Today we are going to talk about a topic that is a bit of a taboo subject, but it is very important. This is especially important for young men. Have you ever felt something different, like a small lump, in your testicles? It is normal to feel a little scared if you feel something like that. But before you panic, it is best to be fully aware of this. Because testicular cancer is a disease that can be completely cured if detected early.
What exactly is testicular cancer?
Simply put, testicular cancer occurs when cells in the testicles start to grow abnormally and uncontrollably. This growth of cells causes a lump or tumor to form.
Now let's look at what the testicles are and what they do. The two testicles in your body are like two walnuts. They are located in a pouch of skin just below the penis. We call this the scrotum. They have two main functions:
1. Production of sperm.
2. Production of testosterone, a male hormone.
Like any cancer, this is a serious condition. But the good news is that testicular cancer is a disease that can be treated with very high success rates and is completely curable.
What are the main types of this cancer?
About 90% of testicular cancers arise from germ cells, the primary cells that give rise to sperm. These are divided into two main types. Knowing the difference between the two is important in determining treatment.
| Cancer type | Description |
|---|---|
| Seminoma | This type usually grows slowly and is most common in people between the ages of 40 and 50. |
| Non-seminoma | This type grows faster than seminoma. It mostly affects young people, that is, those between the ages of 15-35. There are several subtypes of these as well. |
Sometimes a cancer tumor can contain a mixture of both types of cells.
How common is this disease?
Testicular cancer is actually a relatively rare disease. It affects about one in every 250 men. However, what's special about it is that it's the most common type of cancer in men between the ages of 15 and 35 .
How to recognize it? What are the symptoms?
The most common symptom of testicular cancer is a painless lump in the testicle, but there may be several other symptoms.
The important thing is that these symptoms can also be caused by other medical conditions. So don't panic when you see them. But, don't ignore them either. Definitely see a doctor and get checked out.
| Symptom | Simply explained |
|---|---|
| A lump or swelling | Feeling a lump or swelling in one or both testicles. This is often painless. |
| A feeling of heaviness in the scrotum | A feeling of heaviness in the scrotum or a feeling of fluid filling it. |
| A dreamy ache | A dull ache or pain in the lower abdomen or groin area. |
| Pain or discomfort | Feeling pain or discomfort in the testicles or scrotum. |
| Testicular shrinkage | Smallness or shrinkage of one testicle (testicular atrophy). |
Delaying diagnosis increases the time it takes for cancer cells to spread. This makes treatment more complicated. Therefore, it is very important to act quickly.
What are the risk factors for developing testicular cancer?
The exact cause of testicular cancer is not yet known. However, researchers have found that certain factors can increase the likelihood, or risk, of developing the disease. These are called risk factors.
- Age: Most common in people between the ages of 15 and 35.
- Undescended testicles: Normally, the testicles develop in the abdomen as a fetus develops in the womb. They settle into the scrotum before birth. Sometimes, this does not happen. Even if this condition is corrected with surgery, it increases the risk of developing testicular cancer in the future.
- Family history: If your father or brother has had the disease, you are at slightly higher risk of developing it. Some genetic conditions (such as Klinefelter Syndrome) can also increase your risk.
- Having cancer in one testicle: A person who has been cured of cancer in one testicle has a small risk of developing cancer in the other testicle.
- Infertility: Some studies have suggested that there may be a link between certain factors that affect male infertility and testicular cancer. This is being further researched.
Doctor, how do you diagnose this?
When you go to see a doctor, he will do several tests to diagnose this disease accurately. Don't worry, let's see what these steps are.
1. Physical examination and medical history: First, the doctor will ask you about your symptoms. Then, he will physically examine your testicles to check for any lumps or swelling. If there is any doubt that the cancer has spread, the lymph nodes may also be examined.
2. Ultrasound Scan: If something unusual is found during the examination, an ultrasound scan is often the next step. This is a painless test. It can provide a clear picture of what is inside the testicles. It can tell you a lot about whether the lump is solid or fluid-filled, and how likely it is to be cancerous.
3. Inguinal Orchiectomy and Biopsy: If the scan strongly suggests cancer, the next step is to surgically remove the affected testicle. This is done through a small incision in the groin area. A piece of the removed testicle is taken and examined under a microscope (biopsy). This test will confirm whether or not there are cancer cells.
