Not all enlargements of the testes are cancerous. More often it is epidedymitis, inflammation of the tubes, leading to and from the testes, or even presence of fluid in the pouch around the testes, the condition called hydrocele, that causes an enlarged testes.
Cancer of the testes occurs in younger men between the ears of 15 to 40.
Cancer of the testes are mainly of two types:
1. Seminoma
2. Teratoma
Seminoma
Cause(s)
It is not known with certainty. Failure of the testes to descend completely from the abdomen where it is situated in the foetus, to the scrotum, is one of the known causes.
Symptoms
- It is a malignant tumour of the testes, appearing as a swelling, often painless, in the scrotum.
- Occurs in age group of 30 to 40 years.
- Enlarged and painful testes.
- Spread occurs into the lungs.
Diagnosis
Routine: Blood: Hb, RBC, TLC, DLC, ESR may show no change.
Special: Needle biopsy of involved testes and its examination establishes the diagnosis.
Additional: Ultrasound and CT scan of the liver and lungs indicate whether the cancer has spread in these organs.
Treatment
Depends upon the stage of the disease:
Stage I: Cancer confined to the testes.
Stage II: Cancer has spread in the lymph nodes in the abdomen.
Stage III: Cancer has spread further and invade the abdomen. liver and lings.
Surgery: Removal of the testes if in stage I may cure the disease.
Radiation: If the stage is I or II radiation is done over the lymph nodes in the abdomen. 4 to 5 exposures a week for 3 to 4 weeks. Cure rate is over 90 per cent.
Chemotherapy: Stage III cancer needs extensive surgery of the parts involved and radiation. as well as chemotherapy.
Teratoma
This tumor spreads from the testes via the lymph channels as well as the bloodstream.
Cause(s) It is not mown.
Diagnosis
Routine: Blood: Hb, RBC, TLC, DLC, ESR may be normal.
Special: Increased levels of Human chorionic gonadotrophin (HCG) and Alfa fetoprotein (AFP), which are produced by this cancer, are increased.
Needle biopsy examination for cancer cells can confirm the diagnosis.
Additional: X-ray chest and CT scan of the lungs, to see if the cancer has spread there.
Blood tests to measure liver- and bone marrow function. If the function is deranged, it indicates the spread of cancer over there.
Treatment
Staging is more or less similar to that of scminorm.
Surgery: Removal of the testes and the extensive removal of the lymph glands from the abdomen, cures over 90 per cent in stage I and over 80 per cent in stage II.
Radiation: Radiation is given to the lymph glands in the abdomen in all stages of the disease.
Chemotherapy: It is used in stage II and III. High doses or a combination of drugs like Cis-plastin, Bleomycin and Vinblastine, cure a high percentage of cases. Side-effects of chemotherapy are fairly large. These are:
- Feeling of fatigue.
- Nausea and vomiting.
- Loss of hair.
- Damage to the lungs and subsequent breathlessness.
- Increased risk of infection.
Prognosis
Detected early, the cure rate is high.
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