Oncology of the testicles is relatively rare, however, this does not detract from its aggressiveness, because under the influence of such a cancer a man can burn on average in three years. Therefore, men need to be more responsive to health in order to notice signs of testicular cancer in a timely manner and take the necessary measures.
Concept of the disease
Testicular cancer is a malignant tumor process, for which the unpredictability of the development and growth of pathological oncocells is inherent.
The tumor forms and develops directly in the genital glands, but soon it begins to spread through the body( more often into the cerebrospinal and bone structures, the liver and lungs) by hematogenous and lymphogenous pathways.
According to statistics, a malignant testis is considered the most common cancer among men 15-35 years of age.
Similar cancer pathology is predominantly one-sided, although there are also bilateral forms of the tumor process( in 1,5-2%).
Ovarian cancer is classified into mixed, germogenic and non-germogenic tumors.
- Germinogenic tumors are formed from seminal germ cell structures and occupy about 95% of cases.
- Non-germogenic tumors are formed from the stroma of the testicle.
- Mixed tumors contain cells of both germogenic and non-germogenic formations.
The photo shows how the testicular cancer looks in men in the
section. In turn, germinogenic tumors are divided into:
- Neseminomy( embryonic cancer, chorion carcinoma, teratoma, etc.).
Non-hormonal formations occur in less than 5% of cases and are represented by tumors such as leidigomas, sertoliomas, dysherminomas.
Causes of development of
It is rather difficult to say for sure what causes the development of testicular cancer. However, there are several patterns and risk factors in the development of such an oncology:
- Men with a high and lean physique are more likely to develop testicular cancer;
- The presence of a tumor of another testicle in the past;
- In the presence of an immunodeficiency virus, the likelihood of such a cancer increases;
- Belonging to the white race raises the risk of developing testicular cancer tenfold, while African Americans and Asians suffer from this pathology ten times less often;
- Cryptorchidism or undescended testicle;
- Traumatic damages of scrotum;
- Endocrine pathology;
- Radiation and radiation effects;
- Hereditary factors;
- Congenital underdevelopment of testicles;
- Nevuses and moles prone to malignancy can also provoke testicular cancer;
- Early puberty;
- Infertile men triple the risk of developing testicular cancer;
- Regular overheating of the scrotum, etc.;
- Testicular torsion;
- Nicotine dependence, manifested by daily smoking a pack of cigarettes for 10 years or more, doubles the likelihood of developing sex gland cancer in men;
- Hypospadias - a similar disease is associated with impaired development of the genital organs of a man, when the outlet of the urethra opens below the head of the penis or on the scrotum.
Sometimes an ovarian malignant oncology develops against the background of Klinefelter or Down syndrome. The professional environment also has significance, as men, men in the leather, gas, oil, coal mining industry and firefighters are more likely to suffer from pathology.
Symptoms of testicular cancer in men
A fundamental manifestation of the malignant tumor process is the appearance in the tissues of the scrotum of a dense formation that promotes organ enlargement.
Such seals can be both painful and painless.
Patients complain of soreness in the abdomen and scrotum, swelling in the testicles.
Thus the scrotum strongly swells up and becomes much more. With the further development of the tumor process, respiratory difficulties and dyspnea, an increase in lymph nodes, spinal pain, weakness occur.
The patient feels a noticeable decrease or lack of sexual desire, soreness and enlargement of the mammary glands, intensive growth of hair on the face and body long before the onset of sexual development. When metastasizing the tumor, patients observe pronounced right-lateral tenderness, coughing and jaundice, dyspnea, etc.
When the tumor grows into the epididymis, the following symptoms appear:
- A slight painless seal is felt;
- Deformation of the organ;
- Increased testis;
- Painful sensations along the spermatic cord and lower abdomen;
- There may be pain in the back and chest;
- Edema of the scrotum;
- Enlargement of lymph nodes;
- Difficulty breathing.
Cancer of the epididymis helps develop secondary sexual characteristics and endocrine diseases that can change the appearance of the patient.
Staging of malignant lesions is based on international criteria for the TNM system:
- T-1 - formation does not cross the boundaries of the belly coat;
- T-2 - the tumor is also limited, but there is already deformity of the scrotum and an increase in the testicle;
- T-3 - the tumor permeates the belly coat, germinating into the adnexal tissues;
- T-4 - the tumor process extends beyond the boundaries of the testicle, germinating in the seminal cord or scrotal tissue;
- N-1 - with radiological and radioisotope diagnostics, regional metastases to lymph nodes are identified;
- N-2 - enlarged regional lymph nodes with metastases easily palpable on examination;
- M-1 - in diagnostic studies, distant metastasis is found in the hepatic, pulmonary, cerebrospinal and renal tissues.
