Testicular cancer is a special type of malignant tumor that develops in the testicles (male gonads). This disease differs from many other oncological diseases by rapid growth and active metastasis. Every man, having heard such a diagnosis, wants to know if it is possible to defeat the disease and how to do it.
Testicular cancer: statistics
In terms of frequency of occurrence, this type of oncology is far from the first place. Of all cancers in men, testicular tumors account for approximately 0.5%. Most of all patients with this diagnosis are young men aged 15 to 45 years. As you get older, your risk of developing testicular cancer decreases slightly.
It has been observed that Caucasian men have this disease 10 times more often than blacks and Asians.
Today, doctors are talking about an increase in cases of this disease. According to statistics, over the past 5 years, the incidence rate has increased by 30%. In general, this is associated with the deterioration of the environmental situation and a large number of bad habits.
Causes of disease
Leading scientists andoncologists in many countries regularly conduct research in this area, but so far they have not been able to figure out why testicular cancer develops in men. No one can name the exact reasons, but factors have been established that, according to doctors, can become an impetus for the appearance of pathological (cancerous) cells in the body:
- Various diseases of the male genital organs. Among them: testicular torsion, cryptorchidism, testicular underdevelopment and many others.
- Injury to the scrotum, as well as its regular overheating.
- Pathologies of the endocrine system.
- Human Immunodeficiency Virus.
- Hazardous production, including prolonged contact with heavy metals.
- The action of radiation.
- Bad habits, including drug addiction, smoking and alcohol abuse.
Risk factors
Risk factors have also been identified. In the presence of one or another factor (or a combination of them), the representatives of the stronger sex should be extremely careful about their he alth.
Cryptorchism is a pathology in which the testicle does not descend into the scrotum. According to medical statistics, the presence of cryptorchidism in a man increases the risk of developing malignant neoplasms of the testicle by 5 times. Bilateral cryptorchidism increases the risk by 10 times.
The influence of estrogen. Men living in areas with increased environmental pollution are significantly more likely to suffer from this type of cancer.
Heredity. Studies have shown that an important role inincreased risk plays a genetic predisposition. Fathers and sons have a 4-fold increased risk, while brothers have almost a 10-fold increase.
Klinefelter syndrome and Down syndrome.
Types of testicular cancer
All existing types of testicular tumors are divided into several varieties. This characteristic allows you to determine the peculiarity of the development of the disease, find the most effective method of treatment and give the most realistic prognosis. The main criterion for difference is the localization of pathological cells.
1. Non-germinogenic types of tumor. This term refers to those types of tumors that grow from the stroma. The frequency of their occurrence is quite low - only about 5% of all cases of testicular cancer. These varieties include:
- leidigoma;
- sarcoma;
- dysgerminoma;
- sertolioma.
2. Germinogenic tumors. These cells affect the tissues of the seminal epithelium. They are diagnosed much more often - their number reaches 95% of all types of testicular tumors. This category includes:
- seminoma (nearly 35% of cases);
- fetal testicular cancer;
- chorionkacinoma;
- cancer of the adnexa;
- teratoma;
- yolk sac cancer;
- teratoblastoma.
3. mixed species. In this case, cells from both types of tumor will be present.
Stages of the disease
The course of the disease is divided into stages, this helps doctors describe the full picture of the disease as accurately as possible. So, according to the internationalTNM system, there are the following stages in the development of testicular cancer:
- T-1 - at this stage, the tumor is quite small and is located within the albuginea.
- T-2 - the tumor is still limited to the albuginea, but there is already a slight deformity in the scrotum.
- T-3 - malignant cells grow through the albuginea and pass to adnexal organs.
- T-4 - at this stage of the development of the disease, the spermatic cord or scrotal tissue is involved in the process.
- N-1 is the initial stage of metastasis, in which abnormal cells are found in nearby lymph nodes.
- N-2 - at this time, the lymph nodes are significantly enlarged and painful, easily palpable on palpation.
- N-3 - distant metastases to organs (liver, lungs, kidneys, brain and bone tissue) are detected.
There is another classification of the stages of development of testicular cancer in men. Symptoms and signs in this case are classified into one of three stages or substages. When making a diagnosis, doctors also take into account the degree of metastasis and tumor marker.
1 stage
The tumor in this case is characterized by small size and clear localization within the testis. At this stage of the development of the disease, men do not notice any symptoms. Cancer detection at this stage is rare, usually during routine diagnostics. With such signs of testicular cancer in men, the treatment prognosis is optimistic - patient survival is 98%.
2stage
The stage of the disease in which cancer cells affect the inguinal lymph nodes. 50% chance of recovery.
3A stage
Metastases spread to lymph nodes between or in the lungs.
3B stage
The tumor spreads to distant lymph nodes, possibly affecting the lungs. Marker level is medium.
3C stage
The last stage of the development of the disease. At this time, cancer cells appear in many organs. Most often, the liver, lungs, kidneys, and brain are affected. Marker level is high.
Clinical picture
At the earliest stage of the disease, the characteristic symptoms and signs of testicular cancer are practically absent. This is due to the small size of the tumor. The first manifestations of the disease most often occur from the second stage.
- Increase in the size of the testicle, asymmetry of the scrotum. Many patients come to the clinic for this very reason. Men are wary of testicular enlargement, especially in cases where this was not preceded by trauma. However, pain is not always present.
