Symptoms, causes and effects of cancer of the epididymis
Testicular oncology is relatively rare, however, this does not detract from its aggressiveness, because under the influence of such cancer a man can burn out on average in three years. Therefore, men need to take a more responsible attitude to health in order to notice signs of testicular cancer in a timely manner and take the necessary measures.
Concept of disease
Testicular cancer is a malignant tumor process, which is characterized by the unpredictability of the development and growth of pathological cancer cells.
A tumor is formed and develops directly in the genital glands, but soon it begins to spread throughout the body (usually in the brain and bone structures, liver and lungs) through hematogenous and lymphogenous pathways.
According to statistics, a malignant tumor of the testicle is considered the most common cancer among men 15-35 years old.
Such a cancer pathology is predominantly one-sided, although bilateral forms of the tumor process are also found (in 1.5-2%).
Testicular cancer is classified into mixed, germ cell and non-germ cell tumors.
- Germinogenic tumors are formed from seminal germinal cell structures and occupy about 95% of cases.
- Non-germinogenic tumors form from testicular stroma.
- Mixed Tumors contain cells of both germinogenic and non-germogenic formations.
Photo shows sectional testicular cancer in men.
In turn, germ cell tumors are divided into:
Non-normative formations occur in less than 5% of cases and are represented by tumors such as leidigomas, sertoliomas, dysgermomas.
Reasons for development
It is rather difficult to say for sure what causes the development of testicular cancer. However, there are several patterns and risk factors in the development of such oncology:
- Often exposed to testicular cancer are men of tall and thin physique,
- The presence of a tumor of another testicle in the past,
- If there is an immunodeficiency virus, the likelihood of such cancer increases,
- Belonging to the white race increases the risk of developing testicular cancer tenfold, and African Americans and Asians suffer from such a pathology ten times less
- Cryptorchidism or undescended testicle
- Traumatic damage to the scrotum,
- Endocrine pathology,
- Radiation and radiation exposure,
- Hereditary factors
- Congenital underdevelopment of the testicles,
- Nevuses and moles, prone to malignancy, can also provoke testicular cancer,
- Early puberty,
- In infertile men, the risk of developing testicular cancer is tripled,
- Lack of exercise,
- Regular overheating of the scrotum, etc.,
- Testicular torsion,
- Nicotine addiction, manifested by daily smoking a pack of cigarettes for 10 years or more, doubles the likelihood of developing genital cancer in men,
- Hypospadias - a similar disease is associated with impaired development of the male genital organs, when the outlet of the urethra opens below the head of the penis or on the scrotum.
Sometimes testicular malignant oncology develops against the background of Klinefelter or Down syndromes. The professional environment is also important, since men who work in the leather, gas, oil, coal mining and firefighters are more likely to suffer from pathology.
Symptoms of testicular cancer in men
The fundamental manifestation of a malignant tumor process is the appearance in the scrotum tissue of a dense formation that promotes organ enlargement.
Such seals can be both painful and painless.
Patients complain of pain in the abdomen and scrotum, swelling in the tissues of the testicle.
In this case, the scrotum is greatly swollen and becomes much larger. With the further development of the tumor process, respiratory difficulties and shortness of breath, enlarged lymph nodes, back pain, and weakness occur.
The patient feels a noticeable decrease or lack of sex drive, soreness and enlargement of the mammary glands, intensive growth of hair on the face and body long before the onset of mature development. When tumor metastasis, patients observe pronounced right-sided soreness, cough and jaundice, shortness of breath, etc.
With the germination of a tumor in the epididymis, the following symptoms occur:
- There is a slight painless seal
- Organ deformation,
- Testicular enlargement,
- Pain along the spermatic cord and lower abdomen,
- There may be pain in the back and chest,
- Scrotal edema
- Swollen lymph nodes
- Difficulty breathing.
Cancer of the epididymis contributes to the development of secondary sexual characteristics and endocrine diseases that can change the patient's appearance.
Malignant staging is based on international criteria according to the TNM system:
- T-1 - the formation does not cross the boundaries of the protein coat,
- T-2 - the tumor is also limited, but there is already deformation of the scrotum and enlarged testicle,
- T-3 - a tumor penetrates the protein membrane, growing in the adnexal tissues,
- T-4 - the tumor process extends beyond the borders of the testis, germinating in the spermatic cord or scrotum tissue,
- N-1 - during X-ray and radioisotope diagnostics, regional metastases to the lymph node structures are detected,
- N-2 - enlarged regional lymph nodes with metastases are easily palpated upon examination,
- M-1 - during diagnostic studies, distant metastasis is found in the liver, lung, brain and kidney tissues.
It is used in determining the degree of development of testicular cancer and another staging system:
- I - the formation is localized within the testicle,
- II - the tumor process spreads to the lymph nodes of the paraaortic value,
- IIa - lymph nodes with metastases do not exceed 2 cm,
- IIb - parameters of lymph nodes of the order of 2-5 cm,
- IIc - the size of the lymph node structures exceed 5 cm,
- III-0 cervical and thoracic lymph nodes are involved in the tumor process,
- IV - metastasis extends to distant organs such as bone tissue, brain, liver and lungs.
If testicular cancer in men is detected at an early stage, then 90% of patients have every chance of a full recovery.
But the statistics are such that most men, upon detection of signs of pathology, turn to specialists only after a time when the tumor process goes to more advanced stages. In such a situation, treatment is not always successful and has many consequences.
If the patient undergoes an orchiectomy, i.e., removal of the affected testicle, then for many men this becomes the basis for a serious inferiority complex. From a physiological point of view, the remaining testicle is quite capable of coping with its functions in two.
A cosmetic problem is completely eliminated with the help of a correction, when a prosthesis is implanted instead of a removed testicle.
If the treatment was accompanied by chemotherapeutic or radiation exposure methods, then the likelihood of complications is very high:
- Against the background of exposure to large doses of radiation, irreversible infertility occurs,
- Chemotherapy with Cisplatin develops azoospermia (lack of sperm), which is often eliminated after about 4-5 years,
- Anticancer drugs like Ifosfamide and Cisplatin lead to toxic kidney damage,
- All chemotherapy drugs are dangerous for bone marrow structures.
In addition, chemotherapy and radiation, as a rule, are accompanied by nausea-vomiting syndrome, hair loss, etc.If a man pulls with treatment, then the cancer progresses rapidly, metastasizes, disrupts the functioning of all organs and leads to death.
How to identify testicular cancer?
To identify testicular cancer, you must consult a specialist who will properly conduct palpation of the scrotum and a general examination.
Sometimes already at this stage it is possible to suspect the presence of a malignant formation, which most often differs in density and painlessness.
In parallel, lymph node locations of the inguinal, supraclavicular and abdominal locations are examined.
After a medical examination, the patient is sent for diagnostic tests:
- Ultrasound diagnostics. Such a study allows us to determine the tumor process with almost one hundred percent accuracy,
- MRI and computed tomography. These studies have a similar purpose to ultrasound, however, they are more informative, but their cost is much higher,
- Osteoscintigraphy. This technique allows you to clarify the presence of metastases,
- Identification of specific tumor markers,
- Morphological diagnosis of tumor fragments. Such a study is usually carried out after the removal of the affected testicle, since if the integrity of an unremoved tumor is damaged, the risk of local metastasis is high.
Based on the diagnostic results, the most optimal therapy is selected.
Testing for cancer markers for testicular cancer is invaluable. Tumor markers are specific substances produced by malignant tumors.
Depending on their level, the degree of development of the tumor process is determined. In laboratory blood tests, attention is usually paid to the level of tumor markers such as AFP (α-fetoprotein), LDH (lactate dehydrogenase) and hCG (β-subunit of human choriogonadotropin).
Normally, the indicators of these substances are:
- ACE - less than 15 ng / ml,
- LDH - less than 2000 U / l,
- HCG - less than 5 mU / ml.
ACE increases in 70% of patients with testicular cancer. The value of LDH in the study is low, however, if the level of lactate dehydrogenase rises above 2000 U / L, then this is a direct sign of the tumor process. HCG increases in 10% of patients with seminoma, in 25% with a yolk sac tumor, in 60% with embryonic carcinoma, and in 100% with testicular chorion carcinoma.
Such a study is very useful for diagnostic purposes, staging, choice of therapy and monitoring the response to treatment.
Disease treatment and life prognosis
Therapy of testicular cancer is based on the traditional surgical approach, chemotherapy and radiation exposure.
Surgical treatment usually involves an orchifunilectomy, i.e., surgical removal of a testicle affected by a tumor process. Sometimes such an operation is supplemented by the removal of lymph node structures (retroperitoneal lymphadenectomy).
