Testicular Cancer: Prevention, Early Signs and Treatment Options

What is Testicular Cancer? 

Testicular cancer (睪丸癌) is a relatively rare cancer primarily affecting young and middle-aged men.  It originates in the testicles, the male reproductive organs responsible for producing sperm and testosterone. It occurs when abnormal cells in the testicles grow and multiply uncontrollably. There are different types of testicular cancer, including germ cell tumors (the most common type) and non-germ cell tumors. Germ cell tumors can further be categorised as seminomas or non-seminomas. Testicular cancer can spread to nearby lymph nodes and, in advanced cases, it may metastasize (distant spread) to other parts of the body. 

How to prevent testicular cancer? 

There is no guaranteed way to prevent testicular cancer, but certain strategies may help reduce the risk. Here are some recommendations for testicular cancer prevention:  

• Perform regular self-exams: Regular testicular self-exams can let you know the average size, shape, and texture of your testicles.    
• Be aware of your risk factors: Understanding your personal risk factors can help you take proactive steps. Some risk factors for testicular cancer include family history, undescended testicles, and certain genetic conditions.   

Remember, while these measures may help reduce the risk of testicular cancer, they do not guarantee prevention. 

Causes of Testicular Cancer 

The exact cause of testicular cancer is often unknown. However, certain risk factors may increase the likelihood of developing the disease. These risk factors include:  

• Age: Testicular cancer is most common in young and middle-aged men, typically between 15 and 35.  
• Undescended testicle (cryptorchidism): Men who had one or both testicles fail to descend into the scrotum before birth have an increased risk.  
• Family history: Having a close relative with testicular cancer can slightly raise the risk.  
• Personal history: A previous diagnosis of testicular cancer increases the chances of developing it again.  
• Abnormal testicular development: Certain conditions affecting testicular development, such as Klinefelter syndrome (patients carry an extra X chromosome), may increase the risk. 
  

Symptoms of Testicular Cancer 

Recognising the symptoms of testicular cancer is crucial for early detection. Common symptoms include:  

• Testicular lumps or swelling: A painless lump or swelling in the testicle is often the first noticeable sign of testicular cancer.  
• Testicle pain or discomfort: Although not always present, some individuals may experience a dull ache or heaviness in the scrotum or testicle.  
• Changes in testicular shape or size: Noticeable changes in the size or shape of the testicles should be promptly evaluated.  
• Accumulation of fluid in the scrotum: In some cases, fluid may collect in the scrotum, causing swelling or lumps.  

Symptoms can vary from person to person, and some may not experience any symptoms. A doctor should evaluate any concerns or changes in the testicles. 

Do I have the risk of getting testicular cancer?  

Early detection of testicular cancer improves treatment outcomes. There are two primary methods of diagnosis: self-examination and medical examination.  

Self-Exam:  

Performing regular testicular self-examinations is an essential part of early detection. Here is a step-by-step guide on how to perform a self-exam:  

• Stand before a mirror and visually inspect the scrotum for any swelling or abnormality.  
• Examine each testicle individually by gently rolling it between the thumb and fingers. Look and feel for any lumps, swelling, or changes in size or shape.  
• Pay attention to the epididymis, a tubular structure located at the back of the testicle, as it can sometimes be mistaken for an abnormality.  

If you notice any changes or abnormalities during a self-exam, it is important to consult a doctor for further evaluation.  

Medical Exam:  

A medical examination is necessary for a comprehensive evaluation. A doctor will physically examine the testicles, groin, and abdomen. They may also request additional tests, such as:  

• Ultrasound: This imaging test uses sound waves to create a detailed image of the testicles and can help determine if a lump is solid or fluid-filled.  
• Blood tests: Blood markers, such as alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH), can be measured to assist in the diagnosis and staging of testicular cancer.  

Regular check-ups with a doctor are essential for early detection and prompt treatment if testicular cancer is suspected.  

Testicular cancer treatments  

The treatment of testicular cancer depends on various factors, including the type and stage of cancer and the individual's overall health. The primary treatment options include:  

• Surgery: Surgical removal of the affected testicle, known as a radical inguinal orchiectomy, is often performed. In some cases, additional lymph node removal may be necessary.  
• Radiation therapy: High-energy rays are used to target and destroy cancer cells. It may be recommended after surgery or as a primary treatment for specific situations.  
• Chemotherapy: Chemotherapy involves the use of drugs to kill cancer cells. It may be administered before or after surgery or used as the primary treatment for advanced cases.  
• Surveillance: Is necessary after initial treatment (surgery to remove cancerous testis) even for early stage cancers for prompt intervention should another tumour be detected in the other (contralateral) testis. 

The doctor will determine the choice of treatment based on individual circumstances. Discussing each treatment option's potential benefits, risks, and side effects with a doctor is important.   

Testicular cancer is a significant health concern especially for males of reproductive age that requires attention and awareness. Individuals can take proactive steps towards their testicular health by understanding the importance of prevention, recognising early signs, and being informed about treatment options. Regular self-exams and timely medical check-ups play a crucial role in the early detection of testicular cancer. If any concerns arise, it is essential to consult a doctor for proper evaluation and guidance.  

References

1. Cancer Council. Testicular cancer. 13 Oct 2023 Retrieved from https://www.cancer.org.au/cancer-information/types-of-cancer/testicular-cancer  
2. Urology Care Foundation. What is Testicular Cancer? 13 Oct 2023 Retrieved from https://www.urologyhealth.org/urology-a-z/t/testicular-cancer  
3. Fifth Avenue Urology. Testicular Cancer: Symptoms, Diagnosis, and Treatment. 13 Oct 2023 Retrieved from https://www.topurologistnyc.com/testicular-cancer-symptoms-diagnosis-and-treatment/  
4. Mayo Clinic. Testicular cancer. 13 Oct 2023 Retrieved from https://www.mayoclinic.org/diseases-conditions/testicular-cancer-care/diagnosis-treatment/drc-20352991  
5. American Cancer Society. Treating Testicular Cancer. 13 Oct 2023 Retrieved from https://www.cancer.org/cancer/types/testicular-cancer/treating.html