|
Testicular Carcinoma
What is Testicular Carcinoma?
Testicular carcinoma is a kind of cancer that starts in one or both
testicles in younger men. A ‘carcinoma’ is any cancer that occurs in
a surface lining of the body. Luckily testicular cancer is a very
treatable cancer and, in many cases has a good chance of a complete
cure.
A man’s testicles or ‘testes’ are part of the male reproductive
system. The two testes are housed in a skin sac called the scrotum
and found beneath the base of the penis.
The testicles make male hormones like testosterone and produce sperm
for reproduction. There are several kinds of cells found in the
testicles and it is these cells that may develop into different
kinds of cancer. These different cancers have different outcomes so
it is important to understand the differences in treatment and
outlook for each type of testicular cancer.
Different Kinds of Testicular Carcinoma
1) Germ Cell Tumors
More than 90% of testicular cancers start in the germ cells of the
testes. These cells are the ones responsible for making sperm. Two
kinds of germ cell tumors can occur in the testes and these are 1)
seminomas (60%) and 2) nonseminomas (40%). They are further
classified according to the way they appear when viewed under a
microscope. The two types respond differently to treatment programs.
Seminomas usually occur in men in their late 30’s and late 50’s,
while non-seminomas occur in younger men – typically between the
late teens and early 40’s.
Invasive testicular germ cell cancers can start as non-invasive
‘carcinoma in situ’. It is thought that this cancer may develop into
testicular carcinoma within about five years but it may not always
progress in this way.
A testicular cancer is said to be ‘invasive’ when the cells of the
tumor have penetrated the surrounding tissues or spread into other
parts of the body via the bloodstream or lymph nodes and vessels.
2) Stromal Tumors
When a tumor forms in the supportive and hormone-producing tissues,
or stroma, of the testicles they are called gonadal stromal tumors.
This type of cancer accounts for less than 4% of adult testicle
tumors and up to 20% of childhood testicle cancers. The main types
of gonandal stromal tumors are Leydig cell tumors and Sertoli cell
tumors.
3) Secondary Testicular Tumors
These are tumors that begin in another organ and spread to the
testicle/s. Such spread usually occurs from cancers like lymphoma
but may also be caused by spread from prostate, lung, skin, kidney
and other cancers. In men older than 50 years of age testicular
cancer related to lymphoma is more common than primary testicular
tumors.
What Causes Testicular Carcinoma?
Testicular carcinoma is one of the least common cancers accounting
for a risk of about 1 in 300 men getting the disease in their
lifetimes. Even if you have one or more risk factors for the disease
your chance of dying from this kind of cancer is only 1 in 5000. No
clear cause has been found for the disease.
However, there are some risk factors that have been identified that
may cause testicular cancer. This does not mean that if you have one
or more risk factors for the disease that you are sure to get it or
that if you have none you will not be affected by this kind of
cancer.
Cryptorchidism is the primary risk factor for testicular cancer.
This is a condition where in a fetus the testicles don’t descend
before birth. It may be in the abdomen or get stuck in the groin.
This condition is found in about 14% of cases of testicular
carcinoma.
Younger men are more at risk of developing this kind of cancer as it
usually affects men who are between15 and 40 years of age. It can
affect men of any age, including babies and elderly men.
A family history of testicular cancer may increase your risk. If
your brother had the disease you may have a higher risk of getting
it but it is not common in families so it is not likely that it will
be inherited by your children.
Some studies suggest that nonseminoma germ cell tumors may happen
more frequently in men who are miners or oil and gas workers,
leather workers, food and beverage processing workers, janitors,
firefighters, and utility workers. This has not been proven,
however.
Multiple atypical nevi is an unusual condition in which multiple
pigmented spots or moles occur on the back, chest, abdomen and face
and it may be associated with a higher risk of testicular cancer. It
may also lead to a skin cancer called melanoma. Melanoma has been
found to occur more frequently in men who had testicular carcinoma.
HIV infections are thought to carry a risk of this kind of cancer
but no other infections have shown any cause for concern.
Men who have carcinoma in situ may have an increased risk of
developing cancer in the testicles but this is still being studied
to determine its validity.
If you had or have cancer in one testicle you may have an increased
risk of getting it in the other testicle - About 3-4% risk is usual.
White American men are more at risk for this kind of cancer (about
5-10 times more likely) than are African-American men and more than
twice that of Asian-American men. In fact the number of testicular
cancer cases have more than doubled among white Americans in the
past 40 years.
If your mother took the synthetic estrogen diethylstilbestrol (DES)
during pregnancy in order to avoid miscarriage you have a greater
risk of certain reproductive system dysfunctions at birth and these
may include testicular cancer. Again, this has not been proven.
What are the Symptoms of Testicular Carcinoma?
In the majority of cases, there are no obvious early symptoms of the
disease and it is often only suspected when the tumor is felt in the
testes. Of course a mass in the testes could be due to a number of
other reasons and does not always indicate the presence of cancer.
For this reason, men should examine their testes at regular
intervals to check for any lumps in that area. If the cancer is in a
late stage and has already spread to other areas in the body some
symptoms may be present and can include:
How is Testicular Carcinoma Treated?
Which treatment you will be given to help fight your cancer will
depend on the stage of cancer, your age and your general health.
Usually surgery will be done to remove the tumor and if the cancer
has spread to other parts of the body you will be given chemotherapy
with anti-cancer drugs such cisplatin, bleomycin, vincristine,
etoposide, and methotrexate taken by mouth or injected into your
veins.
Chemotherapy will attack the cells in your body that are growing
quickly in an effort to kill the cancer but in so doing it may
affect your normal, healthy cells as well. This can lead to side
effects like:
If the side effects are impacting negatively on your health your
doctor can give you medicines to take with the chemotherapy drugs to
minimize nausea and vomiting, increase your infection resistance or
keep your blood cells at normal levels.
During chemotherapy you will need to take extra safety precautions
to prevent illness from infection.
Radiation Therapy
If you have been diagnosed with testicular cancer your doctor may
recommend radiation therapy or radiotherapy as a treatment option.
Radiation uses ionizing radiation to destroy cancer cells and
eradicate them from your body. As the radiation passes through your
body it forms ions and releases electrons from atoms. Ions are
simply atoms that have gained an electric charge by the gain or loss
of an electron.
This is called ionization and damages the DNA of both normal healthy
cells and cancer cells in the body. This need not be worrisome as
these normal cells are able to repair themselves once the therapy is
completed. Radiation therapy may be used alone or in combination
with chemotherapy or surgery. Radiation therapy involves using
high-energy x-rays or radioactive material to kill the cancer in
your body and may lead to temporary side effects like skin rash or
reddening and local irritation.
How to Cope with Testicular Carcinoma
Testicular cancer does not need to be fatal and can be treated with
success if it is found early. Do periodic examinations of the testes
for the best chance at avoiding this kind of cancer. If you have
been diagnosed with testicular carcinoma talk to you doctor about
the stage of your illness, the goals of treatment and any side
effects from surgery or other therapies that you may receive.
General measures you can take include eating a well balanced diet,
getting enough rest and taking moderate exercise. Men may feel that
their manhood is adversely affected by surgery and these issues can
be helped by positive support and counseling.
A positive mental attitude and outlook will help you to fight your
illness so talk to a supportive person or group about your feelings,
anxieties and other issues surrounding your cancer. These approaches
together with good care from your doctor will give you the best
chance of fighting your illness and staying healthy.
|