After surgical treatment, radiation and chemotherapy are additionally prescribed. The success of therapy is influenced by several factors:
- The prognosis for such oncology is positive only with early detection of cancer, when the survival rate is about 90%,
- If it is detected at stages 2-3 with active metastasis, a complete cure is impossible, however, 5-year survival reaches 50%,
- If a man plans to have paternity in the future, it is recommended that cryopreservation of the seed material be made prior to the start of therapy, since modern technologies allow this.
Pathogenesis and etiology of the pathological process
So, a tumor of the epididymis, as a rare disease, is superficially examined by modern specialists, however, the prevailing clinical picture of the disease is obvious.
A malignant neoplasm is located in the tail of the appendage (in isolated cases - in the body of the appendage itself), and is a small seal a few centimeters in diameter.
If the tumor has a benign nature, then its surface is smooth, and in the case of malignant neoplasms - tuberous and uneven.
Diseases are difficult to conservative and surgical treatment, and the clinical outcome is not the most favorable. The question of where the appendageous malignant tumor originates from is relevant not only to doctors, but also to patients at risk.
The etiology of the pathological process remains unclear to the end, however, qualified specialists after numerous studies have concluded that the following pathogenic factors are predisposing:
All of these causes may in the future provoke the appearance of cancer cells, prone to their reproduction and spread.
At an early stage, cancer of the epididymis does not manifest itself in any way, and the patient may not be aware of the pathological process in his body. Problems appear much later, and they cannot be treated successfully anymore..
Diagnosis of the disease
The main diagnostic method in this clinical picture is diaphanoscopy, which consists in a detailed study of a pathogenic tumor and reliable determination of its shape.
Moreover, ultrasound of the testicle, retroperitoneal space and abdominal cavity is necessary, since it is this method of clinical examination that allows you to find a dystopian testicle and, accordingly, a malignant tumor.
Straight lymphangioadenography reliably determines the presence of affected lymph nodes and their degree of distribution, and an x-ray measures the degree of damage to the lungs and mediastinum. When performing excretory urography and venocavagraphy, a doctor can judge abnormal changes in the venous system and urine transport.
However, a comprehensive approach is required in determining the diagnosis of Cancer of the Epididymis, so a conclusion cannot be made without detailed laboratory tests. Among them are the following obligatory analyzes:
- blood chemistry,
- clinical blood test,
- immunochemical blood test.
Doctors also do not exclude biopsy, because the contents of the tumor are as colorful and truthful as possible about its features, origin and nature.
However, this method of laboratory research is appropriate exclusively for a single testicle, and in other clinical pictures such laboratory research can activate the dissemination of the process. In doubtful cases cytological examination may be required.
At first, a man may think that his prostatitis has worsened, but detailed diagnosis shows a more serious and life-threatening disease.
It is necessary to correctly identify the diagnosis, otherwise the treatment regimen will be assigned incorrectly and will not provide a lasting therapeutic effect.
Lost time will allow metastases to spread to the entire reproductive system and even neighboring organs, thereby accelerating the patient's death. That's why timely response of the patient to the problem and a trip to a specialist for an appointment is very important.
Prevention and prognosis
An excellent prevention of malignant neoplasm of the epididymis is the timely diagnosis and early detection of the pathological process. If you immediately remove the affected appendage, after additional conservative therapy and chemotherapy, the patient can return to his previous lifestyle.
In order to avoid the aggravation of this deadly disease, it is necessary to avoid testicular injuries, lead a healthy lifestyle, avoid increased radiation and bad habits, as well as timely study of all hereditary diseases existing in the family.
If the diagnosis is made, and it is a malignant tumor, then disease prognosis is disappointing. The patient loses working capacity and may even die in the absence of timely treatment. So it is important to respond to your health problems in a timely manner.
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What is the treatment of testicular orchitis, what are the symptoms of the disease and how to prevent it - all the details are here.
A little about the testicles
The testicles (also called testes) are part of the male reproductive system. These two organs are located in a leather pouch called the scrotum. The scrotum hangs under the base of the penis.
Illustration showing the testicles relative to the penis, urethra, bladder, prostate, scrotum, vas deferens and appendages.
Seed plants perform two main functions:
- They produce male hormones (androgens) such as testosterone.
- They make sperm, the male cells needed to fertilize an egg in order to start a pregnancy.
Sperm cells are made in long, filiform tubes inside the testicles, called the seminiferous tubules. They are then stored in a small spiral tube behind each testicle, called the epididymis, where they mature.
During ejaculation, sperm are transferred from the epididymis through the vas deferens to the seminal vesicles, where they mix with fluids formed by the vesicles, prostate and other glands to form sperm. This fluid then enters the urethra, a test tube in the center of the penis through which both urine and semen leave the body.
The testicles are made up of several types of cells, each of which can develop into one or more types of cancer. It is important to distinguish between these types of cancer from each other, because they differ in their approach to treatment and life forecasts.
Testicular cancer is a malignant tumor disease that develops in the gonads (textiles) and quickly gives metastases throughout the body through the bloodstream and lymph flow. This disease has several types, and classify it based on where the tumor is located, as well as what severity the course of the disease has. Thus, testicular cancer can be divided into the following types:
Non-germinogenic - arise from testicular stroma, is less common than in 5% of episodes, but refers to them:
Germ cell tumors - originate in the seminal epithelium and occur most often (95% of cases). Such tumors include:
embryonic testicular cancer,
seminoma (more than 35% of all cases),
swelling of the yolk sac, etc.
Mixed - contain both non-germinogenic and germinogenic cells.
There are several classifications of testicular cancer. So, based on the international criteria for the TNM system, there are the following stages of the course of the disease:
T-1 - the tumor does not extend beyond the protein membrane,
T-2 - the formation is limited by the protein membrane, but deformation in the scrotum is observed, and testicles also increase,
T-3 - tumor cells penetrate the protein membrane, grow into the adnexa,
T-4 - a tumor formation extends beyond the verge of the testicle, germinates in the spermatic cord of the testis or tissues of the scrotum,
N-1 - there are metastases in the structures of the lymph nodes, and they are detected by radioisotope or radiological diagnostics,
N-2 - there are metastases, enlarged lymph nodes are detected upon examination by palpation.
M-1 - metastases affect distantly located organs: liver, kidneys, lungs, bone tissue and brain.
There is a classification in which 3 stages are divided, while the stage is divided into substages A, B and C, they take into account the cancer marker, as well as the degree of distribution of metastases in the internal organs and lymph nodes. This classification is more common and it has such stages:
Stage 1 - the tumor process is limited to the testicle, there are no metastases, other organs and lymph nodes are not damaged, the symptoms of testicular cancer in men are practically absent, and full recovery occurs in 98% of cases,
2 Stage - tumor cells infect paraaoral and abdominal lymph nodes, metastases germinate, recovery occurs in 50% of cases,
3A Stage - damage to the lymph nodes that are located in the lungs or between them,
3B Stage - metastases are formed in distant lymph nodes and lungs, has an average marker level,
3C Stage - metastases spread to internal organs (liver, kidneys, etc.), have a high level of marker.
Causes and types of tumors of the epididymis
The exact cause of cancer of the epididymis has not been established. Scientists suggest that the tumor process develops under the influence of the following provoking factors:
- Burdened by heredity,
- Chronic diseases of the endocrine system,
- Bad habits
- Radiation radiation
- Male genital trauma and microtrauma.
Most neoplasms of the epididymis develop from germ cells and are called germ cell tumors. They are divided into 2 main types: seminoma and non-seminomic tumors. These neoplasms have different characteristics and differ in the ability to spread, the methods of treatment used.
Seminoma, in which germ cells become malignant at an early stage of their development, is more sensitive to radiation therapy. Non-seminomic tumors grow and spread faster than seminoma. They are of several types:
- Embryonic cancer (develops from mature germ cells)
- A yolk sac tumor, in which a tumor develops from the yolk sac usually found in an embryo,
- Choriocarcinoma is a rare but especially malignant tumor, similar in structure to the placenta,
- Teratoma, when germ cells are differentiated inside the epididymis in various tissues during embryonic development.
If the tumor consists of seminoma cells and a non-seminoma tumor, it is treated as a non-seminoma formation.
It arises from the cells of the germinal epithelium of the seminiferous tubules. It is a soft neoplasm with dense inclusions, in the section - it has a white-gray color. Atypical forms are accompanied by the appearance of necrosis, prone to rapid growth. The tumor is characterized by an aggressive course, metastases rather early. It affects almost the entire testicle, leaving only a small area of healthy tissue under the protein coat. Found in 40% of all testicular tumors. After treatment may occur again.