- Pain. At first, pain is present on palpation of the scrotum, however, with the development of a tumor, cancer patients complain of frequent bouts of pain even at rest. Pain may radiate to the lower abdomen.
- Signs of gynecomastia (breast enlargement). This is one of the common symptoms of testicular cancer. The reason for this is the defeat of the appendages, which entails hormonal changes. In cases of development of suchpathology in boys, early puberty is observed (rapid growth of hair on the body and face).
- Feeling of pressure and heaviness in the scrotum.
- Noticeable enlargement and soreness of the lymph nodes in the groin.
- Sharp decrease in libido (sex drive).
- Low sensitivity in the genital area.
- In the later stages, the outflow of urine is disturbed.
If, with all these symptoms, treatment for testicular cancer in men has not been started, new signs appear that accompany all cancers:
- fatigue;
- loss of appetite;
- drastic weight loss;
- apathy;
- appearance of irritability.
It is very important to understand that speed and accuracy of diagnosis are important for successful treatment. At the last stage of the disease, the five-year survival rate of patients reaches no more than 10%. That is why doctors recommend contacting the clinic at the first suspicion of a disease.
Diagnostic procedures
The symptoms of some diseases (testicular tuberculosis and hydrocele) are very similar to the symptoms and signs of testicular cancer. When diagnosing a doctor, it is necessary to correctly differentiate the disease, because the effectiveness of treatment depends on it. There is a special protocol for diagnosis, which includes a number of laboratory tests and hardware examinations.
1. Initial appointment and examination of the patient. At the same time, the doctor will ask a series of questions to identify increased risk factors, listen to the patient's complaints. At the initial examination, it is mandatory toexamination and palpation of the scrotum, inguinal lymph nodes and mammary glands.
2. Blood analysis. Such a laboratory study helps to detect the presence of oncomarkers AFP, hCG and LDH in the blood. Their presence in a man's body makes it possible to diagnose a tumor even at the stage when there are no characteristic symptoms yet.
3. ultrasound. Testicular ultrasound is one of the most accurate ways to diagnose cancer. Effective in 98-100% of cases.
4. CT, MRI, PET. These types of hardware diagnostics provide accurate data on the location, size and shape of the tumor. These procedures are very reliable for detecting soft tissue metastases.
5. Bone scintigraphy. This type of diagnostic is used to detect bone metastases.
6. Biopsy. This analysis allows you to determine the nature of the tumor (benign or malignant). It is carried out in the following way. A tissue sample is removed from the tumor tissue, which is subsequently subjected to a thorough histological examination.
Features of treatment
Each specific case requires an individual approach and the development of a special course of treatment for testicular cancer. The causes, symptoms of the disease, the type of tumor, the stage of cancer development, the absence or presence of metastases, the size of the neoplasm, the age of the patient - all this affects the selection of methods to combat the disease.
The most commonly prescribed set of measures:
- surgery;
- chemotherapy;
- radiotherapy;
- taking hormonal drugs;
- course of vitamins and immunostimulants.
Surgical removal of the tumor
Surgery is a radical method of treatment, but it is this approach that in most cases gives the maximum effect. During surgery, the doctor performs an orchiectomy (removal of the affected testicle). Most often, during the operation, the inguinal lymph nodes, in which metastases are present, are also removed.
The operation is almost never used as the only independent treatment - it is usually supplemented with a course of chemotherapy and radiation therapy. This allows you to eliminate all the pathological cells remaining in the patient's body after the operation. The result is a significant reduction in the risk of recurrence (tumor recurrence).
As for the cosmetic defect (after the removal of the testicle), modern medicine solves this problem very effectively. There is a special testicular prosthesis that is implanted in place of the removed organ.
Radiation therapy
With this approach, the tumor is exposed to ionizing radiation. This therapy is based on the increased sensitivity of cancer cells to radioactive rays. Under their action, the structure of the pathological cell disintegrates, and it loses the ability for further growth and development. The treatment is carried out in several approaches, the doctor chooses their number and radiation dose individually in each case.
Such procedures may be prescribed before surgery to significantly reduce the size of the tumor. Quite often, radiotherapy is also carried out after surgery to eliminate all pathological cells that were not removed by the surgeon.
In some cases, radiation therapy acts as the main treatment if the tumor is inoperable for one reason or another.
Chemotherapy
This method of fighting cancer is one of the main ones. Its essence lies in taking potent drugs that enter cancer cells and disrupt their work. Medicines come in a variety of forms and are available as tablets or injections for intravenous administration.
In total, there are several courses with breaks. The duration, dose and type of drug is chosen by the attending physician. Medicines are taken under strict medical supervision, as all the medicines presented have numerous side effects.
Additional measures
The patient is having a very hard time undergoing treatment for testicular cancer, both psychologically and in view of the general deterioration in his condition. Chemotherapy and radiotherapy cause nausea and bouts of vomiting, dizziness, lack of appetite, loss of strength. There is also a sharp drop in immunity, in connection with which cancer patients are at risk of contracting respiratory diseases.
To restore the condition, patients are prescribed vitamin complexes and immunomodulators. It helps the body regain its natural strength.
Given all of the above, it can be emphasized that today the tumor of the testicle is effectively treated. However, for a good result, timely diagnosis and proper treatment are necessary. To be as safe as possible, men should not wait for the progression of testicular cancer - at the first symptoms and signs, you should immediately consult a doctor.
