What is Testicular Cancer and Types of Testicular Cancer?
When cells expand out of control, cancer begins. Almost every cell in the body may turn into cancer and spread to other places of the body.
What is cancer?
When cancer begins in the testicles, it is termed testicular cancer. Knowing how the testicles normally look and work will help you comprehend this malignancy.
The good news is that you can frequently find out whether you have testicular cancer by using a simple Testicular Cancer Self Exam (TSE). We think you should do this "self-check" once a week. You have a far better chance of detecting Testicular Cancer in its early stages, when it has the highest chance of being treated, if you do a frequent Testicular Self Exam. A shocking 62% of the people who are most at danger don't know how to check themselves. Every day, one man dies from testicular cancer. Make it less likely that "one" man is you. It just takes a minute to do a quick self-exam! Learn how to do a self-check and what is usual for you so that you can respond if anything changes.
Male reproductive system
The scrotum is a pouch of loose skin that holds the testicles below the penis. The male reproductive system includes the testicles, which produce sperm and male hormones like testosterone. The spermatic cord is a part of the body that links the testicles to the rest of the body. It has veins and arteries that provide blood to the testicles so they may get oxygen, nerves, and the vas deferens, which take sperm from the testicles to the urethral hole in the prostate where it is released during ejaculation. There are lengthy, thread-like tubes in the testicles called seminiferous tubules that make sperm cells. After that, they are kept in a little coiled tube behind each testicle called the epididymis. This is where they grow up. When a man ejaculates, sperm cells go from the epididymis via the vas deferens to the seminal vesicles. There, they combine with secretions from the vesicles, prostate gland, and other glands to make semen. This fluid then goes into the urethra, which is the tube in the middle of the penis that lets both urine and semen out of the body. Testicular cancer is not as common as other forms of cancer. But testicular cancer is the most frequent kind of cancer in American men between the ages of 15 and 35.
Even when cancer has progressed beyond the testicle, testicular cancer is quite easy to cure. You may get one of many therapies or a mix of them, depending on the kind and stage of your testicular cancer.
The initial indicators of testicular cancer are usually an enlarged testicle or a tiny lump or hard spot. If you have a lump, swelling, hardness, discomfort, or soreness, you should see a doctor very once.
Other signs of testicular cancer normally don't show up until the disease has progressed to other regions of the body.
This year, around 9,910 men in North America will find out they have testicular cancer. One in every 250 men and boys will have the illness at some point in their lives. In 2020, some 74,458 persons throughout the world were told they had testicular cancer.
One out of every five new cancer cases in males is prostate cancer.
That stated, everyone will die if they don't seek help. According to the numbers, the longer someone waits to go to the hospital, the longer the list of treatments will be. Waiting to visit the doctor might make the difference between needing to have chemotherapy and not.
Men who have been told they have testicular cancer may wonder about their chances of survival and what their future holds. These things rely on a lot of things. A doctor can only look at all the information and make a diagnosis if they know a lot about the patient's medical history, the sort of cancer they have, the stage of the illness, its symptoms, and how the patient has responded to therapies.
8 warning signs and symptoms of testicular cancer:
1. A lump or swelling on one of the testicles that doesn't hurt. A testicular tumor may be the size of a pea or a marble when it is first diagnosed, but it may become considerably bigger.
2. Pain, pain, or numbness in a testicle or the scrotum, with or without swelling.
3. A change in how a testicle feels or a heavy sensation in the scrotum.
4. A dull pain in the groin or lower abdomen
5. A sudden increase in fluid in the scrotum
6. Tenderness or development in the breasts. Some testicular tumors generate hormones that may make breasts sore or cause breast tissue to expand, although this is not common.
7. Symptoms of later-stage testicular cancer might include discomfort in the lower back, shortness of breath, chest pain, and bloody sputum or phlegm.
8. A blood clot might cause one or both legs to swell or make it hard to breathe, which can be a sign of testicular cancer. For some young or middle-aged men, the formation of a blood clot may be the first indication of testicular cancer.
Types of testicular cancer
There are many different kinds of cells in the testicles, and each of them may turn into one or more kinds of cancer. It's vital to know what sort of cancer it is and what kind of cell it originated in since these things affect how the disease is treated and how likely it is to get better.
By examining at the cells under a microscope, doctors can identify what kind of testicular cancer you have.
A positive prognosis is likely for 90% of seminomas and 56% of non-seminomas. About 16% of non-seminomas signify a worse prognosis at later stages of the illness, whereas seminomas respond better to therapy even when the disease is more advanced.
Size of the tumor
A seminoma that is larger than 6 cm can be a sign of an advanced stage, the size of the non-seminoma is not an indicator of an advanced stage.