The composition of teratoma includes rudimentary organs or parts thereof, hair, cartilage, teeth, glands and other tissues. These are potentially malignant formations that proceed quite easily. Do not reappear after removal, do not give metastases, do not lead to the development of tumor intoxication and cachexia.
The most malignant and aggressive tumor is chorionepithelioma. It grows rapidly and metastasizes, capturing new sites. Has a tendency to hemorrhage and destructive growth in the depths of tissues.
Embryonic cell cancer is detected in 30% of all testicular tumors. It is characterized by rapid growth, early metastases. After removal, the tumor often reappears.
Epididymal Cancer Symptoms
At an early stage, cancer of the epididymis does not show any signs, and the patient may not be aware of the presence of a malignant tumor in his body.When probing the testicle in the area of the appendage, you can determine the presence of a small dense formation. Its sizes vary from a few millimeters to 2-3 cm, the surface is hilly. At first, the patient does not pay attention to such a neoplasm, however, with the course of the pathological process, the following symptoms occur:
In the initial stages, the skin of the scrotum is not changed. With a large tumor, the patient experiences discomfort when walking, having sexual intercourse, pain in the scrotum, which radiates to the perineum and groin. When metastasizing a tumor through the lymphatic vessels, the following symptoms occur:
- With compression of the ureter - a violation of the outflow of urine, acute urinary retention, the development of secondary pyelonephritis and hydronephrosis,
- With metastasis to the cervical lymph nodes and compression of the airways - a painful cough, shortness of breath,
- With metastasis to the brain - changes in the psyche, paralysis and paresis,
- With the spread of tumor cells into the bone tissue - bone pain and fractures,
- With compression of the inferior vena cava - edema of the lower extremities,
- With the localization of metastases in the lymph nodes of the gastrointestinal tract - violation of bowel movements, intestinal obstruction.
Malignant tumors of the epididymis can lead to infertility in men. Its cause is not only mechanical compression of the vas deferens, but also a change in the chemical composition of sperm. Scientists believe that a tumor increases the local temperature in the scrotum, which has a detrimental effect on sperm. With testicular cancer, the concentration of antisperm antibodies increases. Sperm cells stick together and lose their mobility, which significantly reduces the likelihood of successful fertilization of the egg.
Diagnosis of cancer of the epididymis
Identify a tumor of the epididymis using self-examination. Urologists recommend that all men aged 15 to 40 years at least once a month to conduct an independent examination of the genital glands. Particularly attentive to their health should be men at risk (with burdened heredity, suffering from cryptorchidism). Self-examination is carried out according to the algorithm:
- In a standing position, put one foot on a stand,
- Carefully probe the scrotum and find the testicle,
- Examine the sex gland for suspicious seals,
- Repeat the procedure on the other side.
It is better to conduct a self-examination after a shower, when the scrotum is in a relaxed state. Normally, the testicle is quite dense, but not too hard. Behind the male reproductive gland, the spermatic cord is well palpated. In most men, the right testicle is located above the left. During the examination, a man should not experience discomfort or pain.
If there is any formation in the testicle, an increase in the size of one of the testes, pain during palpation, you should contact a urologist. Highly qualified doctors work in the Yusupov hospital, who underwent special training in leading domestic and foreign urological centers.
Upon examination, the urologist pays attention to the condition of the skin, reveals the presence of redness or swelling of the scrotum. The doctor conducts a manual examination of the testicles, paying attention to their size and symmetry, reveals pathological formations. Early diagnosis of cancer of the epididymis is carried out by determining the level of the following tumor markers:
- Beta-hCG (beta subunits of human chorionic gonadotropin),
- LDH (lactate dehydrogenase),
- AFP (alpha-fetoprotein).
Normally, in the blood of men, these substances are not detected or are found in minimal concentrations. The appearance of tumor markers with a high probability indicates the presence of a malignant process. Monitoring the markers of testicular cancer helps in time to identify a relapse of the disease.The main method for diagnosing tumors of the epididymis is ultrasound (ultrasound). When conducting an ultrasound examination, the doctor can not only detect the tumor, but also distinguish it from other pathological formations in the scrotum.
With any change in the echostructure of the testicle, sonologists exclude a malignant tumor. Initially, the neoplasm is usually located on the back of the testicle. For a long time, the shape and volume of the testicle may not change. Seminoma, lymphoma is characterized by the hypoechoic structure of the tumor with the presence of small random internal echo signals. Hyperechogenic neoplasms are represented by teratoma, embryonic carcinoma, chorionepithelioma. Doctors sometimes reveal mixed structures. With decay, hemorrhage, or an internal cyst, ultrasound shows fluid within the tumor. A cyst also occurs in teratomas. A benign tumor looks like a local lesion with clear even contours, a malignant tumor looks like a massive neoplasm that destroys the parenchyma with irregular outlines. To clarify the diagnosis, identify metastases, computed or magnetic resonance imaging, PET-CT are performed. X-ray examination is used to search for distant metastases. According to the testimony, a radiography of the lungs and bone scintigraphy are performed at the Yusupov hospital. Computer tomography helps to identify metastases of a testicular tumor.
Testicular cancer in men: prognosis of development and survival
Testicular cancer is a common cancer pathology among young men. This disease accounts for 3% of all malignant neoplasms. Usually they suffer from people from 35 to 55 years old, but sometimes young men (aged 15 years).
Epididymal Cancer Treatment
The only way to get rid of a malignant tumor of the epididymis is surgery. The volume of surgical intervention depends on the type of neoplasm, the patient's age and the presence of concomitant pathology. The standard surgical intervention for malignant neoplasms of the epididymis is the removal of the gland - orchofuniculectomy. The testes are removed before the start of radiation and chemotherapy. In the serious condition of the patient and multiple metastases, chemotherapy is preliminarily performed.
The operation is performed under general anesthesia through inguinal access. The urologist removes the testicle along with the spermatic cord. The material directs to histological examination. In difficult cases, when it was not possible to establish an accurate diagnosis before surgery, histology is performed urgently - within the next 15-30 minutes. According to the results of the study, the volume of surgical intervention can be expanded.
The use of cytostatics and other drugs that inhibit the growth of atypical cells is carried out with the development of malignant neoplasms and the identification of distant metastases. Doctors of the Yusupov hospital determine the dosage of drugs and the duration of therapy individually in each case, depending on the stage of the disease, the age of the patient and the location of the metastatic foci.
Radiation exposure is carried out with seminomas. Other malignant neoplasms of the testis respond poorly to radiation therapy. In most cases, irradiation is carried out after removal of the testicle, but according to indications, radiologists can change the treatment regimen.
If a man plans to become a father in the future, sperm are taken and frozen before chemotherapy. Subsequently, the biological material is thawed and used for artificial insemination. When detecting cancer of the epididymis in young men, it is recommended to conduct a biopsy of a healthy testis. After the operation, a control study of tumor markers is mandatory. The analysis is performed after 7 days and then every 7-14 days until the indicators normalize.
The prognosis for benign tumors of the epididymis is favorable.Excision of the tumor eliminates the problem. The second sex gland completely copes with spermatogenesis and hormone synthesis. Removing one testicle does not affect a man’s sexual activity, does not interfere with paternity, and does not impair the quality of life. If surgeons are forced to take a testicle during an operation, a prosthesis can subsequently be placed in the scrotum.
The prognosis for malignant tumors of the epididymis depends on the stage of the disease, the presence of metastases and the level of tumor markers. The appearance of multiple metastases is an unfavorable sign. Treatment is more effective in the initial stages of the disease. For this reason, if you have found a seal on the testis, make an appointment.
Testicular cancer refers to malignant neoplasms, it is characterized by unpredictable development and rapid growth of cancer cells.
This cancer is more common among other malignant tumors. And since he is considered very aggressive, statistics call him one of the most common causes of death among cancer patients under the age of 35.
This form of cancer is considered the most common cancer among men aged 15-35 years. Usually, such a cancer pathology is one-sided, although there are cases of a bilateral form of the cancer process (about 2% of diseases of this form).
This male tumor forms and rapidly develops in the male gonads (testicles), but then begins to spread throughout the body through hematogenous and lymphogenous methods (usually in the brain and bone structures, lungs, and liver).
Causes of Testicular Cancer
Three age-related peaks were identified when testicular cancer occurs:
- In boys under 10 years old,
- In men aged 20 to 40 years,
- In men after 60 years.
In children, a similar form of cancer can develop against the background of malignancy of fetal benign teratoma.