Used in determining the degree of development of testicular cancer and another staging system:
- I - the formation is localized within the testicle;
- II - the tumor process spreads to the lymph nodes of para-aortic value;
- IIa - lymph nodes with metastases do not exceed 2 cm;
- IIb - the parameters of the lymph nodes are of the order of 2-5 cm;
- IIc - the size of the lymph nodes exceeds 5 cm;
- III-0 cervical and thoracic lymph nodes are involved in the tumor process;
- IV - metastasis spreads to distant organs such as bone tissue, brain, liver and lungs.
If testicular cancer in men is detected at an early stage, then 90% of patients have all the chances for a full recovery.
But the statistics are that most men, when signs of pathology are detected, turn to specialists only after a time when the tumor process passes to more neglected stages. In such a situation, treatment is not always successful and has many consequences.
If the patient undergoes an orchiectomy, that is, removal of the affected testicle, then for many men this becomes the basis for a serious inferiority complex. From the physiological point of view, the remaining testicle is fully capable of coping with its functions for two.
Cosmetic problem is completely eliminated by correction, when a prosthesis is implanted in place of the removed testicle.
If treatment was accompanied by chemotherapeutic or radiotherapy, the likelihood of complications is very high:
- Against the background of irradiation with large doses of radiation, irreversible infertility occurs;
- Chemotherapy Cisplatin develops azoospermia( lack of sperm), which is often eliminated after about 4-5 years;
- Antineoplastic medications such as ifosfamide and cisplatin lead to toxic kidney damage;
- All chemotherapy drugs are dangerous for bone marrow structures.
In addition, chemotherapy and radiation are usually accompanied by a nausea-vomiting syndrome, hair loss, etc. If a man pulls with treatment, the cancer quickly progresses, metastasizes, disrupts the work of all organs and leads to a fatal outcome.
How to identify testicular cancer?
To identify an ovarian cancer, you should contact a specialist who will properly perform scrotal palpation and general examination.
Sometimes already at this stage it is possible to suspect the presence of malignant formation, which most often differs in density and painlessness.
In parallel, lymph node locations of the inguinal, supraclavicular and abdominal location are examined.
After the medical examination the patient is referred for diagnostic tests:
- Ultrasound diagnosis. Such a study allows to determine the tumor process with almost 100% accuracy;
- MRI and computed tomography. These studies have a similar ultrasound designation, however, they are more informative, but they have a much higher cost;
- Osteoscintigraphy. This technique allows you to clarify the presence of metastases;
- Identification of specific oncomarkers;
- Morphological diagnosis of tumor fragments. Such a study is usually carried out after the removal of the affected testicle, since the risk of local metastasis is great if the integrity of the unsuccessful tumor is damaged.
Based on the diagnostic results, the most optimal therapy is selected.
Analysis for the detection of cancer markers in testicular cancer is invaluable. Tumor markers are specific substances produced by malignant tumors.
Depending on their level, the degree of development of the tumor process is determined. Usually, in laboratory blood tests, attention is drawn to the level of such oncomarkers as AFP( α-fetoprotein), LDH( lactate dehydrogenase) and hCG( β-subunit of human choriogonadotropin).
Normally, these substances are:
- ACE - less than 15 ng / ml;
- LDG - less than 2000 U / l;
- hCG - less than 5 mU / ml.
ACE increases in 70% of patients with testicular cancer. The value of LDH in the study is not high, however, if the level of lactate dehydrogenase rises above 2000 U / l, this is a direct sign of the tumor process. HCG increases in 10% of patients with seminoma, 25% - with a yolk sac, in 60% - with embryonic carcinoma and in 100% - with chorion carcinoma of the testicle.
Such a study is very useful for diagnostic purposes, staging, selection of therapy and monitoring the response to treatment.
Treatment of the disease and life expectancy
Therapy of testicular cancer is based on the traditional surgical approach, chemotherapy and radiation exposure.
Surgical treatment usually involves orhifunilectomy, i.e., surgical removal of the testicle affected by the tumor process. Sometimes such an operation is supplemented by the removal of lymph nodes( retroperitoneal lymphadenectomy).
After surgical treatment, irradiation and chemotherapy are additionally prescribed. The success of therapy is affected by several factors:
- The prognosis for such an oncology is positive only in the early detection of cancer, when the survival rate is of the order of 90%;
- If it is detected in stages 2-3 with active metastasis, complete cure is not possible, however, the 5-year survival rate reaches 50%;
- If a man plans to paternity in the future, it is recommended to cryopreserve the seed material before the start of therapy, as modern technologies allow it.
Video about testicular cancer: