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How is testicular cancer manifested and treated in men?

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Testicular cancer is a malignant tumor that originates from epithelial cells. Neoplasm occurs mainly in young men. Cancer of the testicles is well amenable to chemotherapy and radiation, which significantly increases the chances of a favorable outcome of the disease with timely access to a doctor.

A normal testicle and an egg, affected by cancer

Testicular cancer - malignant tumors arising from epithelial cells

content

  • 1 reasons
  • 2 Classification
  • 3 Symptoms
  • 4 Diagnostics
    • 4.1 Inspection urologist or a oncologist
    • 4.2 ultrasound
    • 4.3 Radiography
    • 4.4 Analysis for tumor markers
  • 5 Therapies
    • 5.1 Surgery
    • 5.2 Radiotherapy
    • 5.3 Chemotherapy
  • 6 Prevention

Reasons for

According to statistics, testicular cancer occurs mainly between the ages of 20 and 40a. The peak incidence falls to the age of 32 years. After 40 years, the probability of developing the disease is significantly reduced.

The exact causes of carcinoma are not known. There are several risk factors for the development of this pathology:

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  • genetic predisposition;
  • cryptorchidism;
  • radiation training;
  • accommodation in an ecologically unfavorable territory.

The impact of factors such as: testicular trauma, instrumental interventions and infertility - is currently not proven.

Congenital cryptorchidism

Cryptorchidism: 1 - scrotum;
2 - a normal testicle;
3 - undescended testicle

Cryptorchidism( undescended testis in the scrotum) is considered one of the leading risk factors for developing testicular cancer. Normally testicles should descend into the scrotum at the time of the birth of the child or within two years after it was born. In the retroperitoneal space, the testicles can not exist: too high a temperature changes the structure of the testicles and provokes the growth of a malignant tumor. To prevent this from happening, at the age of 2 years, doctors suggest that an operation be performed to lower the testicle into the scrotum and thereby free the boy from the risk of developing cancer.

Some statistics:

  • With cryptorchidism, the probability of developing testicular cancer increases 3-10 times( according to different data).
  • With unilateral cryptorchidism, the tumor often occurs in a non-descending testicle.
  • The operation to lower the testicle in the scrotum reduces the risk of developing cancer, but does not completely eliminate this possibility.

Hereditary predisposition is another cause of development of testicular cancer. Scientists managed to find out: there are certain areas of genes responsible for the occurrence of carcinoma. The presence of a testicle in the grandfather, father or brothers is an occasion for careful examination and constant monitoring of the testicular condition.

If there is a family predisposition, the likelihood of developing cancer is increased several times.

Classification of

By origin, ovarian tumors are divided into several groups:

  • germinogenic( arising from the seed epithelium);
  • tumors of the stroma of the genital tract;
  • mixed tumors.

In clinical practice, separation of germinogenic neoplasms into seminoma and non-seminoma is important. The type of tumor is revealed after a histological examination. The type of tumor determines the rate of its growth and the likelihood of the appearance of distant metastases.

Practicing oncologists use the international TNM classification to determine the stage of tumor development. This system takes into account the size of the neoplasm, the presence of regional and distant metastases. The TNM stage affects the choice of the therapy regimen and largely determines the prognosis of the disease.

Symptoms of

The manifestations of testicular cancer include:

  • appearance in the scrotum of a palpable tumor( rounded painless formation);
  • increased scrotum in size( due to tumor growth);
  • pain in the testes( in the late stages of the disease).
All the symptoms of testicular cancer are not specific and can occur in many other diseases. For an accurate diagnosis, you need to see a doctor( urologist or oncologist).

Testicular cancer develops from a single cell that can divide uncontrollably. At the initial stages the tumor is invisible and not detected by known methods. Since the inception of the first atypical cell to the appearance of volumetric education takes about 5-7 years. In the future, the tumor begins to grow rapidly, increasing in size 2-3 times every 2-3 months. There are cases when the testicular carcinoma reached a very large size, interfered with walking and caused considerable discomfort with one of its existence.

symptoms of testicular cancer

If you experience at least one of the symptoms, you should immediately call your doctor!

Testicular cancer is an aggressive tumor with rapid growth and the appearance of distant metastases. When metastasizing, cells of the carcinoma spread with blood and lymph flow to other organs. Metastases are most often found in retroperitoneal lymph nodes and lungs.

Symptoms associated with testicular cancer metastases:

  • shortness of breath, coughing and shortness of breath( with lung damage);
  • swelling of the lower extremities( due to compression of the inferior vena cava);
  • pain in the lumbar region( as a result of increased retroperitoneal lymph nodes);
  • renal colic( due to compression of the ureter);
  • kidney damage and development of renal failure;
  • intestinal obstruction( due to compression of the intestine by altered lymph nodes).

The appearance of metastases indicates a significant prevalence of cancer and requires a special approach to the treatment of the disease.