It is difficult to accurately determine the cause of the onset and formation of such a cancerous tumor. But there are certain patterns and risk factors that contribute to the emergence and development of this type of oncology:
- Belonging to the Caucasian race (it was noted that African Americans and Asians suffer from this type of oncology much less often),
- Tall and slim
- Male infertility (with this diagnosis, the risk of testicular cancer is tripled)
- Nicotine addiction (when smoking at least a pack of cigarettes a day for 10 years or more increases the risk of testicular cancer by half),
- Hypospadias (impaired development of the male genital organs when the urethral opening is below the head of the penis or on the scrotum),
- Congenital underdevelopment of the testicles,
- Hereditary factors
- Moles, if they are prone to transformation into malignant tumors, can also provoke testicular cancer,
- Early puberty in adolescents,
- Lack of exercise,
- Regular overheating of the scrotum or its injury,
- Torsion of the testicle, cryptorchidism (undescended testicle increases the risk of testicular cancer by 10 times),
- The effects of radiation in the past,
- Endocrine pathologies (hylogonadism, gynecomastia, infertility),
- Immunodeficiency virus
- If in the past there was a tumor of another testicle.
Another factor contributing to the development of such oncology is the presence of Klinefelter or Down syndrome. Professional activity is also of great importance: men working in the oil, coal, gas, leather, and firefighters are more susceptible to this pathology.
Signs of testicular cancer
The first signs and symptoms of such a malignant process are the appearance in the scrotum tissues of dense formations that contribute to an increase in the organ. These seals can be both painful and not cause discomfort.
Usually, patients feel some swelling on the testicle of a man, painful sensations usually appear in the abdomen and scrotum. In men, the following symptoms may occur:
- Dramatic weight loss
- Fast fatiguability,
- Low constant temperature (37.5%).
A further sign of the formation of a cancerous tumor is the feeling that the testicles are very swollen - they greatly increase in size. Then there are difficulties in breathing, shortness of breath appears, lymph nodes increase, back pain appears, general weakness is felt.
Another sign is a marked decrease (or lack) of sex drive, soreness and enlargement of the mammary glands. If there is a process of tumor metastasis, then a cough appears, right-handed soreness, shortness of breath occurs.
If the tumor grows into the epididymis, then the following symptoms may occur:
- Testicular deformity and enlargement,
- There is a painful tightness
- Scrotal edema
- Pain along the spermatic cord and lower abdomen,
- Other symptoms (chest pain, back pain, swollen lymph nodes, shortness of breath).
Cancer of the epididymis, in turn, can provoke the formation of secondary sexual characteristics and thyroid diseases, which can change the appearance of the patient. In adults, there is a decrease in libido, impotence, feminization is possible. Boys often have gynecomastia, premature masculinization (hirsutism, voice mutation, frequent erections, macrogenosomia).
Differences in cancer of the right and left testicle
Despite the fact that these are paired organs, cancer of the left testicle is different from cancer of the right. The causes of the appearance of a cancerous tumor, the form of growth and the course of the disease of both testicles are similar, but metastases spread differently.
When localized in the right testicle, the tumor metastases to the lymph nodes, which are located along the aorta and in the space between the aorta and the inferior vena cava. With cancer of the left testicle, nodes located around and in front of the aorta are more affected. From a cancerous tumor of the right testicle, metastases to the retroperitoneal lymph nodes on the left side can be expected, which is unusual for the tumor localization on the left side. If the tumor is diagnosed in one testicle, then there is a likelihood of occurrence in another.
Diagnosis of testicular cancer
To make such a diagnosis, it is necessary to undergo an examination with a specialist who will palpate the scrotum and a general examination, find out why it swells. Sometimes even at this stage, there is a suspicion of a malignant formation. Lymph nodes in the groin, supraclavicular and peritoneal location are also examined.
After conducting such an examination, the doctor gives a direction for diagnostic tests. Usually assigned:
- Ultrasound This study helps determine the presence or absence of a tumor with almost 100% accuracy,
- MRI and computed tomography. Similar to ultrasound, but is more informative about the disease,
- Osteoscintigraphy. She clarifies whether there are or are no metastases,
- Tumor marker assays,
- Morphological diagnosis of tumor fragments (this study is prescribed after removal of the testicle to determine the risk of metastasis).
Analysis of tumor markers is of great importance in identifying the degree of tumor development, the choice of therapy and monitoring the response to prescribed treatment. Tumor markers (ACE, LDH, hCG) are characteristic substances that are produced by malignant neoplasms. For example, ACE increases in 70% of testicular cancer patients. HCG is elevated in patients with testicular chorionic carcinoma. Diagnosis of testicular cancer at the initial stage of the disease can be done with a pregnancy test. The fact is that an increase in the level of hCG in the urine, this test will show immediately.
The final diagnosis is made after a biopsy of the testis through inguinal access.As a rule, during such a diagnosis, an urgent morphological study of the biopsy is carried out, and if the presence of cancer is confirmed, then the excision of the genital gland with spermatic cord (orchifuniculectomy) is performed.
Based on all studies, the most appropriate therapy is prescribed.
Testicular Cancer Treatments
Common methods used to treat testicular cancer:
- Surgical intervention,
- Radiation therapy.
Surgical intervention involves the removal (orchifunilectomy) of the testicle, which has undergone a tumor process. Sometimes this operation also involves the removal of lymph node structures (retroperitoneal lymphadenectomy). After surgery, a course of chemotherapy or adjuvant radiation therapy is usually prescribed.
The downside of the comprehensive treatment of testicular cancer (removal, chemo and radiotherapy) may be temporary or prolonged infertility and impotence. That is why, prior to the start of therapy, it is advised to preserve the seed fund by cryopreservation if the man plans to have a child in the future.
A successful outcome after treatment is influenced by many factors:
- Early detection of cancer (survival rate is about 90%)
- Detection of cancer at stages 2-3 with metastases (a complete cure is impossible, but 5-year survival is about 50%).
If a man plans to become a father in the future, it is recommended that cryopreservation of the seed be performed before starting treatment. Unfortunately, a complete exclusion of the likelihood of developing this type of cancer is impossible, since in most cases it is laid in the prenatal period. But timely treatment of urological pathologies and abnormalities (dropsy, cryptochism) will help greatly reduce the risk.
Given the high rate of tumor growth, you should be more careful about any suspicious changes in your body and consult a specialist in time. Then the risk of capturing the disease in the initial stage and completely getting rid of it is great enough.
My husband’s egg was swollen severely. The difference is visible to the naked eye. What is this disease?
Cancer is possible. But to confirm the diagnosis, you need to undergo an examination with a doctor.
Cones appeared on the man’s testicle. Maybe it can be cancer and how to find out for sure.
Quite possible. Healthy testicles should not have any seals. But to confirm the diagnosis, you must definitely go to the doctor. If the diagnosis is confirmed, he will prescribe therapy.
Can testicular cancer be cured at home?
Not. The sooner you begin the examination and treatment with an oncologist, the more chances to avoid bad consequences.
How long does a person diagnosed with testicular cancer live in a medical history?
With timely treatment of testicular cancer in 90% of cases, the life expectancy is more than 5 years, the later treatment is started, the greater the percentage of people dying.
Can I do chemotherapy for multiple sclerosis? Dad has testicular cancer.
With multiple sclerosis, chemotherapy can be done if it is prescribed for the treatment of cancer.
The most common symptoms of epididymal cancer
Most often, a painless tumor formation at an early stage is detected by chance, by self-palpation. Men can for a long time not pay attention to the neoplasm and perceived discomfort. However, as the disease progresses, when the first signs and symptoms appear, such as sharp pain and fluid accumulation in the scrotum, patients seek medical help.
The tumor substrate consists of nodules that are clearly visible using ultrasound. As a rule, sarcoma or cancer is diagnosed, giving metastases to the body of the testis, less often to other organs.
Diagnosis is very important, consisting of a thorough history, palpation, ultrasound of the scrotum, magnetic resonance therapy, and especially a biopsy.Differentiate the disease with epididymitis and seminal cysts.
In men suffering from cancer of the appendage of the right or left testicle, the following symptoms are noted:
A deformed testicle and its increase more often, on the one hand.
Severe swelling of the scrotum and a feeling of heaviness.
A sharp, shooting pain in the projection of the spermatic cord.
Lymphadenopathy of regional lymph nodes.
Drawing pain in the groin and lower back.
Asthenic syndrome, unmotivated subfebrile condition.
Cancer of the left testicle differs from cancer of the right testicle only in metastasis. Right-sided cancer metastasizes to the lymph nodes of the aorta, between the aorta and the inferior vena cava, as well as to the retroperitoneal lymph nodes. Left testicular cancer affects the lymph nodes around and anterior to the aorta.
