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Testicular cancer: causes, symptoms, stages, prognosis, treatment and diagnosis

Testicular cancer lies in wait for men of all ages, from children and adolescents to the elderly, but the greatest number of diseases occurs at the age of 30-35 years. There are different types and stages of cancer.

If the tumor is detected at the first stage and immediate treatment is carried out, the probability of complete healing is 95-100%, as the disease progresses, the chances of a favorable outcome are reduced. Therefore, with painful sensations in the testicles and the detection of seals, a visit to the doctor can not be delayed.

Classification and stages of testicular cancer

There are several classifications of the stages of this cancer. Within the most common classification, 3 stages of testicular cancer are distinguished, taking into account the presence and spread of metastases.

The third stage, in turn, is divided into 3 sub-stages, A, B and C, in addition to the spread of metastases, the level of cancer markers is taken into account.

The international TNM classification distinguishes 4 stages of the disease depending on the tumor site:

  • in the first stage (T1) it is localized within the protein membrane, and there are no pronounced testicular deformities,
  • T2 - joins the deformation and increase in the affected testicle,
  • T3 - the epididymis is affected by the tumor,
  • at the last (T4) stage she goes beyond the testicle.

This classification also evaluates the condition of the lymph nodes, 3 stages are distinguished depending on the presence and severity of metastases - N0, N1 and N2 (metastases are absent / detected by x-ray (radioisotope) examination / detected by palpation). Another evaluation parameter is the presence (M1) or absence (M0) of distant metastases.

To prescribe treatment and prognosis, it is necessary to take into account not only the stage of the disease, but also the histological type of cancer, that is, the type of cells that form the tumor.

Testicular malignancies are divided into seminomas (tumors from cells involved in sperm production) and nonseminomas (tumors from other cells).

Non-semenomas, in turn, are divided into tumors of this type:

  • embryonic cancer
  • yolk sac
  • teratoma
  • choriocarcinoma.

Stage 1

The tumor is localized within the testicle, without affecting the lymph nodes and other organs, metastases are absent. If cancer is diagnosed at this stage, the chance of a complete cure exceeds 95%.

Regardless of the type of tumor, it is removed along with the testicle. In some cases, treatment is limited by this, but the patient is prescribed medical supervision for 10 years.

In more complex cases, antitumor drugs or radiation therapy, chemotherapy are prescribed after surgery. The same treatments may precede surgery to reduce the size of the tumor.

If the tumor is not seminomial, the risk that the disease will progress is higher, in some cases it is necessary to resort to surgical removal of the lymph nodes located in the abdominal cavity.

2 stage

Progressing, testicular cancer affects primarily retroperitoneal lymph nodes, as well as paraaortic. The second stage of the disease is characterized by the presence of metastases in them.

For a seminar, the probability of healing at this stage is 85-90%. For nesemin, for example, if choriocarcinoma or embryonic testicular cancer is diagnosed, the prognosis is less favorable, the probability of recovery without relapse is reduced to 70%. Teratoma and a yolk sac are more treatable.

Treatment, as in stage 1, is operational, in addition to the testicle, it is often necessary to remove the affected lymph nodes. 3-4 courses of chemotherapy or radiation are required.

  1. 3A - Mediastinal lymph nodes located between the lungs and / or the lungs themselves are affected.
  2. 3B - metastases penetrate into the lungs and distant lymph nodes, while the level of markers is moderately high.
  3. 3C - the level of markers is much higher, and metastases spread to other internal organs, can affect the liver, brain.

Stage 3C is sometimes considered as stage 4 testicular cancer. Even at this stage, the prognosis is favorable at least in 48% of cases, after the operation, the patient can live 5 years or more.

As in the early stages, radical orchiectomy is mandatory - removal of the testis affected by the tumor. In the postoperative period, the administration of antitumor drugs is combined with chemotherapy, several courses are carried out.

If metastases in the removed organs have reached a sufficiently large size (from 3 cm), their surgical removal is also recommended. The patient should undergo regular thorough examinations to timely detect metastases.

What else do you need to know about testicular cancer?

The main symptoms of testicular cancer are:

  • dull pain in the lower abdomen, in the scrotum, back,
  • resizing of one of the testicles, enlargement of the scrotum, usually asymmetric,
  • the appearance of round seals,
  • subfebrile temperature, weakness and fatigue, weight loss, characteristic of any cancer
  • in the later stages - cough, shortness of breath, pain in the liver.

Diagnostics

Along with the signs that can be detected during self-diagnosis and medical examination, hardware examinations and laboratory tests are carried out.

A blood test is aimed at identifying cancer markers. An ultrasound of the scrotum is performed at an early stage, and computed or magnetic resonance imaging of organs where they can spread is necessary to detect metastases.

Treatment

Radical orchiectomy is the main treatment for testicular cancer, regardless of type and stage.usually performed under general anesthesia. After the operation, a histological examination of the removed testicle is performed, which allows to establish the type of tumor and decide on the feasibility of using other methods.

As a rule, cancer treatment should be combined, in addition to surgery for different types and stages of cancer, such methods are used:

  • antitumor therapy
  • chemotherapy,
  • radiation (radiotherapy).

Prevention

The most effective testicular cancer prevention method is regular self-diagnosis., examination and palpation of the testicles to identify seals, changes in shape, weight and size. It should be carried out monthly after hygiene procedures.

Pain in the scrotum and lump in the testes are not necessarily a sign of cancer, but if symptoms appear, contact a urologist to clarify the diagnosis.

