Testicular cancer - causes and signs

testicular cancer

Testicular cancer is a malignant tumor that is relatively rare, accounting for less than two percent of all new cancers. However, it plays an important role especially in men in young and middle age, because here is the most common tumor of the new man. If the cancer is detected early, it can be permanently cured in most cases and even in the metastatic stage, as opposed to many other malignant tumors a good chance of recovery. Accordingly, warning signs such as swelling and hardening in the testicle should always be taken seriously and examined by a doctor or urologist.

contents

• testicular cancer
• Testicular carcinoma: definition and frequency
• Signs and symptoms of testicular cancer
• Testicular tumor causes
• Testicular cancer diagnosis
• Therapy for testicular cancer
• Testicular Cancer Precaution: Correct palpation important

Testicular carcinoma: definition and frequency

The term "testicular cancer" or "testicular carcinoma" is referred to in medicine as a malignant tissue proliferation, which spreads in the testes of the man, but can also affect the bloodstream of any other body organ. Especially affected are younger men between the ages of 25 and 45 years, in which this type of cancer is the most common malignant tumor disease. According to the Robert Koch Institute, however, testicular cancer is one of the rarer types of cancer, accounting for around 4,000 new cases a year, accounting for about 1.6 percent of all male cancers.

Tumor in the testicles: These are the causes and symptoms. Picture: ghazii-fotolia

For most people (95%), the cancer is one-sided. In addition, almost all tumors (90%) are derived from germ cells ("germ cell tumors"). A distinction is made here between tumors originating from the testicular tissue or the so-called "spermatogonia" (seminomas) and the so-called "non-seminomas", which may consist of different types of tissue and, accordingly, more specifically z. B. be referred to as yolk sac tumor or choriocarcinoma. Both forms are about equally common, with non-seminomas developing on average a little earlier. Accordingly, the mean age at onset of a non-seminomatous testicular tumor is 27 years and that of seminoma is 37 years.

The remaining 10% of malignant testicular tumors have their origin in the supporting tissue ("Sertoli cell tumors"), in the testosterone-producing cells ("Leydig cell tumors") or in the lymphoid tissue of the testes (lymphoma). In addition, daughter tumors (metastases) of tumors of other organs in the testes can occur.

Signs and symptoms of testicular cancer

In most cases, this type of cancer shows clearly recognizable symptoms, which is why a disease is usually discovered by those affected themselves. Typically, this is a predominantly unilateral testicular swelling, which gradually increases but does not cause any pain. In addition, there are often noticeable nodular indurations, a feeling of pressure or heaviness in the testicles as well as a pulling in the groin. Some sufferers also report testicular pain, swollen mammary glands, blood in the semen, a decrease in sexual desire or an accumulation of fluid in the scrotum (hydrocele). In the advanced stage of the disease, it can also cause back pain and shortness of breath due to lymph node swelling in the abdominal area.

However, swelling and hardening do not necessarily indicate cancer. Instead, often benign diseases such as epididymitis or a so-called "twisted testicles" (testicular torsion) are responsible for the symptoms. Nevertheless, the complaints should always be taken seriously and promptly clarified by a doctor or urologist to avoid health risks.

Testicular tumor causes

The causes of testicular cancer are not yet fully understood. However, some risk factors are known that can have a beneficial effect on the development. These include above all a so-called "undescended testicles" (cryptorchidism), in which one or both testicles after birth not as usual in the scrotum, but z. B. in the abdominal cavity or in the inguinal canal. It is the most common congenital malformation of the urinary and genital apparatus, which occurs in just under one to three percent of mature male babies. Preterm infants, on the other hand, are affected much more often by up to 30 percent due to their immature development.

In some cases (about 7%), the testicles migrate into the scrotum by themselves in the first few months of life, but after the first year of life this process is very unlikely. If an undescended testicle is not treated early, on the one hand increases the risk for limited fertility (infertility), testicular torsion and inguinal hernia. In addition, according to recent studies, the risk of developing a testicular tumor increases twice or even three times over. Since damage can already occur within the first six to twelve months of life, experts today recommend concluding therapy before the end of the first year of life. Accordingly, if the situation does not change by itself within the first half of the year, an attempt is made to treat the high level by medication with the administration of hormones. If there is no success, a small surgical procedure is usually required to alter the position of the testicle.

In addition, hereditary factors are suspected as the cause of an increased risk of disease, since the tumor occurs partially accumulated within a family. Accordingly, according to the German Cancer Aid in a family with several sons a case of testicular cancer would lead to an approximately twelve-fold increased risk for the brothers. The same applies if the father is ill, because even here, the risk of cancer for the son is higher, as compared to peers without family bias.