When the disease progresses and is complicated by metastasis, patients note heavy breathing with pronounced shortness of breath, persistent cough, cachexia. When a malignant tumor is detected, the epididymis is removed with Duchenne surgery, radiation therapy of the pelvic and lumbar lymph nodes.
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The male testicle consists of numerous shells formed by all kinds of tissues, each of which has peculiar qualitative features. Tumors of different origin can form in any kind of tissue. Consequently, the appearance of a neoplasm of the testis and malignant tumors is explained by the features of the complex structure of the organ.
Today in medicine there is a certain classification of developing testicular tumors, all information is provided in three sections. First of all, the sections pay attention to gonadal stroma tumors (germinogenic), and then to other, less common varieties.
Testicular neoplasm is a common pathology, men aged 15 to 40 years are at risk. Experts say that in a man’s life there are several special periods in which the appearance of a testicular tumor is extremely common:
- Up to 10 years
- From 20 to 40 years old,
- After 60 years.
According to statistics, for every 100 cases of detecting a tumor in the testicle, cancer of this organ is diagnosed in two. Tumors can be attributed to the "young", since in most cases they develop in adolescence and reproductive age.
Factors that can provoke the appearance of a neoplasm of the organ of the male reproductive system:
Cryptorchidism. Pathology occurs during fetal development or immediately after the birth of a boy. In other words, cryptorchidism is an undescended testicle. Without descending into the scrotum, the testicle "remains" in the abdominal cavity, rarely in the inguinal canal.
It is important to note that with this pathology, the risk of a further malignant tumor in the testicle increases many times. Most often, testicular cancer is diagnosed in patients with the location of the testicles in the abdominal cavity (in the medical synthdominal location).
When a man has both testicles inside the abdominal cavity, the risk of malignant neoplasm increases by at least 30 percent.
Explain this dependence is quite simple. In the scrotum, the optimal temperature for the vital functions of the testicles is lower than in the abdominal cavity within three degrees. With cryptorchidism, one or both testicles are in the abdominal cavity, therefore, there they suffer from fever. Mutations can occur as a result of such vital activities; it is precisely such changes that can lead to the appearance of a cancerous tumor in a short period of time.
An interesting fact: several years ago, among doctors there was an opinion that a malignant formation in the testicle could appear as a consequence of a bruise. However, now, most experienced doctors are confident that a bruise is only a good reason to be urgently examined by a specialist, since a cancer tumor can "live" in the organ for a long time, and a man can not even guess about it.
Separately, it is worth noting the hereditary factor. If there was a similar disease in the male line, the child is extremely likely to develop a testicular cancer.
Causes of the disease
The causes of testicular cancer in men are not known reliably, but there are factors predisposing to the development of this pathology. These include the following:
- the presence of human immunodeficiency virus,
- physique: very thin figure with high growth,
- hypospadias - abnormal development of the genital organs,
- hormonal failure in the body,
- hereditary addiction (close relatives had testicular cancer)
- testicular torsion - a pathology in which compression of nerves and blood vessels and tissue death occurs,
- race (Europeans are more likely to suffer from ailment than African Americans),
- testicular cancer
- labor activity (work in the field of the oil or gas industry, underground mines, with metals and chemicals),
- age (at risk are men from 35 to 55 years old).
Symptoms of testicular cancer
The first alarming symptom, after the appearance of which, a man urgently needs to go to a medical institution for examination is a neoplasm in the scrotum, which can be easily felt.
Tumor formation is most often detected by chance. It is unfortunate that our doctors do not conduct propaganda calling for frequent independent examination of the scrotum - after all, such a method is considered one of the best in identifying a disease at the initial stage of development.
In our state, unfortunately, they say very little that a cancerous tumor of the testicle is a common disease of our time. But it has been proved more than once that by discovering a small swelling of the scrotum or a nodule in the organ (even if it is painless) and contacting a medical institution, the man saved his own life.
It is worth emphasizing that in every tenth case of diagnosis of testicular cancer, the primary manifestations of the disease are associated only with the appearance of some clearly distant metastases.
With a malignant neoplasm of the testicle, multiple metastases appear in the retroperitoneal lymph nodes. They can compress the ureters, therefore, interfere with the normal passage of urine. Such pathological phenomena usually cause an acute inflammatory process in the kidneys, or lead to hydronephrosis.
In addition, metastases can also be in the lymph nodes that are on the neck. This arrangement provokes compression of the upper part of the respiratory tract, the man feels severe shortness of breath, a choking cough may appear.
With a malignant tumor of the testicle, metastases may appear in the brain. In this case, the patient has a mental imbalance, neurological disorder (from paresis to paralysis).
Another organ that can affect metastases in testicular cancer is the lungs. Very quickly metastases disrupt respiratory function. If metastases spread to the skeletal system, an extremely dangerous pain syndrome occurs, which is accompanied by numerous fractures.
There are times when a man has testicular cancer with severe gynecomastia (an increase in the mammary glands in volume).
It is important for all representatives of the strong half of humanity to realize that after the appearance of the primary signs, you should immediately visit a qualified doctor. The primary signs include: swelling of one or both testicles, palpation in the organ of seals, nodular forms.
Diagnosis of the disease
A typical diagnosis of malignancy is based on existing clinical data, which includes: a full examination of a man, a thorough examination and palpation of the scrotum. No less important is the examination and palpation of all areas into which the tumor could metastasize.
During the examination, ultrasound diagnostics is used, all organs located in the abdominal cavity are examined. This method of examination allows to exclude / confirm the presence of metastases in the internal organs of men. You can also qualitatively examine the lymph nodes and organs that are located outside the abdominal cavity for the presence / absence of metastases in them.
Of great importance is an ultrasound examination of the testicle itself, because it sometimes allows you to detect the connecting elements between the resulting tumor and neoplasms in the scrotum. The patient is often asked to do a chest x-ray. This type of examination may show whether or not there is metastasis in the lungs.
When diagnosing malignant neoplasms of the testis, a standard blood test is always used, with which you can analyze the characteristic markers that occur only if there is a cancerous tumor in the body. Markers are substances of protein origin, their presence in the blood proves the presence of a malignant formation.
In addition to the standard blood test, an additional one, necessary for the study of AFP (alpha-fetoprotein), the beta subunit of chorionic gonadotropin and lactate dehydrogenase, is used.
Testicular Cancer Prevention
The best preventive measure is a monthly self-examination by probing the scrotum. If even minimal doubts appear during this process, you should immediately consult an experienced doctor.Only with timely detection of a tumor can one completely recover from this serious and dangerous disease.
How does an independent examination of the scrotum occur? A man needs to stand in front of a mirror. First inspect the scrotum visually, then proceed to palpation. If slight redness is found on the scrotum skin, or if one testicle suddenly increases in size relative to another, you should consult a doctor in the near future.
The next stage of an independent examination is to take the scrotum in your hand, support the testicle with four fingers, and feel it very slowly and extremely carefully with your free finger.
Urgently need to contact a specialist when:
- An increase in the volume of at least one testicle is noted,
- With an independent examination, painful sensations arise, even with a weak manifestation,
- When probing, a seal was found in the form of a tubercle or nodule, which had not previously been,
- There was a feeling of heaviness in the scrotum,
- Constant dull pain in the groin, lower abdomen,
- An admixture of blood appeared in the urine,
- There is an unexpected increase in the mammary glands in men.
Features of the treatment of testicular cancer
Naturally, the features of treatment directly depend on what stage of the disease is diagnosed. For example, if the initial stage of the seminoma is diagnosed (the lesion has not yet spread to the lymph nodes), the affected testicle is completely removed, then radiation therapy of the retroperitoneal and iliac lymph nodes is performed.
With a late call to a specialist, the third, advanced stage of testicular cancer is often diagnosed. In this case, treatment implies a standard course (testicle removal, radiation therapy) plus the use of powerful chemotherapy.
Epididymal tumor: symptoms.
Tumor formations of the epididymis most often do not have any vivid clinical manifestations. The main clinical manifestations are the formation in the area of the epididymis of a small, painless compaction. Over time, the tumor increases, pain appears. If the tumor is malignant, then it grows into the testes and metastasizes.
Markers of a testicular tumor are a diagnosis that sometimes can not be dispensed with.
To diagnose a testicular tumor, the following tumor markers are tested in the blood:
- AFP - alpha-fetoprotein. Normally, its value is up to 15 ng / ml.
- HCG - human chorionic gonadotropin (beta subunit). Normal hCG values are up to 5 IU / ml.
