Testicular cancer is a disease where one of the many kinds of testicular cells multiply uncontrollably forming mass in one or both testis. This cancer is rare compared to other types of cancers.
Testicular cancer is most frequently diagnosed in males between 14 and 44. Although its incidence is increasing, testicular cancer affects less than 10 men in 100,000, with a 2% risk of developing cancer in other testis within 15 years of the initial diagnosis. Dr. Marinka Hoek, a urologist at The Urology Hospital in Pretoria (the only specialist Urology hospital in Africa), provides us with expert insight.
While the exact cause of testicular cancer remains unknown, certain risk factors have been identified. Dr. Hoek explains, “Undescended testicles, where the testicles fail to descend into the scrotum during foetal development, are a significant risk factor (this can be corrected through surgery before the baby is 18 months). Other risk factors include cancer in other testes and a family history of testicular cancer. You must be a first-degree relative, i.e., a father or brother.”
Recognising the symptoms of testicular cancer is crucial for early detection. Dr. Hoek says although symptoms can vary, common symptoms to watch out for include “a lump in the testis that can be felt that was not there before. Although this is painless, about 1/3 of patients do complain of a dull ache in the affected area.”
Surgery is typically the first step. “Radical orchidectomy, or the removal of the affected testis through an incision in the groin, is usually the first step,” says Dr. Hoek. In certain instances, a urologist might elect to biopsy the testis before removing it. But this is usually done in a theatre with the pathologist in attendance.
Other treatments include chemotherapy and radiation, as well as the surgical removal of lymph glands that contain cancer. Often times, a combination of all the above-mentioned treatments is used at different stages of the disease.
Following surgery, regular follow-up of blood levels of tumour markers, various types of scans to monitor response to treatment and diagnose recurrence of the cancer, and regular self-examination are the mainstays of follow-up.
Dr. Hoek also emphasises the importance of a generally healthy lifestyle with regular exercise, as this improves your body’s ability to maintain health and withstand side effects that will stem from the treatments.
Potential long-term side effects
As chemotherapy forms an integral part of treatment, there are long-term side effects, but these would depend on the specific drug used. One of the long-term side effects most patients are worried about is that testicular cancer treatment can involve the removal of one or both testis, as well as chemotherapy and radiation, which can reduce fertility.
Because of this, most urologists will recommend cryopreservation of semen before the start of the treatment to give patients the option of conceiving once they have recovered. “Cancer elimination and treatment are the most important goals.
The cancer itself destroys sperm production and causes infertility even without treatment; therefore, instead of gambling whether there might be or might not be future fertility, we save the sperm beforehand,” says Dr. Hoek.
Early detection is crucial
Recognising the symptoms and exploring the available treatments for testicular cancer are crucial for facilitating early detection and successful treatment. With the support of medical professionals and ongoing surveillance, the prognosis for testicular cancer patients can be greatly improved. “Early detection is key to successfully treating testicular cancer. Regular self-exams and routine check-ups with a urologist can greatly improve the chances of catching the disease in its early stages.”
There are several ongoing trials that are looking into chemotherapy for the treatment of testicular cancer as well as treating recurrences of the cancer. Research is also looking into using artificial intelligence to improve the diagnostic evaluation of lesions.
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