Testicular cancer, the most common solid tumour among males aged 15 to 34 years, is curable. While early symptoms — like swelling in the scrotum or testes and abdominal pain — can be identified by physical examination, the treatment is usually surgery or chemotherapy.
What is testicular cancer?
“While tumours [grow] in the testes in cases of testicular cancer, we have also observed [cases of] lymphoma in the testes. This is a type of blood cancer,” says Dr R Srivathsan, consultant urology, uro-oncology & robotic surgery, Apollo Proton Cancer Centre, Chennai.
“The germ cell in the testis is responsible for sperm production, which becomes cancerous. Two types of cancers could possibly take place: seminoma, which usually occurs during old age, and non-seminoma, which usually occurs in the adolescent age group (10-16 years). It is also important to consider the concept of fertility and reproduction when a young individual has testicular cancer.”
Causes of testicular cancer
Dr Srivathsan adds that testicular cancer has no sighting factor such as a lifestyle habit or a certain type of food consumption (including smoking and drinking alcohol).
“Most cases of testicular tumour are because of chromosomal issues or genetic issues, which could be either inherited or acquired during pregnancy,” he says. “The range of appearance of testicular cancer is one in 10,000 or one in 20,000. But there isn’t much awareness about it.”
Symptoms
Dr Moideen Nafseer, consultant urologist, Mangala Kidney Foundation, Mangaluru, Karnataka, lists some of the symptoms of testicular cancer:
- Enlargement of the scrotum or testes
- Dull ache in the testicular area
- Pain in the abdominal region
- Cough along with the appearance of blood in the cough
- Enlarged lymph nodes in the stomach region
- Swelling in the testes.
Diagnosis
- Physical evaluation: “Self-evaluation is extremely crucial, just like how doctors recommend in the case of breast cancer,” says Dr Srivathsan. “Ideally a male individual should self-evaluate their testicular region to observe for any lump or swelling. If the testis is undescended, this could be a risk factor for the cancer. When you notice something abnormal or difference in one side of the testis as compared to the other, you should approach the doctor.”
- Scrotal ultrasonography is the preferred initial imaging study for evaluating a testicular mass.
- Radiological imaging such as CT scan or MRI is done to assess the type of cancer.
- Presence of tumour marker in a blood test is seen to assess the testicular tumour.
Treatment
Testicular cancer is one of the most curable forms of cancer. The tumour is melted through:
- Surgery (radical orchiectomy or removal of testis) or
- Chemotherapy
Suresh Mittal, a 48-year-old who works with a private firm in Mumbai, overcame testicular cancer through just chemotherapy and is leading a healthy life today.
“I went through a lot of pain in the scrotum and was diagnosed with testicular cancer after several scans,” says Mittal. “I was nervous, but chemotherapy helped me recover.”
Dr Shreyas Nagaraj, consultant, urologist, uro-oncology and andrology, and renal transplant surgeon at Cytecare Cancer Hospitals, Bengaluru, recalls the case of a 30-year-old who visited the hospital in February 2023 complaining of a weeklong right-side scrotal swelling.
“He was a software engineer residing in Bengaluru,” says Dr Nagaraj. “He underwent all diagnostic procedures — like the ultrasound of the scrotum — and a testicular tumour was found. He underwent the removal of the testis. The lymph node enlargement was noted in this man through an abdomen CT scan for which he needed chemotherapy.”
Precautions are taken to preserve the fertility of the patient. The risk of testicular cancer recurrence is greatest within two to three years of primary treatment, and surveillance is continued for up to five years. Testicular cancer and its treatment also increase the risk of hypogonadism (a condition where the body does not produce enough testosterone).
Takeaways
- Testicular cancer is curable.
- Physical examination is the first step of diagnosis when an individual notices a swelling or extreme abdominal pain.
- The treatment is either through a surgery or chemotherapy.