- LDH - lactate dehydrogenase. Normal up to 2000 U / L
- PSF - placental alkaline phosphatase.
How to treat a testicular tumor in men
Treatment of a testicular tumor is a task that requires a comprehensive approach. Testicular tumors can grow from different tissues, with different degrees of differentiation of tumor cells, have a different stage from each other, pass with or without damage to different levels of lymph nodes and surrounding or distant organs. Depending on all these parameters, it is possible both to remove the testicular tumor and to remove the testicular tumor medically, that is, without surgery. Also, depending on how much the tumor has spread to the surrounding tissue and its degree of malignancy, it is only possible to remove the tumor or remove the tumor along with the testicle, and in the presence of metastases in the surrounding lymph nodes, the removal of all surrounding lymph nodes is also possible.
Tumor in the testicle in men, what to do?
If you find an incomprehensible formation in your testicle, first things first you need to calm down and remember all the recent events. You may have recently been hit by a scrotum and a swelling has occurred as a result of an injury. This of course also requires going to the hospital. In any case, you need to make an appointment with a urologist in the near future. If you live in a small town and there is no urologist in your clinic, then consult a surgeon.At the appointment with a specialist, you will be examined, assigned tests and studies. If you suspect a tumor, you will be referred to an oncologist or to the nearest oncology center. There, they will conduct all the necessary research and will definitely establish a diagnosis, explain everything and tell you the necessary further actions. Do not panic in advance, a testicular tumor in men can be benign (it also should not be left without treatment), there are also many diseases that for a layman may look like a testicular tumor in men, treatment without surgery in this case will be carried out, and indeed the diseases themselves will not sound so frightening.
There are several basic and many additional ways to treat tumors.
The main ones:
- Surgical (removal of a tumor by a surgeon on the operating table).
- Radiation (exposure to a tumor by various types of radiation, using special emitting devices).
- Chemotherapeutic (effect on the tumor with medications that act on the tumor cells and destroy them).
- Immunotherapy (the introduction of funds or stimulating the body's own immunity, or ready-made antibodies against the cells of this tumor).
- Hormone therapy - the introduction of hormones or stimulants of hormone secretion into the body, under the influence of which the tumor begins to collapse.
- Local hyperthermia - the creation of elevated temperature in a certain area of the body in order to destroy tumor cells. Used in cases where tumor cells are subject to destruction by a temperature at which healthy cells are not destroyed.
- Local hypothermia - the creation of low temperatures in a certain area of the body in order to destroy tumor cells. It is used in cases when tumor cells are subject to destruction at temperatures at which healthy cells are not destroyed.
It is worth noting that one method of treatment is rarely used, often an integrated approach is used to treat tumors.
The first operation, which will be performed even if a testicular tumor is suspected before treatment and a full diagnosis is established, is a testicular biopsy. It refers to minimally invasive operations and in most cases comes down to a puncture of a tumor with a special needle for collecting tumor tissue under the control of an ultrasound device. With its help, the doctor will be able to accurately determine whether it is a tumor or not, the type of tumor, a malignant tumor or benign, from which tissue it grows, the degree of malignancy, is a primary tumor or metastasis of a tumor from another organ that did not manifest itself (for example, if there was a tumor liver, it metastasized, a left testicular tumor has formed in men, treatment will already be directed to a completely different type of tumor). Depending on the data obtained by biopsy, further treatment tactics will be built.
There are several options for operations. For tumors of small size (not visible to the naked eye) that do not have metastases, the surrounding lymph nodes are not affected, or for benign tumors, only the tumor tissue is excised. With tumors that sprouted through the entire tissue of the testis, but without damage to the surrounding lymph nodes, a complete removal of the testicle and epididymis is performed. In cases of tumor damage to the nearest lymph nodes, all surrounding lymph nodes are removed along with the surrounding subcutaneous fat. A chemotherapy course is also provided. In those situations where distant lymph nodes are affected, several courses of chemotherapy are performed. If, in addition to lesions of the testicle and lymph nodes, there are metastases to any organs, several courses of chemotherapy are carried out and combined with radiation therapy.
Cure testicular tumor with folk remedies.
Symptoms of pathology
How to timely determine testicular cancer in a man? Signs of the disease appear as it develops. At the initial stage of the disease, it is almost impossible to suspect that an oncological process was born in the body.
As the tumor grows, unpleasant symptoms occur. A man begins to feel discomfort in the testicle, and then discovers a seal in it. The tumor increases in size, resulting in pain in the affected organ.
Further, the testicle is deformed and becomes denser. The location of the neoplasm is determined by the change in the scrotum parameters: the side in which there are atypical cells increases in size.
So, testicular cancer can be identified by the following symptoms:
- pain in the lower abdomen
- fluid in the scrotum,
- change in the size of the testicle (usually an increase)
- decreased libido
- an increase in the size of the scrotum.
At the second stage of the disease, signs arise due to the development of metastases:
- regular pain pulling in the groin and lower abdomen,
- discomfort in the leg and its swelling (from the affected organ),
- back pain,
- breast enlargement (due to hormonal changes),
- disruptions in the functioning of the intestines and stomach,
- frequent cramps.
The third and fourth stages of the pathology are characterized not only by specific signs, but also by disorders of various internal organs.
The development of a tumor adversely affects the state of the body, as a result of which symptoms are observed:
- decreased performance
- back pain,
- poor appetite.
When the first symptoms of testicular cancer appear, consult a doctor. The sooner treatment of the pathology is started, the more favorable the prognosis for the patient. As the tumor progresses, atypical cells will penetrate other organs, which will certainly provoke poor health.
Diagnosis and treatment of testicular cancer in men
You can suspect the presence of the disease through a routine physical examination or through self-diagnosis. For a more detailed identification of the tumor, laboratory and instrumental examinations are used.
First of all, the patient is sent for a blood test to detect cancer markers.
An ultrasound of the scrotum is performed at an early stage of the disease, and resonance imaging of those organs where they could penetrate is performed to detect metastases.
Testicular cancer diagnostic methods:
|Diagnostic method||What reveals|
|Ultrasound of the scrotum||Dimensions and contents of neoplasms|
|Blood test for tumor markers||The number of tumor cells|
|Tomography||Atypical cells in various organs|
Some of these diagnostic methods are used for women to detect ovarian cancer. Oncological pathologies of the reproductive organs suffer not only from the stronger sex. However, in women, ovarian cancers are also determined by other studies.
Testicular cancer in men is easily treatable at the initial stage. The doctor develops therapeutic tactics based on the stage of the disease. There are three main ways to combat pathology: surgery, chemotherapy and radiation.
At the first stage, the testicle is removed with radical orchiectomy. Then irradiation is carried out, and the patient is recommended to periodically visit a doctor for ten years after surgery. In the second stage, the tumor is also surgically removed along with the affected organ and a course of radiotherapy is performed.
The third stage involves surgery followed by chemotherapy and medication. Radical orchiectomy is the main treatment for ovarian cancer. The operation is performed under general anesthesia.After removal of the affected organ, the patient should adhere to bed rest and follow other recommendations.
The prognosis of testicular cancer in men
Testicular cancer is not a sentence. It can be treated even in advanced cases, but with early detection of atypical cells, the chances of a full recovery are much higher. If you find suspicious symptoms, you should consult a doctor and undergo treatment. If an operation has been performed, then in the future it is worth following all medical recommendations.
Perinatal factors and an inherited background affect the prognosis of testicular cancer.
So, 76% of mothers whose sons suffer from embryonic ovarian cancer had a hormonal imbalance during the gestational period. The hereditary factor played a role in 56% of cases.
At the same time, the probability of developing pathology in young men whose fathers had testicular cancer was 2-4 times higher than in the population, and in their brothers - 8-9 times.
Risk factors for the disease and the likelihood of its development:
|Risk factor||The likelihood of developing testicular cancer|
|Increased estrogen levels in a pregnant woman||43 %|
|Mother age||35 %|
|Cryptorchidism (unilateral)||4-5 times higher than in the population|
|Cryptorchidism (bilateral)||9-10 times higher than in the population|
|Elderly age||26 %|
Smoking father is also considered a factor provoking the development of cancer. This is due to the fact that 78% of men suffering from nicotine addiction have insufficient sperm motility, and 23% have azoospermia. By the way, the representatives of the stronger sex, who had cancer of one testicle, later develop a tumor in another testicle.
