×
Carcinoma testis
A. The testicles (also called the “testes”) are part of the male reproductive system. They are found in the scrotum-the pouch of skin that hangs below the penis. The testicles make testosterone and sperm.
A. Testicular cancer is a growth called a tumour that starts in the testicle and can sometimes spread to other parts of the body. There are two main types of testicular tumour:
A. The risk factors are:
A. As testicular cancer grows, you might feel a lump or swelling in part of one testicle. This is the most common symptom. You might have pain in a testicle or the scrotum, but testicular cancer is not usually painful.
A. Your doctor will give you a physical exam and ask about your medical history. Depending on your symptoms and risk factors, blood tests and ultrasound may be ordered to check for testicular cancer. If testicular cancer has spread to other part of the body (metastasis), you might have dull aches or feel lumps in other areas as well.
If you have one of these symptoms, it is important to see your doctor right away. The sooner testicular cancer is caught, the better the chance of cure.
A. The stages describe a tumour’s size and whether the cells have spread to other tissues or organs. This information helps you and your doctor understand how serious the cancer is and how to treat it.
Stages of testicular cancer
Stage 1: Cancer is only in the testicle.
Stage 2: Cancer has spread to the lymph nodes in the abdomen.
Stage 3: Cancer has spread beyond the lymph nodes in the abdomen. The cancer may have spread to parts of the body far from the testicles, such as the lungs or liver.
A. Prognosis (risk of the cancer growing and/or coming back after treatment) depends on following factors:
A. Testicular cancer is usually treated with surgery. The testicle must be removed (orchiectomy) to remove the cancer. The tissue may be examined during surgery to confirm the diagnosis and stage. Additional surgery, drug treatment (chemotherapy), or radiation therapy also may be needed.
A. All testicular cancers are treated with surgery (Radical or High inguinal orchidectomy) with very few exceptions.
You might have bleeding or an infection after surgery. In the long term, you might have poor semen quality or low testosterone. This can affect your ability to father children.
Tell your doctor before orchiectomy, if you wish to have children after treatment. Most men can become fathers even after treatment for testicular cancer. However, you should be offered semen analysis and cryopreservation of sperm (freezing deposits of sperm samples in a sperm bank) as options.
A. Other surgical options might include biopsy of the other testicle, removal of lymph nodes, or removal of testicular cancer tissue from the lungs, liver, or other sites.
Biopsy of the other testicle: Your doctor may recommend taking tissue from the other testicle to look for precancerous cells. This should be considered especially if you had an undescended testicle, if you have very small testicles, or if you have poor semen quality. Precancerous cells are treated with radiation or removal of the testicle.
Removal of lymph nodes: If testicular cancer cells spread, they often go to the lymph nodes at the back of the abdomen. Removal of these lymph nodes is called “retroperitoneal lymph node dissection” (RPLND). This Surgery is considered for men with a high risk of cancer spreading. It might also be performed to remove any cancer that remains after chemotherapy.
Removal of tumours at other sites: The spread of testicular cancer cells might have caused tumours to grow in other tissues and organs. These tumours are typically treated with chemotherapy. Surgery might be performed after chemotherapy to remove any cancer that remains.
Chemotherapy: Chemotherapy treats cancer with drugs that kill cancer cells. Chemotherapy drugs are usually given through an IV directly into the bloodstream. Chemotherapy is usually given one to four times at 3-week intervals, depending on the stage of the disease.
Radiation therapy: Radiation therapy treats cancer by exposing cancer cells to high energy rays. The rays damage and kill the cells. Radiation therapy is sometimes used to treat seminoma-type testicular cancer, but not non-seminomatous tumours. The goal of radiation therapy is usually to kill cancer cells that have spread to the lymph nodes behind the abdomen.
Radiation can also damage healthy cells in other organs, so the radiation beam must target the cancer cells to limit damage. Side effects are usually mild.
Common side effects of radiation therapy
A. Your doctor will schedule you for regular visits after treatment to see if the cancer has come back (recurrence). Visits may include a physical examination, blood tests, chest x-ray, and/ or a CT scan to look for new tumours. Visits are usually more frequent just after treatment ends. Follow-up typically continues for at least 5 years. If there is no recurrence, you do not need further treatment.
A. If new cancer is detected during follow-up, it will be treated with surgery, chemotherapy, or radiation therapy, as described. Even with recurrence, the chance of cure is good.
A. Examine your testicles regularly, especially if you have a risk factor for testicular cancer. The best time to examine your testicles is right after a hot bath or shower. The scrotal skin will be relaxed, and the testicles can be felt more easily. It takes only a few minutes.
Do the exam standing:
A. If testicular cancer runs in your family, tell your doctor. The risk of getting this cancer is higher if a close family member, like your father or brother, was diagnosed with it. There are no routine tests to screen for testicular cancer. Your son might want to do a self-examination regularly.
A. With one testicle, most men will still produce sperm and the male sex hormone testosterone. Some men, however, will need medical treatment to restore normal levels of testosterone in the body. It is usually not possible to restore normal sperm production after damage to the testicular tissue. You can have a false testicle (prosthesis) put into the scrotum during the operation. This is sometimes done, for cosmetic reasons only, to give a normal appearance.
A. If you wish to father children after treatment for testicular cancer, you should be offered a semen analysis and cryopreservation of sperm (freezing deposits of sperm samples in a sperm bank). This should be performed before orchiectomy, a surgical procedure in which one or both testicles are removed, ideally, but in any case prior to chemotherapy treatment. In the very rare case of testicular cancer on both sides, where both testicles are removed, a man will not be able to father children naturally after surgery. However, sperm banking before treatment still gives a fair chance of success.
A. Removing one testicle should not take away your sexual ability or fertility. Most men can have a normal erection after surgery. However, some sexual difficulties are common after a diagnosis of testicular cancer. The ability to ejaculate may change after surgery. If you have any of these problems, counselling or medical treatment may help.
Before you have your abdominal lymph nodes removed, talk to your surgeon about possible side effects. Your sex life can be affected by this surgery:
• RPLND can cause your semen and sperm to go backward into your bladder instead of coming out of your penis (retrograde ejaculation). Your orgasms will feel different because they will be dry. Medication helps sometimes, but you might not be able to have children by natural sexual intercourse.
• RPLND can cause nerve damage that can make you lose the ability to have erections.
Low sex drive: You may find that you have less sexual desire (libido) than usual, at least for a while. This is perfectly normal. Any testicular cancer treatment can make you feel like this. Feeling tired or sick can also lower your libido. Testicular cancer treatment can create, or bring up, emotions such as fear, anxiety and anger. Once treatment is done and you are living with having had cancer, you will find your libido comes back.
Social and psychological effects: A cancer diagnosis can have a big impact on your life and the lives of your loved ones. Cancer can make you feel powerless. It can make you feel anxiety, anger, fear, or depression. Some patients are exhausted during or after treatment. It is very common to worry about the cancer coming back. During treatment you will be away from your work. Talk to your boss about the best way for you to get back to work. Perhaps you could work part time or in a different function. Find support or treatment for these issues. Talk with your doctor.
A.
A.
