Based on their occurrences, some cancers are considered common and some rare. Testicular cancer is among the latter and is said to be rare both worldwide and in India, with an incidence of less than 1 per 1 lakh men in a year. 

As the name goes, testicular cancer develops in the testicles, also called testes, that are a part of the male reproductive system. Each man normally has 2 testicles that are located in a sac-like structure called the scrotum, just below the penis. It is the testes that are responsible for the production of sperms and releasing the male sex hormone testosterone. Testicular cancer develops within these testicles. The most common type of testicular cancer develops in the sperm-producing cells called germ cells.

Signs and symptoms

Testicular cancer is easily diagnosed and the signs and symptoms appear in the early stages of the disease. One of the earliest symptoms of this cancer is the presence of a painless lump or swelling in one of the testicles. Other signs and symptoms of testicular cancer when it has not spread to other organs include:

  • A feeling of heaviness in the scrotum or lower abdomen
  • Collection of fluid in the scrotum
  • A dull ache in the groin area 
  • A change in the shape and texture of the testicles
  • A difference in the firmness of the testicles

Other symptoms when testicular cancer has spread to other organs include:

  • Pain in the lower back when the cancer spreads to the lymph nodes
  • Difficulty in breathing, shortness of breath, chest pain, cough with or without blood are seen when testicular cancer spreads to the lungs
  • Severe abdominal pain when the cancer spreads to the liver
  • Frequent and sometimes severe headaches when cancer spreads to the brain.

One would be happy and relieved to know that about 95% of men with testicular cancer make a complete recovery after treatment completion, provided the cancer was diagnosed early.

Treatment

The treatment for testicular cancer, like most cancer types, is dependant upon the stage and type of cancer. While all seminomas are treated in one way, the non-seminomas as well as mixed-cell tumours are treated alike. Most often, the treatment of this cancer involves a combination of treatment options – surgery, radiotherapy, and chemotherapy. The first line of treatment is usually orchiectomy which is the surgical removal of the affected testes and is done in cases of carcinoma-in-situ, where the cancer has not spread outside the testicle.

Treatment of Seminomas:

  • Stage I seminomas – are completely curable and the affected testicle is completely removed by surgery. Other treatment therapies may be used after surgery.
  • Stage II A seminomas- are treated the same way as the stage I seminomas but the radiation and chemotherapy dosages are higher than in stage I cases.
  • Stage II B seminomas- these seminomas have spread to lymph nodes and so chemotherapy is the preferred choice of treatment. Radiation therapy may be used if the lymph nodes haven’t gotten enlarged.
  • Stage II C seminomas- Chemotherapy is the preferred choice of treatment for these seminomas and radiotherapy is not usually used.

Treatment of Non-Seminomas:

  • Stage I non- seminomas- Nearly all stage I non-seminomas can be treated. The first step involves the removal of the affected testicle surgically. The subsequent treatment following the surgery depends upon the stage of the cancer. Retroperitoneal Lymph Node Dissection(RPLND) and Chemotherapy are routinely used for stage 1A and 1B non-seminomas.
  • Stage II non- seminomas- The treatment of stage II A and II B non-seminomas depends upon the level of tumour markers and the extent to which the cancer had spread to the lymph nodes. Based on this, a RPLND or chemotherapy is performed.
  • Stage III seminomas and non-seminomas – Though most of these are diagnosed quite late, they are almost always treatable. The first step in treating them both is radical inguinal orchiectomy followed by chemotherapy.

It is natural to feel anxious and worried about being diagnosed with testicular cancer. But, after you have come to terms with your emotions, it is best to gather courage and opt for treatment. Though the cancer is rare, easily diagnosable and has a good prognosis, one still needs to fight to beat it! While people with testicular cancer may face a variety of symptoms, it is better to go for a personalised consultation to assess your case better. Here’s where you can know in detail about testicular cancer.

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