Other tests that may be needed
- Serum Tumor Marker Test: Some types of cancer release specific substances into the blood. We call these `tumor markers`. In testicular cancer, the levels of `AFP`, `HCG` and `LDH` can be elevated. By looking at the levels of these, we can get some idea about the type of cancer and its spread.
- CT scans, X-rays, and MRIs: These scans are used to see if the cancer has spread to other areas outside the testicle, for example, to the lymph nodes in the abdomen, the lungs, or the brain.
What are the stages of cancer?
Once the diagnosis is confirmed, the doctor will determine the stage of the cancer. This means how far the cancer has spread. Treatment is planned based on this stage.
- Stage 0: Abnormal cells have grown, but are still inside the testicle.
- Stage I: The cancer is limited to the testicle.
- Stage II: The cancer has spread to the lymph nodes in the back of the abdomen.
- Stage III: The cancer has spread to the lymph nodes outside the abdomen or to other organs such as the lungs, liver, or brain.
What are the treatments for this?
The treatment method depends on several factors, such as your health condition, the type of cancer, and the stage of the cancer.
| Treatment method | Description |
|---|---|
| Surgery | The main and most common treatment is removal of the cancerous testicle (`Radical inguinal orchiectomy`). In some cases, if the cancer has spread, surgery to remove the testicles in the abdomen (`RPLND`) may also be performed. |
| Radiation Therapy | This involves using high-energy X-rays to destroy cancer cells. It is most commonly used for seminoma, a type of cancer, to prevent the disease from coming back after surgery. |
| Chemotherapy | This involves giving the body drugs that kill cancer cells. These drugs can be given through a vein or as pills. This treatment is very important in cases where the cancer has spread. |
Can this disease be completely cured?
Yes! Absolutely. This is the best and most important message about testicular cancer.
Testicular cancer is a disease that can be successfully treated and completely cured with a success rate of more than 95%. If the disease is detected early, that is, in the early stages, the cure rate is as high as 98%.
Therefore, this disease is rarely fatal. The key here is early detection and proper treatment.
Even if you can't prevent it, you can recognize it quickly! - Self-Exam
There is no surefire way to prevent testicular cancer. But there is one very important thing you can do. That is to perform a monthly testicular self-exam (TSE). This will give you a good idea of the general condition of your testicles. Then, if there is any unusual change, such as a lump, you can quickly identify it.
This will take about two minutes.
Here's how to do a self-check:
1. Choose the best time: It's best to do this during a hot bath or right after a shower. This is because the heat loosens the skin of the scrotum, making it easier to feel what's inside.
2. Check one testicle: Place your index and middle fingers under the testicle, and your thumb on top. Now, check the testicle by rolling it between your fingers.
3. Identify the normal: During the examination, you will feel a cord-like structure at the back and top of the testicle. It is called the epididymis. It stores and transports sperm. Do not confuse this with a lump. It is also normal for the two testicles to be slightly different in size.
4. Be alert for unusual things: When examining in this way, look for any new growths, lumps, thickenings, or swellings that are the size of a pea or larger.
5. Examine the other testicle in the same way.
If you notice any lumps, swelling, changes in size, or anything else unusual, don't panic or delay, see a doctor immediately.
What impact will the treatment have on my life?
Many people have questions about what will happen to their sex life and ability to have children when a testicle is removed.
Normally, one healthy testicle can produce enough testosterone for the body. Therefore, sex drive does not decrease. Erection and ejaculation should occur normally.
Also, one testicle is enough to father children. But if you have any doubts or fears about it, talk to your doctor before starting treatment. If necessary, your sperm can be collected before treatment and stored safely for future use. We call this sperm banking.
Take-Home Message
- Testicular cancer is a rare disease, but it is the most common type of cancer in young men between the ages of 15-35.
- The most common symptom is a painless lump in the testicle.
- Make it a habit to do a self-exam once a month. This will help you spot any changes quickly.
- If you notice any unusual changes (a lump, swelling, pain), don't be afraid, don't be embarrassed, and don't delay . See a doctor immediately.
- This disease can be completely cured with a cure rate of more than 95% if detected early. Therefore, awareness and early action are the most important things.
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