Diagnosis

The following methods are used to detect testicular cancer:

Inspection of a urologist or oncologist

Upon examination, the doctor evaluates the skin condition, draws attention to the size of the scrotum and palpates the testicles. It is necessary to determine the location and size of the tumor, its relationship to the epididymis, the spermatic cord and the subcutaneous fat. Palpable and accessible lymph nodes in the groin area. Based on the results of the initial examination, the doctor can identify a tumor or suggest the presence of other similar diseases( dropsy, hematoma, inguinal hernia, epididymitis, etc.).

US

Any tumor-like formation or compaction in the testicles is an indication to an ultrasound examination. During ultrasound, a doctor can detect a tumor or distinguish it from other diseases in this area.

Read more: Carrying out ultrasound of the testicles

This is how the testicular cancer looks on the MRI image

MRI examination allows to determine reliably whether a tumor is an oncology

Radiography

X-ray examination of the lungs helps to identify distant metastases. According to the indications, a computed tomography of the thorax and retroperitoneal space is performed.

Analysis for the tumor markers

In testicular cancer, the following substances are found in the blood:

  • AFP( alpha-fetoprotein);
  • b-hCG( b-subunit of human chorionic gonadotropin);
  • LDH( lactate dehydrogenase).

All these substances are commonly called tumor markers( oncomarkers).Normally, they are not found in the blood or are detected in low concentrations. Exceeding the established threshold speaks in favor of testicular cancer. The definition of oncomarkers allows you to diagnose, evaluate the stage of the pathological process, determine the tactics of treatment and presume the prognosis of the disease. Regular monitoring of cancer markers also helps in time to detect a relapse of cancer.

Treatment methods

Treatment of testicular cancer always begins with the removal of the tumor. Further tactics will depend on the stage of the process, the presence of metastases and concomitant pathology.

Surgical treatment

Orhifanyctectomy - an operation to remove the testicle along with the spermatic cord - is performed under anesthesia. Do not delay with the procedure. The earlier the tumor is removed, the more likely a favorable outcome of the disease.

The technique of performing the operation depends on the size of the tumor. During the procedure, there is a high probability of throwing cancer cells into the bloodstream and metastasizing them into internal organs. To prevent this from happening, the surgeon bandages the testicles feeding the testicles and thereby prevents the spread of the altered cells. The tumor is removed, after which the material is sent for urgent histological examination to the laboratory. The result of the study will be ready after 15-30 minutes. If the diagnosis of cancer is confirmed, the operation expands to complete removal of the testicle along with the spermatic cord. With a benign tumor, it can be excised within healthy tissue.

Testicular Cancer Surgery

It is not necessary to delay with the operation - the testicle cancer at the advanced stages assumes their removal

The testicle cancer at the late stages with the lesion of retroperitoneal lymph nodes suggests their removal. After excision of lymph nodes many men develop a specific complication - the absence of ejaculation in normal sexual intercourse( dry sexual intercourse).In this situation, a man can not have children. Due to the high risk of such complications, many clinics offer a procedure for cryopreservation of seminal fluid before surgery. The conserved spermatozoa can be used later for artificial insemination.

Sexual life after the removal of one testicle does not suffer. In the case of bidirectional orhifunueloctomy, substitution therapy with male sex hormones is prescribed.

Radiotherapy

Radiation irradiation is indicated for seminoma testicular tumors. This form of the disease is sensitive to radiation therapy. Nonseminomnye neoplasms are not easily irradiated. The procedure is carried out both before surgery and after removal of the testicle. The area of ​​irradiation and the duration of the course of therapy are determined by the doctor individually for each patient.

Chemotherapy

The use of potent drugs is indicated with the appearance of distant metastases. The drugs used suppress the growth of cancer cells and promote recovery. The dosage of drugs and the duration of the course are determined based on the stage of the disease.

Prognosis for testicular cancer depends on the type of tumor and the stage of the pathological process. With unilateral damage to the testicle, the absence of distant metastases and a low level of oncomarkers, the prognosis is quite favorable. With timely treatment, the five-year survival rate of patients with testicular cancer is up to 90%.

Prevention

Specific prophylaxis of testicular cancer is not developed. Not knowing the exact cause of the disease, it is difficult to take any measures to prevent it. Nonspecific prevention is reduced to the following recommendations:

  1. Regular testicular self-examination.
  2. Visit the urologist at least once a year( even with complete well-being and absence of symptoms of the disease).
  3. Timely surgical treatment of cryptorchidism.

All men are encouraged to conduct regular self-examination of the testicles. At palpation, attention should be paid to the size, density and shape of the testicles, their symmetry, the state of the skin above the genitals. Tumors are most often localized on the anterior or lateral surface of the testicle. If any suspicious formation occurs, please contact your doctor.

Read more: Disease of testicles in boys and men - what they are?

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