Testicular cancer is a malignant tumor that grows in the testicles or testicles. Testicular cancer is usually characterized by a lump accompanied by pain in one testicle.
The testes are male reproductive organs located in the scrotum or testicular pouch. This organ functions to produce sperm and the hormone testosterone which plays an important role in male sexual development and function.
Testicular cancer is a type of cancer that is quite rare. This condition is most common in men aged 15–49 years.
Types of Testicular Cancer
Testicular cancer is divided into several types. This division is based on the type of cell in which testicular cancer begins. The most common type is germ cell testicular cancer. Germ cells are a type of cell used by the body to make sperm.
Germ cell testicular cancer is further divided into 2, namely seminoma and nonseminoma. The seminoma type develops more slowly than the nonseminoma type.
In addition to germ cell testicular cancer, there are other rare types of testicular cancer, namely Leydig cell tumors and Sertoli cell tumors. These two types of testicular cancer only occur in 1-3% of all testicular cancer cases.
Causes of Testicular Cancer
Testicular cancer occurs when cells in the testicles grow abnormally and uncontrollably. The exact cause of this condition is not known, but there are several factors that are thought to increase a person's risk of developing testicular cancer, namely:
- Have cryptorchidism, which is an undescended testicle
- Suffering from testicular developmental disorders, for example due to Klinefelter syndrome
- Have had testicular cancer before
- Have a family history of testicular cancer
- Suffering from HIV/AIDS
- 15–49 years old
Symptoms of Testicular Cancer
Testicular cancer usually only grows in one testicle. The most common symptom is the appearance of a lump or swelling in the testicle. The lump can be the size of a pea or larger.
In addition, there are several other symptoms that arise from testicular cancer, including:
- Pain in the testicles or scrotum
- Accumulation of fluid in the scrotum
- Heaviness or discomfort in the scrotum
- Pain or soreness in the abdomen and groin area
- Differences in size and shape of the two sides of the scrotal pouch
If not treated immediately, testicular cancer can spread (metastasize) to other organs. This condition can cause a number of symptoms according to where the cancer cells have spread, such as:
- Cough constantly
- Bleeding cough
- A lump or swelling appears in the neck
- Lower back pain
- Hard to breathe
- Breast engorgement and enlargement
When to go to the doctor
Check with your doctor if you experience the complaints mentioned above. Immediately see a doctor if the lump you experience grows rapidly, changes color, or is accompanied by urinary problems. Early examination and treatment can prevent complications.
Testicular cancer has a high enough risk for recurrence. Therefore, testicular cancer patients who have recovered still need to do regular screening or control, according to doctor's recommendations. Some experts recommend getting testicular cancer screening every 5-10 years to determine the risk of testicular cancer recurrence.
Testicular Cancer Diagnosis
The doctor will ask about the symptoms experienced by the patient, then perform a physical examination to see lumps in the patient's testicles. After that, to determine whether the lump is cancerous or not, the doctor will perform the following investigations:
- Ultrasound of the scrotum, to see if the type of lump is in the testicles
- Blood tests, to measure levels of tumor markers (tumor markers) in the blood, such as the hormones AFP (alpha feto-protein), HCG (human chorionic gonadotrophin), and LDH (lactate dehydrogenate).
If the lump that appears is suspected to be cancerous, the doctor will perform a testicular biopsy, which is a sample of testicular tissue to see what type of cells are growing. Through this examination, the doctor can determine the type of testicular cancer experienced by the patient and determine the appropriate treatment.
In contrast to biopsies for other cancers, a testicular cancer biopsy is usually performed at the same time as the surgical removal of the entire testicle affected by cancer. This procedure is called an orchiectomy. The goal is to prevent the spread of cancer cells.
Next, the doctor will perform a scan with X-rays, CT scans, or MRIs to determine the stage or extent of cancer spread. This staging is important so that patients receive accurate treatment.
The following is an explanation of the stages of testicular cancer:
- Stage 1: the cancer is only in the testicles (seminiferous tubules)
- Stage 2: the cancer has spread to other tissues around the testicles
- Stage 3: the cancer has spread to the lymph nodes in the abdomen
- Stage 4: the cancer has spread to other organs, such as the lungs, liver, or brain
Testicular Cancer Treatment
Testicular cancer treatment depends on the type and stage of cancer the patient has. Treatment methods include:
1. Orchiectomy
Orchiectomy is the surgical removal of a cancerous testicle. This surgery is the first choice for treating all types and stages of testicular cancer.
2. Lymph node removal
Removal of lymph nodes is performed on testicular cancer that has spread to lymph nodes in the abdominal area.
3. Radiotherapy
Radiation therapy aims to destroy cancer cells by using high radiation beams. Radiotherapy is usually performed after orchiectomy in seminoma type testicular cancer, especially those that have spread to the lymph nodes.
4. Chemotherapy
In chemotherapy, doctors will give anticancer drugs to kill cancer cells. Chemotherapy can be done as a therapy to stop the growth of cancer cells, as well as therapy before and after surgery to remove lumps and lymph nodes.
5. Testosterone replacement therapy
Removal of the testicles can affect the production of the hormone testosterone. To overcome this, the patient will be given hormone replacement therapy in the form of synthetic testosterone.
Testicular Cancer Complications
If not treated immediately, testicular cancer can spread (metastasize) to other parts of the body. In most cases, testicular cancer spreads to the lymph nodes, stomach, or lungs. Although rare, testicular cancer can also spread to the liver, bones, and brain.
Another complication that can occur is infertility after the orchiectomy procedure, but this usually only occurs when both testes are removed. If only one testicle is removed, sexual function and the patient's ability to have children will not be compromised.
Testicular Cancer Prevention
Testicular cancer cannot be prevented, but you can detect it early by performing a testicular self-examination. If testicular cancer is detected early, the spread of cancer cells can be prevented. In addition, the chances of recovery will also be greater.
Testicular self-examination should be done after bathing when the testicles are relaxed. The trick is to place the testicles between the thumb and forefinger in a standing position. After that, gently palpate all parts of the testicle. This check should be done at least once a month.
Immediately consult a doctor if there are symptoms such as:
- The testicles are painful when touched
- Swelling or lump in the testicles
- There are differences in texture, size, shape, or hardness between one testicle and another.
It is important to remember, testicular cancer patients who have fully recovered are still at risk of recurrence. Testicular cancer recurrence usually occurs 2-3 years after treatment is complete. Therefore, testicular cancer patients who have recovered still need to have regular check-ups according to the doctor's advice.