Symptom statistics for testicular cancer
It is worth paying attention to the statistical indicators for testicular cancer:
- 30-40% of men feel aching pain in the affected organ or heaviness in the lower abdomen,
- about 10% of patients have acute testicular pain,
- 25-35% of men suffer from hormonal gynecomastia
- in 15% of patients find atypical cells in the cervical lymph nodes, and in 55% in the inguinal,
- 60% of the stronger sex complain of decreased libido,
- in 11% of men, symptoms appear only after the spread of atypical cells to neighboring organs,
- 54% of young men have signs of masculinization: an early change in voice, persistent erections, and long-term beginnings of pollutions,
- metastasis of the abdominal cavity in 65% of cases leads to nausea, pain,
- in 87% of the stronger sex, atypical cells that invade the lungs cause shortness of breath, hemoptysis, and cough.
Disease Survival Prediction
With the early detection and treatment of the disease, recovery is possible in 95% of cases. As the tumor progresses, the chances of a successful outcome decrease.
It is known that in 2012 in the world of six cases of testicular cancer, only one was fatal. Meanwhile, the data on survival for this pathology in the countries of the world differ from each other.
So, in Germany, men suffering from testicular cancer survive 2 times more often than in the USA.
At the first stage of the pathology, patients undergo a radical inguinal orchiectomy. It gives good results in 99% of cases.
After studying the data of histological examination of neoplasm cells, 98% of patients prescribe lymph node radiotherapy on the side of tumor localization.
With this treatment strategy, survival is 95-99%, and the recurrence rate of the pathology ranges from 3-5%.
For patients with metastasis of regional lymph nodes, radical removal of the affected organ in combination with radiation therapy is practiced.
The chances of a favorable prognosis with such treatment are 92-99%. Men who refuse radiotherapy after surgery are usually prescribed chemotherapy with carboplatin.
The survival rate is 89-91%.
2A stage of the pathology involves irradiation of the lymph nodes on the side of the malignant neoplasm. A favorable forecast is possible with a probability of 95%.
If the disease is at the stage 2A, 2C, 3 or 4, it is recommended to undergo 4 courses of chemotherapy with cisplatin and etoposide. The survival rate is 85-86%.
At the fourth stage of oncological pathology, only 57% of patients remain alive.
Testicular cancer treatment: methods and prognosis
Despite the extremely aggressive course, in the vast majority of cases, testicular cancer responds well to treatment. The best results are observed in the treatment of patients with seminomas. Such malignant tumors grow from the cells of the tissue that produces sperm.
Neseminomas - teratomas, embryonic carcinomas, choriocarcinomas, tumors of the yolk sac - respond somewhat worse to oncotherapy. However, the use of modern drugs and methods allows specialists to successfully cope with these types of neoplasms.
Predictions for the treatment of testicular cancer at different stages
- The 5-year survival rate of patients almost reaches 100% if the tumor can be detected at stage 1, that is, when the lesion has not yet managed to spread beyond the testis. It must be clarified right away that the meaning of the medical term survival is often misinterpreted. In fact, this statistic refers to the percentage of patients who have not had a recurrence of the disease for a given number of years. But this does not mean at all that the life of the treated patient is limited to only one, two or five years.
- With stage 2 testicular cancer, tumor cells are found in nearby lymph nodes, which requires an expansion in the treatment volume, but only slightly worsens the prognosis: five-year survival reaches 90-95%.
- Therapy of patients with metastases (testicular cancer of the 3-4th stage) can also be very successful: in 80 out of 100 such patients, the disease does not return in the next five years. There is one more positive point: if relapse nevertheless occurs, then, more often than not, it can also be stopped.
Recovery after treatment
The duration of the recovery period depends on the nature and composition of the treatment, the severity of side effects (if any), as well as the general health of the man.
At this time, it is necessary to lead a measured lifestyle, rest fully, avoid heavy physical exertion (at least 6 weeks), exclude the possibility of infection in the postoperative area.
In the process of recovery, patients with diarrhea are advised to drink plenty of fluids and adhere to a special diet, eliminating bran, dried fruits, cabbage, bread and cereals from whole grains from the diet, reducing the use of fresh fruits and vegetables, juices. It’s useful to add bananas to the menu.
Subject to the recommendations of doctors regarding nutrition, treatment and personal hygiene, complete healing of postoperative sutures occurs in a few weeks, side effects of radiotherapy disappear within 1-2 weeks, chemotherapy within several days.
It's hard to believe, but after treating testicular cancer, there may be a full life
Testicular cancer is a malignancy that develops in the male sex glands.
According to the classification of ICD codes, this is series C 62 “Malignant testicular formation”, which includes 2 subgroups: “Testicular cancer” and “Germinomas”.
Most often found in men aged 20-40 years, but the disease of the elderly and children is not excluded. More often the tumor develops on one side. A distinctive feature is the unpredictability of the course of the disease.
Symptoms and Diagnosis
At the initial stage of the disease, there are no signs on the male genital organs, so it is difficult to recognize the development of the tumor.
The most characteristic symptoms:
- an increase in the size of the left (right) testis,
- fluid in the scrotum, the presence of which is manifested as a feeling of heaviness,
- painful swelling
- seals or nodules in the scrotum,
- pain in the lower abdomen
- breast enlargement,
- decreased sex drive,
- activation of hair growth on the face and body,
- the development of inflammatory processes in the body.
Testicular cancer: is there any chance of recovery?
Formations in the form of a tumor that appears on either of the two testicles, which are malignant, are called testicular cancer. The main causes of cancer cells on the testicles have not been studied to date, in most cases they are due to the action of some congenital factors, and violations in the development of the reproductive system even inside the womb.
Signs that characterize the onset of cancer are accompanied by visual formation of round seals in the testicle, acute pain in the abdominal cavity, in the scrotum, and a change in the diameter of the scrotum upwards.
For accurate diagnosis of the disease using computed tomography, ultrasound, blood plasma tests for the presence of cancer markers. It should be noted that the disease is easily treatable even when the tumor has metastases. In those cases when the treatment of the disease will proceed correctly, the probability that the patient will receive a full recovery is quite high.
One way to cure the disease is the surgical removal of a diseased testicle. At the end of the operation, an additional irradiation of the tumor is prescribed, or treatment using chemotherapy.
Why does testicular cancer develop?
As mentioned above, the causes of the onset of the disease are not fully understood and are not fully known, although there are several hypotheses that explain the manifestation of this disease:
- A huge role in the occurrence of testicular cancer is played by heredity. As a rule, a high risk of the disease is characteristic of patients whose close relatives also had similar diseases.
- Changes leading to malfunction of the reproductive system in men, as a result of which the testes are not located in the scrotum, but in the abdominal cavity. Patients whose disease has not been treated before they reach 11 years of age with surgical intervention are more likely to develop cancer than the rest.
- Significant deviations in the genitals (hypospadias), upon detection of which the opening of the urethra can open only in the lower zone of the penis. For patients born with hypospadias, the likelihood of cancer increases many times.
- Previously transferred cancer. If the patient had testicular cancer and was removed, then the likelihood of cancer recurring increases.
- A link with the disease also has testicular torsion, almost 64% of patients who have had testicular torsion disease. later suffered from cancer.
Types of stages of the disease
With advanced forms of the disease, the testicles visually change, pathological changes are visible to the naked eye
There are four types of cancer that directly depend on the physiological characteristics of the cells that make up the malignant tumors:
- Embryonic cancer is a formation located in embryonic cells (it remains in the patient’s body during embryonic development). This type is characterized by a negative outcome, because it very quickly allows the penetration of metastases into other organs.
- Tumor of the yolk sac. which is a malignant formation that develops from cells from the moment the embryo develops. This stage of the disease is considered the most common, often found in young patients. But a similar yolk sac tumor lends itself to complete cure.
- Teratoma can also appear due to disruptions in the development of cells. At the same time, mature teratomas consist of cells that do not allow the development of metastases, they develop rather slowly.In addition, immature teratomas can sometimes give metastases and subsequently adversely affect treatment.
- The most malignant form of cancer is considered choriocarcinoma. it is characteristic of men of more mature age, develops and spreads throughout the body quickly, subsequently releasing metastases.
When does it begin to appear?
It should be noted that the disease begins, manifests itself at almost any age, but the largest peak of the disease refers to the level from 15 to 35 years. The likelihood of the disease rises significantly for patients older than 60 years.
The main signs of the disease:
- The most common sign is the appearance of a seal, it can have different sizes. during examination and palpation, the testicle often does not hurt. But at the same time, it must be remembered that the formations that are felt are not always considered cancer. If statistics are taken into account, all seals in the testis turn out to be cancer only in 4% of cases, and in other cases, the formation appears due to other diseases (trauma, spermatocele). But no matter how it is, when identifying such a symptom, you must immediately seek the advice of a specialist, undergo a full examination.
