It is a less common type of cancer compared to other types of cancer. Testicular cancer is a disease whose presence is recognized by the formation of a mass in the male testis and ovaries.
Testicular cancer is popularly referred to as ovarian cancer and can be cured by applying the right treatment methods. Early diagnosis has a great impact on treatment. So what causes testicular cancer and how is it treated?
Testes; They are spongy male organs in the form of eggs, surrounded by a stretched membrane. At the top of this organ is a soft rubbery structure called the epididymis.
Sperm mature inside the epididymis before being expelled from the body. There are testicles in the sac on both sides of the phallus, and there is normally no noticeable difference in size between the two testicles. Testicular cancer is usually diagnosed from a swelling-mass in one of the two testicles.
Testicular cancer is more common in men between the ages of 15-45, but is less common than other types of cancer. The success rate of testicular cancer treatment is quite high. Even when the disease spreads to other organs, it can be controlled with appropriate treatment and regular control. The most common causes of the disease, which develops due to various reasons, are as follows:
The most common symptoms of testicular cancer are listed as follows:
In some cases, testicular cancer can be diagnosed by the patient himself. In this sense, glaring swelling and pain in one of the testicles is distinctive. In other cases, it is noticed by the doctor during routine controls and physical examination. Every lump that develops in the testicles may not mean cancer, so various diagnostic methods are applied to make the correct diagnosis.The first of these is ultrasound. With ultrasound, the detailed image of the testicles is obtained with the help of sound waves. In this test, structures in the testicles can be clearly visualized and it can be understood whether the mass is a tumor or not.
Blood tests are also frequently used diagnostic methods. Tumor signs can be understood from blood levels. Therefore, in cases where there is a suspicion of testicular cancer, a blood test is also required.
Tumor cells secrete certain substances that are tumor markers (tumor markers) into the body's bloodstream. The diagnosis is clarified by measuring these substances in the blood.
Tumor markers used in testicular tumors are AFP (alpha fetoprotein), beta-hCG and LDH. These markers can be detected high in some tumor types. In addition, these markers can be used in post-treatment follow-ups.
In patients diagnosed with testicular tumor, tomography is requested to investigate whether the tumor has spread to the lymph nodes in the abdomen or to the lungs. Testicular tumors can be carried to the retroperitoneal region called the posterior abdominal wall by lymph circulation and cause masses called lymph nodes.
After the diagnosis of testicular cancer is made and the necessary examinations are made, the first basic treatment is the removal of the tumorous testis from the body, that is, orchiectomy. Under spinal or general anesthesia, with an incision made from the inguinal region, the testis and the cord extending from the groin to the testis are surgically removed as a block.
The process takes about 30-60 minutes. Testicular prosthesis can be placed during the procedure for patients who wish. This prosthesis is not functional. It only provides the appearance of the testis, that is, we recommend it to our patients in terms of cosmetics.
Again, preoperative sperm freezing (sperm-cryopreservation) is recommended for patients who want to have children in the future.
Postoperatively, patients are usually discharged either the same day or the next day. Patients can return to work after 1 week-10 days. It is recommended to avoid heavy lifting and heavy exercises for a few weeks. Sexual activity can be started after a few weeks.
The testicular mass removed by surgery is examined by pathologists. During this examination, detailed information such as the tumor's diameter, location, type, spread in the testis layers, and vascular-nerve involvement are obtained.
The most common type of testicular cancer is seminoma. It especially affects men between the ages of 30-45 and has a slow course, does not metastasize too much. Tumors other than seminomas are classified as non-seminomatous germ cell tumors and generally affect men aged 20-35 years more. Mixed germ cell tumors with tumor types other than seminoma and seminoma are also encountered.
Tumor types originating from cells other than germ cells are much rarer types.
The disease is staged by considering the pathology and radiology report and tumor markers. As a result of this staging, evaluation is made together in oncology councils where Urology, Radiology, Oncology and Radiation Oncology specialists participate together.
Early-stage seminomatous and non-seminomatous tumors confined to the testis are followed closely after surgery. Chemotherapy can be used as an alternative in patients who do not comply with the follow-up protocols.
Radiotherapy can be applied to patients with seminoma that has spread to lymph nodes in the retroperitoneal region. In some patients, chemotherapy and radiotherapy can be applied together.
It is a surgical procedure in which persistent lymph nodes in the posterior abdominal wall are cleaned despite the chemotherapy given. It is an operation that requires meticulous surgery and experience. Today, we also apply it with laparoscopic or robotic surgery.
Men diagnosed with testicular cancer are negatively affected psychologically. Sexual functions may be adversely affected by the psychology of losing an organ, fear of being infertile or masculinity. However, the applied surgery or the treatments given do not have a negative effect on penile erection mechanisms.
A single testicle can produce enough male hormones and sperm. Chemotherapy will negatively affect the sperm production of the remaining healthy testis. Therefore, preoperative sperm freezing is recommended for patients.
It should be noted that the effects of chemotherapy are temporary, even if the sperm is frozen.
