When we hear the word cancer, we all get a little scared, don't we? But there are also types of cancer that we have never heard of, and which are very rare. Yolk Sac Tumor is one of them. This name may be new to you. Today, we will talk about this cancer, which can develop especially in young children and young adults, in a very simple way that you can understand. It is very important to be aware of this.
What exactly is Yolk Sac Tumor?
Simply put, Yolk Sac Tumor is a type of cancer. It is also called Endodermal Sinus Tumor. It arises from a special type of cell in our body. That is, from the cells that become sperm in a man, and from the cells that become eggs in a woman. In medicine, we call these cells germ cells. So this belongs to the category of Germ Cell Tumor.
These tumors most often develop in either the ovaries in women or the testicles in men. However, very rarely, they can develop outside these reproductive organs, for example in the chest, abdomen, or brain.
This type of cancer is very rare overall. However, the most commonly reported type of germ cell cancer in young children is this type called Yolk Sac Tumor.
The serious thing about this is that this cancer grows quickly and can spread quickly . Therefore, if left untreated, it can be life-threatening. But the good news is that if the disease is detected early, it can be completely cured with treatment . Therefore, it is very important to recognize the symptoms early.
What are the main types of this cancer?
As we discussed earlier, this cancer can be divided into several main types depending on where it develops.
- Testicular yolk sac tumors: This is a type of testicular cancer. It is most common in boys under the age of 3 and in young men in their 20s and 30s . In most cases, these can be detected early, before they have spread to other parts of the body. This makes them more likely to be cured.
- Ovarian yolk sac tumors: This is a type of ovarian cancer. It is a less aggressive type, meaning it can spread quickly. It is most common in young girls aged 20 or younger . Reportedly, one-third of those diagnosed with this disease are young girls who have not yet started menstruating.
- Extragonadal germ cell tumors: Sometimes, these germ cell tumors develop in other parts of the body, outside the ovaries or testicles. For example, they can develop in the brain, the middle of the chest, the back of the abdomen, or the tailbone .
What could be the symptoms of this?
The symptoms of a Yolk Sac Tumor depend on where in the body the tumor is located. For example, a mother may find a small lump in a baby's testicle while bathing. Or a young girl may experience irregular periods along with abdominal pain. It is important to be aware of these symptoms.
See the table below for common symptoms depending on the location of the cancer.
| Location of the cancer | Symptoms that can be seen |
|---|---|
| Testicles | A painless hardness or lump in a testicle. |
| Ovaries | Abdominal bloating or a feeling of a lump in the abdomen, stomach pain or back pain, changes in bowel habits (such as constipation), irregular or heavy menstrual bleeding. |
| Brain | Headache or vision problems. |
| Chest | Coughing and difficulty breathing. |
| Lower end of the spine (Tailbone) | The area may be swollen, look bruised, or look like an infected lump. |
Why does this kind of cancer develop?
This is a problem that many people have. But to be honest, medical researchers have not yet found the exact cause of Yolk Sac Tumor. Like other cancers, this one is caused by changes (mutations) in the genes, or DNA, in cells. These changes cause the cells to divide rapidly and uncontrollably. Over time, these cells can grow together to form a mass. If left untreated, these cancer cells can spread to other parts of the body.
However, research is still ongoing into why these genetic changes begin in the first place.
How to diagnose this disease?
If you or your child has any of the symptoms listed above, you should see a doctor right away. The doctor will first do a physical exam and look for any unusual lumps or swellings in the abdomen or testicles. Then, they will ask you about your symptoms.
Several tests can be done to confirm the disease:
- Blood tests: A sample of your blood is taken and a special protein is checked. It is called Alpha-fetoprotein (AFP) . This AFP level in the blood is very high in everyone with Yolk Sac Tumor. This is a very important indicator for diagnosing this cancer.
- Imaging tests: CT scans (Computed Tomography scans) and MRI scans (Magnetic Resonance Imaging) are the most commonly used tests. These can clearly see tumors inside the body.
- Surgical excision: This is the only way to be 100% certain about the disease. The doctor will perform surgery to remove the entire tumor (sometimes the entire organ in which the tumor is located). The tumor will then be sent to a lab to be tested for cancer cells.
How are the stages of cancer determined?
Once the disease is diagnosed, doctors determine how far the cancer has spread, or what the 'stage' of the cancer is. This stage is determined by factors such as the size of the tumor and how far the cancer has spread. If the stage is low (e.g. Stage 1), it means the cancer is in its early stages. If the stage is high (e.g. Stage 3, 4), it means the cancer has spread somewhat. Knowing this stage is essential to choosing the best treatment.
For Testicular Tumors
- Stage 1: The cancer is only in the testicle.
- Stage 2: The cancer has spread from the testicle to the lymph nodes.
- Stage 3: Cancer cells have spread to other organs.
For Ovarian Tumors
- Stage 1: The cancer is limited to one or both ovaries.
- Stage 2: Cancer cells have spread to other areas within the pelvis, but have not reached the fallopian tubes.
- Stage 3: The cancer has spread to the lymph nodes and the membrane that lines the inside of the abdomen (peritoneum).
- Stage 4: The cancer has spread outside the lining of the abdomen to other tissues and organs.
What are the treatments for this?
The main goal of treatment is to completely remove the cancerous tumor. Two main treatment methods are used for this.
1. Surgery: This involves removing the entire testicle (called an orchiectomy ) or ovary (called an oophorectomy ) affected by the cancer. If the cancer has spread to the seminal vesicles, they may also need to be removed.
2. Chemotherapy: After surgery, this treatment is given to kill any cancer cells that may be left in the body that are not visible to the naked eye. Sometimes, if the tumor is very large, chemotherapy may also be given to shrink the tumor before surgery.
BEP treatment method
The main chemotherapy treatment for Yolk Sac Tumor is called BEP . Depending on the stage of the cancer and how your body responds to the treatment, you may need to take several rounds of BEP. BEP is a combination of three drugs:
- B leomycin
- E toposide
- Cisplatin ( P latinol®)
When these three drugs are combined, they work very effectively to destroy Yolk Sac Tumor cells.
How is the condition after treatment? (Prognosis)
This is something that many people need to know. It is true that if left untreated, Yolk Sac Tumor is life-threatening. That is why we have said from the beginning that it is very important to diagnose the disease and start treatment early . As with any cancer, the sooner treatment is started, the higher the chances of recovery.
Your prognosis depends on several factors. You should discuss with your doctor things like the stage of the cancer, how your body is responding to treatment, and your AFP level before starting chemotherapy (the lower this is, the better the outcome is usually).
But don't worry. Treatments like surgery and BEP have greatly improved the survival rate for people with Yolk Sac Tumor. For example, Stage 1 testicular cancer can be almost completely cured with these treatments. A recent study showed that 91.5% of people treated for early-stage ovarian cancer were still alive after five years.
Take-Home Message
- Yolk Sac Tumor is a rare type of cancer that is most common in children and young adults.
- Be on the lookout for symptoms like a painless lump in a testicle or swelling/discomfort in the abdomen. If you notice anything like this, don't be embarrassed or afraid, but see a doctor right away.
- Although this cancer spreads quickly, it can be completely cured if detected early.
- Surgery and chemotherapy (especially BEP) treatments are very effective.
- Even after treatment is complete, it is imperative to undergo follow-up examinations at the scheduled time as prescribed by the doctor.
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