- Aching, dull pain in the lower abdomen, back, in the scrotum.
- A jump in body temperature up to 37.5 ° C, fatigue, sudden weight loss.
- When the cancer has already metastasized, the following symptoms are possible: cough, pain in the right hypochondrium, shortness of breath.
Among young men (aged 20-40 years), testicular cancer is the most common malignant tumor. The incidence over the past few decades in industrialized countries has increased.
Testicular cancer develops 1 out of 300 men during life, but 1 out of 5,000 dies from it. Low mortality compared to morbidity is due to the fact that, unlike most other forms of cancer, testicular cancer responds well to treatment and has a favorable prognosis.
Most men with this diagnosis successfully cured and forget about the disease forever.
What is dangerous testicular cancer?
Malignant testicular tumors, like any other type of malignant tumor, are a direct threat to human life.
In the absence of timely treatment, the tumor grows and gives screenings (metastases) to other organs.
In the process of uncontrolled growth, tumor cells destroy organs and consume a huge amount of nutrients, oxygen, vitamins, depriving healthy cells of these resources and leading to their depletion.
Is this a sentence ?!
Fortunately, in the vast majority of cases - NO. Testicular cancer is a rare exception to the general list of malignant tumors, in which the prognosis for treatment is favorable.
Testicular cancer responds well to all the treatment methods available in the arsenal of doctors - surgical, chemotherapy and radiation therapy.
With this form of cancer, it is really possible to achieve a complete cure and forget about the disease forever.
Will I be able to have children?
Contrary to popular belief, the removal of one testicle does not lead to a significant deterioration in the fertilizing ability of sperm and a decrease in the level of male sex hormones. As mentioned above, in half of patients with testicular cancer, sperm quality is reduced before surgery and improves after it.
However, adjuvant (postoperative) treatments significantly reduce reproductive ability. Radiation and chemotherapy impair sperm quality, and retroperitoneal lymph node removal surgery disrupts natural ejaculation.
Therefore, before each stage of treatment, including before removing the testicle, the patient is offered sperm freezing (cryopreservation).
Removing the testicle is a powerful psychological trauma for a man.
Even despite a favorable prognosis, cure for life-threatening illness, the preservation of an erection and sexual desire, the normal ability to reproduce offspring, many men feel inferior due to the presence of one testicle in the scrotum.
Fortunately, today this problem can be easily solved by implanting a testicular silicone prosthesis in the scrotum. The type of scrotum after implantation and the prosthesis itself are completely indistinguishable from the real organ by touch.
Testicular cancer in men: symptoms and diagnosis, treatment, complications
Testicular cancer in men is a malignant neoplasm that affects the gonads of the stronger sex. It is a rare pathology. Of all oncological diseases in men, testicular carcinomas occur in only 2% of cases. This type of cancer occurs mainly between the ages of 20 and 50.
Causes of Oncopathology
In testicular cancer, 3 peak ages can be distinguished. Male reproductive carcinomas are most often diagnosed in the following age groups:
- up to 10 years
- from 20 to 40 years old,
- after 60 years.
Doctors identify the following causes of testicular cancer:
- Cryptorchidism is a pathology in which during intrauterine development the testes - one or both - do not descend into the scrotum. The maximum risk of developing testicular cancer in men in whom both gonads remained in the abdominal cavity. The reason for the development of carcinoma in this case, doctors consider an increased body temperature in the peritoneum. These 2 degrees are enough for the gland cells to begin to mutate. Even if surgery was performed and the organs were lowered into the scrotum, the risk of cancer remains high.
- Male infertility of any genesis.
- Heredity - if in the family there were cases of testicular cancer in men, then the likelihood of developing this pathology is high.
- Pathologies of testicular tissue - too dense or soft, the presence of scars or adhesions.
- A history of Kleinfelter's syndrome is a chromosomal abnormality, when an additional X chromosome is present in the male genotype.
- Constant contact with tin.
- Excess estrogen in food, water, use of pesticides.
The main symptoms
Symptoms of testicular cancer are not painful, so often patients or their sexual partners detect a neoplasm by accident. These are painless knots or seals.
Additionally, testicular cancer symptoms may be accompanied by dull or aching pain in the lower abdomen. A sharp pain syndrome occurs when foci of necrosis occur, hemorrhages due to the high growth rate of the neoplasm, epididymitis - an inflammatory process and swelling of the scrotum.
With the development of oncopathology, the following signs of testicular cancer are added:
- weight loss
- general weakness
- decreased appetite.
How to identify testicular cancer on your own? It is possible to suspect the presence of a neoplasm with the help of palpation. The carcinoma is thick and lumpy to the touch.
The signs of testicular cancer in men should be differentiated from inflammatory diseases of the organ, tuberculosis, and hydrocele. There is a specific protocol for examining and diagnosing.
On examination, the doctor notes the asymmetry of the scrotum. Often, due to hypertrophy of one testicle, the second is not visible at all. The urologist must necessarily palpate the tumor, conduct the so-called “sliding test”. The neoplasms are dense, tuberous to the touch.
Additionally, translucent genital glands will help to recognize the tumor with transmitted light. An ultrasound of the scrotum and a blood test for tumor markers are indicated.
- hCG hormone blood,
- embryospecific alpha-fetoprotein (AFP) and lactate dehydrogenase (LDH).
Analysis of tumor markers helps to recognize the histological structure of the neoplasm. In addition, a blood test is used to control treatment, they help predict the onset of a relapse.
A mandatory procedure before surgery is an x-ray of the chest to exclude or identify distant metastases.
If within 2 weeks from the start of therapy, positive dynamics in treatment are not observed, then open diagnostic procedures are indicated. Initially, the spermatic canal is ligated, then the use of rapid biopsy or transcrotal biopsy is indicated.
After confirming the diagnosis of carcinoma, the stage of the oncological process is established. To do this, carry out the following studies:
- chest and lung x-ray
- CT retroperitoneal space, liver,
- lymphography, urography. If CT examinations were performed, then these procedures are not carried out,
- transabdominal retroperitoneal lymphadenectomy to determine the smallest foci of a secondary tumor.
Treatment of other tumors
If the diagnosed carcinoma is not a semenoma, then organ resection is indicated at stages 1 and 2 of oncopathology. Additionally, the spermatic cord and the nearest lymph nodes are removed. Then continue to treat the patient with chemotherapy drugs. If no secondary neoplasms are found in the lymphatic system, then 2 courses of chemistry are indicated.
At stage 2B, 2C, 3, massive drug therapy is indicated. How many chemotherapy courses are required depends on the patient's condition. On average, this is from 2 to 4 episodes of treatment every 3 weeks.
If the patient is in a state of remission, proved by immunological examination, but he has found secondary foci of the tumor, then surgical intervention is indicated to remove neoplasms.
Further, in such patients, chemotherapy is canceled.
If there are acute manifestations of the disease, then surgical intervention is not advisable.
How to live on?
A consequence of testicular cancer can be infertility. This occurs with damage to both the right and left testicle. Currently, the methods used to treat patients allow preserving reproductive function.
According to medical statistics, 50% of patients after a course of chemotherapy restore both erectile and reproductive function. If only 1 testicle is removed, then the second testicle will completely cope and the patient has a high chance of becoming a father.
Do not forget about the individual characteristics of the body. Therefore, most oncologists recommend that before starting treatment, patients in their reproductive age undergo the procedure of collecting biological material with subsequent cryopreservation.
What to expect?
Having heard the diagnosis, the patient prepares for the worst. How to live further and what are the forecasts for treatment and survival?
The chances of recovery depend on the type of carcinoma, the stage of the disease and how much the lymph nodes and other organs of the peritoneum are affected by metastases.
If the treatment of non-seminal carcinoma is started at stage 1, the neoplasm is resected, and the number of tumor markers decreases, then more than 80% of patients pass the five-year survival threshold and feel great.
If the patient has stage 2 disease, then the size of the neoplasm, the number of secondary tumors in the retroperitoneal space will affect the life expectancy. With quality treatment, 70% of patients survive.
At stage 3 of oncopathology, the prognosis depends on the same factors as for the second stage. In addition, the overall condition of the patient, the quality of the work of other organs and systems, influence the survival rate, since in this period metastases are found throughout the body. At this stage of testicular carcinoma, about 50% of patients survive.
Oncological processes in the testicular glands are difficult for the patient to perceive. But at the same time they respond well to treatment. The main thing is not to lose precious time and not to experience untested treatment methods.Pass a comprehensive examination and treatment and you have every chance of becoming a father, despite the sad diagnosis.