Distant metastasis
Cancer of the testicle that has spread to the lungs or other distant areas is a sign of a sombre prognosis.
Retroperitoneal lymph node
The presence of testicular cancer in the retroperitoneal lymph node is an advanced stage indicator.
For testicular cancer that has spread to the lymph nodes in the back of the abdomen, called the retroperitoneal lymph nodes, the survival rate is 96%. But this depends on the size of the lymph nodes with cancer. About 18% of cases are diagnosed at this stage. For testicular cancer that has spread outside the testicles to areas beyond the retroperitoneal lymph nodes, such as to the lungs or other organs, the survival rate is 73%. About 12% of testicular cancer is diagnosed at this stage.
Germ cell tumors
Germ cells are the cells that initiate more than 90% of testicular malignancies. These are the cells that create sperm. Seminomas and non-seminomas are the two primary forms of germ cell tumors (GCTs) that may happen in the testicles. These kinds happen approximately the same amount of time. A lot of testicular tumors have both seminoma and non-seminoma cells.
These *mixed germ cell tumors* *are treated as non-seminomas* because they develop and spread like non-seminomas. Seminomas Seminomas usually develop and spread more slowly than non-seminomas. There are two primary forms of these tumors: classical (or typical) seminomas and spermatocytic seminomas. *
*Classical seminoma:* Classical seminomas make up more than 95% of all seminomas. These mostly happen to guys aged 25 to 45. *
*Spermatocytic seminoma:* Older males are more likely to have this unusual kind of seminoma. (The average age is roughly 65.) Spermatocytic tumors develop more slowly and are less prone to spread to other parts of the body than traditional seminomas affect different regions of the body.
Some seminomas may raise the levels of a protein in the blood called human chorionic gonadotropin (HCG). A simple blood test can screen for HCG, which is a tumor marker for certain kinds of testicular cancer. It may be used to figure out what's wrong and to see how well the therapy is working.
Non-seminomas
These kinds of germ cell tumors commonly happen in males who are in their late teens to early 30s. Embryonal carcinoma, yolk sac carcinoma, choriocarcinoma, and teratoma are the four primary forms of non-seminoma tumours. Most tumours are made up of multiple kinds of cells, and occasionally they include seminoma cells in them as well. However, this doesn't affect how most non-seminoma malignancies are treated.
*Embryonal carcinoma:* These cells are present in around 40% of testicular tumours, however pure embryonal carcinomas manifest in just 3% to 4% of cases. These tumours may seem like tissues from very early embryos when seen at under a microscope. This kind of non-seminoma usually grows quickly and spreads to other parts of the body. Embryonal carcinoma may elevate blood concentrations of the tumor marker proteins *alpha-fetoprotein* (AFP) and *human chorionic gonadotropin* (HCG).
*Yolk sac carcinoma:* The cells in these tumours resemble like the yolk sac of a young human embryo, which is why they are called that. This malignancy is also known as yolk sac tumour, endodermal sinus tumour, infantile embryonal carcinoma, or orchidoblastoma.
This is the most frequent kind of testicular cancer in kids, particularly babies. However, pure yolk sac carcinomas (tumours that don't include any other forms of non-seminoma cells in them) are not very prevalent in adults.
These tumours are typically treated effectively when they happen in kids. But they're more worrying when they happen to adults, particularly if they're pure. Yolk sac carcinomas react fairly well to treatment, even if they have spread.
This kind of tumour nearly invariably raises the levels of AFP (alpha-fetoprotein) in the blood.
*Choriocarcinoma:* This is an uncommon and rapidly proliferating form of testicular cancer in adults. Pure choriocarcinoma is likely to spread quickly to other regions of the body, notably the lungs, bones, and brain. Choriocarcinoma cells are more often seen with other non-seminomatous cells inside a mixed germ cell tumour. These mixed tumours often exhibit a more favorable prognosis compared to pure choriocarcinomas, despite the fact that the presence of choriocarcinoma is always a concerning indicator.
This kind of tumour raises the levels of HCG (human chorionic gonadotropin) in the blood.
*Teratoma:* Teratomas are tumours of germ cells that include parts that appear like the three layers of a developing embryo when seen under a microscope: the endoderm (innermost layer), mesoderm (middle layer), and ectoderm (outer layer). Pure teratomas of the testicles are uncommon and do not elevate AFP levels.
(alpha-fetoprotein) or HCG (human chorionic gonadotropin) values. Teratomas are most often seen as components of mixed germ cell tumours.
There are 3 main types of teratomas:
* *Mature teratomas* are tumours made up of cells that are very similar to those in adult tissues. They don't spread very often. Most of the time, surgery can fix them, but some come back (recurring) after therapy.
