Many men, reaching middle age, can boast that they have never visited a doctor in their entire lives. Among the fair sex, there are much fewer such cases. This is due to the fact that the genitals of women need constant attention, venereal diseases affect them much more often. After several years of such a trouble-free life, men still decide on a rectal examination, which is often compared to the end of youth. Moreover, the stronger sex, as a rule, does not attach much importance to a visit to a specialist. However, it is precisely such a belated visit that often ends in the fact that a man is diagnosed with quite serious ailments that require competent treatment. One of these rather dangerous diseases is testicular cancer. Photos of this pathology can be viewed in specialized medical reference books. We will tell you more about it in this article.
Description of the disease
Testicular cancer is a relatively rare disease. The main causes of this pathology in adult men include cryptorchidism, disorders at the level of the endocrine system, exposure toradiation, mechanical damage to the scrotum.
In the statistics of oncological diseases, signs of testicular cancer in men are diagnosed in no more than 2% of cases. It is important to note that the disease is characterized by aggressiveness. Among the representatives of the stronger sex under 35 years old, this disease often causes early death.
In a third of cases, the primary symptoms are diagnosed in young boys. In 90% of them, the cause lies in the malignancy of a benign tumor - teratoma. It, in turn, appears due to developmental disorders in the prenatal period.
Testicular Cancer: Causes
Today, the exact causes of the development of this kind of pathology, as well as other oncological diseases, are unknown. However, experts agree on the main factor that provokes the development of the disease - cryptorchidism. This is a special condition in which during the period of intrauterine development of the fetus or in the first few months of a child's life, the testicle does not descend into the scrotum. It simply remains in the so-called inguinal canal or even in the abdominal cavity itself. Most often, oncology is diagnosed in those patients in whom the testicle is localized directly in the abdominal cavity.
Who is at risk?
According to experts, even if a corrective operation was performed on a child in childhood, testicular cancer in men can still be diagnosed in adulthood. Among the main precursor factors that increase the risk of developing this pathology,call the following:
- Hereditary predisposition.
- Infertility.
- Klinefelter syndrome (damage to the sex chromosomes at the genetic level).
- Underdevelopment of the genitals.
- Inclusion of scar tissue in the testicles at the congenital level.
- Permanent mechanical action.
Clinical signs
The main symptoms of testicular cancer in men are:
- slight induration in the affected area;
- fluid accumulation in the scrotum;
- constant discomfort, pain;
- increase in normal testicle size.
At the very beginning of the disease, the symptoms of testicular cancer in men are almost completely absent. Then the patient discovers a small seal in one of them. The organ begins to rapidly increase in size, discomfort and even soreness appear. It is important to note that the malignant tumor itself rarely causes pain. It occurs only after the tumor completely captures the spermatic cord.
At the next stage of the development of pathology, deformation of the testicles and an increase in their density are observed. Due to the constant accumulation of fluid, the damaged part of the scrotum begins to increase in size. If the testicle has not descended, the tumor can be easily felt directly in the inguinal canal. Otherwise, when it is localized in the abdominal zone, the neoplasm can grow to a significant size. There are cases when it occupied about half of the entire cavity.
Further symptoms of testicular cancer in men are associated with the formation of metastases. This is, first of all, shortness of breath, severe pain in the back and groin, discomfort in the leg, swelling. All these clinical signs are very easy to explain.
For example, back pain is associated with constant compression of the nerve roots by the retroperitoneal lymph nodes, which also increase in size. Edema of the legs occurs due to the overlap of metastases of the inferior vena cava. Symptoms of testicular cancer in men can even include manifestations of kidney failure. This is due to compression of the neoplasm of the ureters.
Some forms of this disease entail changes at the hormonal level. In adult patients, they manifest as impotence and decreased libido. Boys in adolescence may develop gynecomastia, hirsutism (excessive hair growth), voice mutation.
Classification
Testicular tumors can be of two types:
- Germinogenic (grow from the epithelium) - seminoma, teratoblastoma, chorionepithelioma.
- Non-germinogenic (develop from the underlying tissues) - leidigoma, sarcoma, sertolioma.