The changes in the testes in testicular cancer can usually be palpated during the self-examination. (Image: joshya / fotolia.com)

Testicular cancer diagnosis

If there is a suspicion of testicular carcinoma, a thorough consultation is usually first carried out, through which the doctor can get a first impression. It is therefore helpful, in advance with questions such. For example, "Since when is the swelling?" Or "What other symptoms have occurred?" To deal with to give the most accurate answers. This is followed by a precise examination of the testicles, through which the doctor can recognize hardened or nodular areas, in addition to an ultrasound examination (testicular sonography) to make any changes visible.

Frequently, a blood sample is taken to confirm or alleviate the suspicion, to provide clues to possible "tumor markers" such. For example, to obtain the protein alpha-fetoprotein (AFP) or the hormone human chorionic gonadotropin beta (ß-HCG). These are biological substances in the blood or other body fluids that may indicate increased levels of the development or recurrence of malignant tumors.

If the suspicion is confirmed, the testicle is usually uncovered in the next step in an operation. In this way, the doctor can often already recognize whether it is a malignant tumor. For a clear diagnosis, however, the examination of a tissue sample from the affected testes is necessary (biopsy). Finally, in order to check whether there is already a metastasis in other organs or a lymph node involvement, other imaging methods, such as e.g. X-ray examinations or computed tomography (CT).

Therapy for testicular cancer

If the diagnosis can be clearly made, the first step in the treatment is usually the surgical removal of the affected testis, including the epididymis and spermatic cord via a section in the groin (orchidectomy). The procedure usually performed under general anesthesia is considered relatively simple and risk-free. In addition, a small tissue sample can be taken from the healthy testis during surgery to discover a possible precancerous stage on the other side. Side effects or consequential damages such. For example, infertility or impotence is very rare in removing a single testicle, as the healthy testis on the other side compensates for the malfunction. In addition, if necessary for cosmetic reasons, an implant made of silicone (testicular prosthesis) can be used, which does not differ in appearance and touch from a healthy testicles.

The further treatment steps after the intervention depend on the type of tumor (seminoma or non-seminoma) and the severity of the disease. In tumors detected early, in many cases a wait-and-see approach ("wait-and-see strategy"), in which no further therapy is performed for the time being, is sufficient. Here, however, very short-term controls are necessary to detect a possible metastasis formation early. Alternatively, in the case of a "seminoma" type of cancer, depending on the stage of the disease, radiation or different chemotherapeutic procedures are used.

In the case of a non-seminoma, on the other hand, no radiation therapy is normally carried out, since this type of tumor is less radiosensitive. Instead, after the removal of the diseased testicle according to the stage of the disease, the wait-and-see surveillance strategy or chemotherapy may also be considered. In addition, in this case, further operations may be required to remove lymph nodes in the back of the abdomen or metastases in individual body organs

If the testicular cancer is discovered and treated accordingly, the prognosis is usually good. However, it is important to recognize and treat it as early as possible, because in this case, more than 95% of the testicular tumors can be permanently cured. In advanced disease, unlike most other malignant tumors, there are good chances of recovery, which according to the Robert Koch Institute, the relative 5-year survival rates with 97% high and mortality with 170 deaths per year is relatively low.

Testicular Cancer Precaution: Correct palpation important

To prevent a malignant tumor, every man should palpate both testes for changes about once a month. This is especially true when the risk due to an undescended testicle or hereditary preloads is greatly increased by a diseased father or brother. In addition, one's own examination should begin as early as puberty, as testicular cancer occurs mainly in very young men. Scanning is simple and uncomplicated when the scrotum is held with the palms of the hands and felt simultaneously with the fingers of both hands. Each testicle should be touched individually and examined thoroughly for changes.

While a healthy testis usually has a smooth surface, testicular cancer usually manifests itself as hardening or painless enlargement of the entire testicle, often affecting only one side. If something happens during the check-up, do not hesitate to contact a doctor immediately. This is especially important, because testicular cancer can be healed the better the sooner it is discovered. In addition, other changes such. As varicose veins of the testicles (varicoceles) discovered in this way and treated if necessary.

A special screening examination with reimbursement by the health insurance at the doctor, there is not. Nevertheless, experts advise men over the age of 20 to undergo a yearly palpation examination by the urologist in order to be able to identify a possible disease at an early stage. Patients who have already been treated with testicular cancer should also seek follow-up care. Because even if relapses occur relatively rarely, it is important to avoid health risks and to regularly check the state of health. (No)