* *Immature teratomas* are malignancies that aren't fully grown yet and have cells that appear like those of a very early embryo. This kind is more likely to infiltrate adjacent tissues, spread beyond the testicle, and come back years after therapy than a mature teratoma.
* *Teratomas with somatic type malignancy* are quite uncommon. Some parts of these malignancies seem like mature teratomas, while other parts include cells that have turned into a kind of cancer that usually grows outside the testicle, such a sarcoma, adenocarcinoma, or even leukemia.
Carcinoma in situ of the testicle
Testicular germ cell cancers can start as a non-invasive form of the disease called *carcinoma in situ* (CIS) or *intratubular germ cell neoplasia*. In testicular CIS, the cells look abnormal under the
microscope, but they have not yet spread outside the walls of the seminiferous tubules (where sperm cells are formed). Carcinoma in situ doesn’t always progress to invasive cancer.
It's hard to find CIS before it becomes an invasive cancer because it generally doesn't cause symptoms or form a lump that you or the doctor can feel. The only way to diagnose testicular CIS is to have a biopsy . (This is a procedure to take out a tiny bit of tissue so it can be checked under a microscope.) Sometimes CIS is found incidentally (by accident) when a testicular biopsy is done for another reason, such as infertility.
When CIS of the testicle becomes invasive, its cells are no longer just in the seminiferous tubules, they've grown into other structures of the testicle. These cancer cells can then spread either to the lymph nodes (small, bean-shaped collections of white blood cells) through lymphatic vessels (tiny fluid-filled tubes that connect the lymph nodes), or through the blood to other parts of the body.
Stromal tumors
Tumors can also start in the supportive and hormone-producing tissues, or stroma, of the testicles. These tumors are known as *gonadal stromal tumors*. They make up less than 5% of adult testicular tumors, but up to 20% of childhood testicular tumors. The main types are *Leydig cell tumors* and *Sertoli cell tumors*.
Leydig cell tumors
These tumors start in the Leydig cells in the testicle that normally make male sex hormones (androgens like testosterone). Leydig cell tumors can develop in both adults and children. These tumors often make
androgens (male hormones), but sometimes they make estrogens (female sex hormones).
Most Leydig cell tumors are not cancer (benign). They seldom spread beyond the testicle and can often be cured with surgery. Still, a small number of Leydig cell tumors do spread to other parts of the body. These tend to have a poor outlook because they usually don't respond well to chemo or radiation therapy.
Sertoli cell tumours
These tumors start in normal Sertoli cells, which support and nourish the sperm-making germ cells. Like the Leydig cell tumors, these tumors are usually benign. But if they spread, they usually don’t respond well to chemo or radiation therapy.
Testicular cancer relative survival after 5 years stands at 97%, which means that a man who is diagnosed with testicular cancer would have, on average, a 97% likelihood of surviving 5 years (or more) following die However, survival varies depending on each stage and the prognostic classification of testicular cancer. As a general rule, the earlier testicular cancer is diagnosed and treated the better the prognosis. That is why it is important to quickly consult a doctor. It is important to note that most testicular cancers are diagnosed at an early stage.
Secondary testicular cancers
Cancers that start in another organ and then spread (metastasize) to the testicle are called secondary testicular cancers. These are not true testicular cancers – they don't start in the testicles. They're named
and treated based on where they started.
Lymphoma is the most common secondary testicular cancer. Testicular lymphoma is more common
in men older than 50 than primary testicular tumors. The outlook depends on the type and stage of lymphoma. The usual treatment is surgical removal, followed by radiation and/or chemotherapy.
leukemia, the leukemia cells can sometimes form a tumor in the testicle. Along with chemotherapy to treat leukemia, this might require treatment with radiation or surgery to remove the testicle.
Cancers of the prostate, lung, skin (melanoma), kidney, and other organs also can spread to the testicles. The prognosis for these cancers tends to be poor because these cancers have usually spread widely to other organs as well. Treatment depends on the specific type of cancer.
Testicular cancer or its treatment can make you infertile (unable to father a child). Before treatment starts, men who might want to father children may consider storing sperm in a sperm bank for later use. But testicular cancer also can cause low sperm counts, which could make it hard to get a good sample
How is Testicular Cancer Treated?
Treatment options for testicular cancer include surgery, which often can include removing the testicle. Testicular biopsy of the mass is rarely done unless the patient only has one testicle. Patients can have a good quality of life and normal fertility with only one testicle. For more advanced cancers, that have spread to the lymph nodes, some patients may need further surgery, radiation therapy or chemotherapy. You may end up receiving more than one type of *treatment for your testicular cancer* Depending on several factors, such as the grade of the tumour, where it is located, and whether it has spread to other parts of your body Your doctors will decide which type or types of treatment is best for your personal condition.