Germinogenic variant of the tumor (seminoma) is the most common. Seminoma is diagnosed in 50% of men with cancer. This tumor is formed in the form of a compacted nodule. As a rule, it grows quite slowly and is not accompanied by complications in the form of bleeding. Seminoma metastases predominantly affect the lungs, lymph nodes, and bones.
Cancer stages
Currentlytime, several stages of the disease are distinguished. Thanks to this separation, doctors have the opportunity to accurately classify testicular cancer in men, and then prescribe the appropriate treatment.
- The first stage. The neoplasm is located in the testicle, does not go beyond it, there are no metastases.
- Second stage. Tumor metastases are localized in the retroperitoneal nodes.
- Third and fourth stages. Metastases penetrate into distant organs and lymph nodes.
Another international classification of the disease is also known - TNM, according to which the main parameters of cancer are indicated by a certain letter (T - characteristic of the tumor itself, N - description of the state of the lymph nodes, M0 - absence of metastases, M1 - presence of distant metastases).
Diagnosis
For the successful treatment of this disease, it is very important to diagnose it in a timely manner. How to identify testicular cancer?
- Physical examination of the patient, including palpation of the scrotum itself.
- Laboratory studies (LDG, BCG, AFP). Based on the level of concentration of the so-called tumor markers, the doctor evaluates the effectiveness of the current treatment, and also predicts the course of the disease.
- Examination of the scrotum through diaphanoscopy. This method involves the transillumination of the affected area with a narrow beam of light. The doctor evaluates whether it is evenly translucent. If the scrotal tissue practically does not transmit light, we can talk about the presence of a malignant neoplasm.
- X-raylung to detect the presence of metastases.
- Ultrasound of the scrotum and pelvic organs.
- CT chest and abdomen.
- Osteoscintigraphy of skeletal bones.
The final diagnosis is established on the basis of the results of a biopsy of the tissues of the testicle itself. Analysis of the biopsy under a microscope allows you to accurately determine the specific type of tumor, as well as predict the rate of spread of pathology.
How to recognize the disease yourself?
First of all, it is recommended to see what testicular cancer looks like in men. Photos of the affected organs are available in specialized reference books. Thus, if there are any abnormalities, the patient should immediately seek medical advice.
It is important to note that he althy testicles should be approximately the same size, but one always hangs below the other. Otherwise, the man could not put his feet together.
Doctors advise to examine yourself monthly, and in a warm room. The thing is that in the cold the scrotum shrinks quite strongly. The ideal option is to inspect while taking a shower. The testicles should feel like hard-boiled chicken eggs and be approximately 4 cm in diameter. Organs should not hurt. Any discomfort during examination can be interpreted as a deviation from the norm.
What does testicular cancer look like? Feeling the back of the upper part of the organ, you can easilyfind its appendage - a thin cord. Any mass attached to it can be regarded as a neoplasm (most often benign). In any case, if you find any deviation from the norm, you should immediately consult a doctor. He will prescribe an additional diagnostic examination, and then, if necessary, therapy.
Treatment
It is complex in this disease and involves the removal of the tumor focus, therapeutic resection of the lymph nodes, as well as systemic chemotherapeutic effects on all atypical cells.
Surgical treatment is the complete removal of the affected area along with the appendage. If during the operation metastases are found in the peritoneal space, retroperitoneal lymphadenectomy is performed.
After surgery, the patient is sent for chemotherapy. It implies the introduction of intravenous injections and the use of special drugs ("Iofosfamide", "Cisplatin", "Vinblastin"), which affects the entire body. Given the fact that cancer cells have a high metabolic rate, they themselves are destroyed first of all.
In some cases, additional radiation exposure is recommended. With large tumor sizes, this method of treatment is used at the preoperative stage.
Forecast
The earlier the disease is diagnosed, the more effective the therapy will be and the probability of a positive outcome will increase significantlyailment. According to experts, timely treatment allows the patient to live for five years or more (in 90% of cases). With the appearance of metastases, survival is reduced to 72%.
