneal radiotherapy.

Unilateral testicular removal does not cause hormonal disorders, since it is compensated by the other testicle. There may be an alteration of the quality of the spermatozoa, which generally improves with time. In patients who will undergo chemotherapy and radiotherapy, it is advisable to obtain semen samples for the sperm bank, since this treatment affects sperm production, which generally improves after 2 years of treatment.

Prevention

There is no way to prevent testicular cancer. However, self-examination is a great help. Just as women do with breast self-examination, men should be aware that a testicular self-examination could lead them to an early consultation with their Urologist so that he can determine the most appropriate course of action, depending on the case, to follow.

When to consult a doctor?

Consult a doctor if you notice pain, swelling or lumps in the testicles or groin area, especially if these signs and symptoms last more than two weeks.

Testicular self-examination