Forecasts

Testicular cancer is not a sentence, even in the later stages of this disease, there are fairly high chances of a cure. But the prognosis is most favorable if the disease is detected in the first stage, when metastases have not yet appeared.

Regular self-diagnosis, medical consultations and screening for detecting alarming symptoms increase the chances of a successful outcome. For patients, early diagnosis, combined treatment and long-term follow-up in the postoperative period are important.

Related video: how to recognize testicular cancer in the early stages?

Palpable testicular enlargement may be a symptom of other diseases, such as dropsy of the testicles in men.

What is cancer of the epididymis and what are its symptoms - find out all the details.

Oncological diseases in men often give metastases to the throat. How is the operation for cancer of the larynx on this page: https://man-up.ru/bolezni/onkologiya/rak-gortani/operatsiya-pri-rk-gort.html

Testicular cancer: signs and symptoms, treatment and prognosis

Testicular cancer is cancer that develops in the testicles (testicles), which are part of the human reproductive system.

Men from a young age to old age are at risk of developing testicular cancer. More than half of patients with this diagnosis are under the age of 35 years.

Although the disease itself occurs only in 3% of cases in men, it has an aggressive course and is often the cause of death of the patient. Based on this, the male sex must with great responsibility monitor their health, in order to timely detect signs of the disease and emergency response.

Disease assigned code in accordance with ICD-10: C62

The testicles (also called testes) are part of the male reproductive system. These two organs are located in a leather pouch called the scrotum. The scrotum hangs under the base of the penis.

Illustration showing the testicles relative to the penis, urethra, bladder, prostate, scrotum, vas deferens and appendages.

Seed plants perform two main functions:

  1. They produce male hormones (androgens) such as testosterone.
  2. They make sperm, the male cells needed to fertilize an egg in order to start a pregnancy.

Sperm cells are made in long, filiform tubes inside the testicles, called the seminiferous tubules. They are then stored in a small spiral tube behind each testicle, called the epididymis, where they mature.

During ejaculation, sperm are transferred from the epididymis through the vas deferens to the seminal vesicles, where they mix with fluids formed by the vesicles, prostate and other glands to form sperm. This fluid then enters the urethra, a test tube in the center of the penis through which both urine and semen leave the body.

The testicles are made up of several types of cells, each of which can develop into one or more types of cancer. It is important to distinguish between these types of cancer from each other, because they differ in their approach to treatment and life forecasts.

Testicular cancer is a malignant tumor disease that develops in the gonads (textiles) and quickly gives metastases throughout the body through the bloodstream and lymph flow. This disease has several types, and classify it based on where the tumor is located, as well as what severity the course of the disease has. Thus, testicular cancer can be divided into the following types:

Non-germinogenic - arise from testicular stroma, is less common than in 5% of episodes, but refers to them:

Germ cell tumors - originate in the seminal epithelium and occur most often (95% of cases). Such tumors include:

  • seminoma (more than 35% of all cases),
  • swelling of the yolk sac, etc.

Mixed - contain both non-germinogenic and germinogenic cells.

  • There are several classifications of testicular cancer. So, based on the international criteria for the TNM system, there are the following stages of the course of the disease:
  • T-1 - the tumor does not extend beyond the protein membrane,
  • T-2 - the formation is limited by the protein membrane, but deformation in the scrotum is observed, and testicles also increase,
  • T-3 - tumor cells penetrate the protein membrane, grow into the adnexa,
  • T-4 - a tumor formation extends beyond the verge of the testicle, germinates in the spermatic cord of the testis or tissues of the scrotum,
  • N-1 - there are metastases in the structures of the lymph nodes, and they are detected by radioisotope or radiological diagnostics,
  • N-2 - there are metastases, enlarged lymph nodes are detected upon examination by palpation.
  • M-1 - metastases affect distantly located organs: liver, kidneys, lungs, bone tissue and brain.
  • There is a classification in which 3 stages are divided, while the stage is divided into substages A, B and C, they take into account the cancer marker, as well as the degree of distribution of metastases in the internal organs and lymph nodes. This classification is more common and it has such stages:
  • Stage 1 - the tumor process is limited to the testicle, there are no metastases, other organs and lymph nodes are not damaged, the symptoms of testicular cancer in men are practically absent, and full recovery occurs in 98% of cases,
  • 2 Stage - tumor cells infect paraaoral and abdominal lymph nodes, metastases germinate, recovery occurs in 50% of cases,
  • 3A Stage - damage to the lymph nodes that are located in the lungs or between them,
  • 3B Stage - metastases are formed in distant lymph nodes and lungs, has an average marker level,

3C Stage - metastases spread to internal organs (liver, kidneys, etc.), have a high level of marker.

The main symptom that indicates the development of a malignant tumor is the appearance of a dense neoplasm in the scrotum, and an increase in this organ. Such seals can be painless or painful.

Usually it is detected by chance or during an independent examination. It is important, at the first detection of such manifestations, turn to a specialist for help, because this can save lives in the future.

So, we list all the possible symptoms of testicular cancer in men:

  • the disease begins with the presence of a seal in the scrotum, testicular edema, a feeling of pressure in the testicles,
  • signs inherent in any cancer: increased fatigue, weakness in the body, headache, low-grade fever, a sharp decrease in weight, loss of appetite,
  • a feeling of pain, heaviness in the spermatic cord and in the abdomen below the navel,
  • with damage to the appendages, a hormonal disorder occurs, for example, painful sensations in the mammary glands and their increase (gynecomastia) appear
  • shortness of breath, shortness of breath,
  • enlarged lymph nodes,
  • decreased sexual desire or its complete absence,
  • violation of sensitivity in the genitals,
  • violations of the outflow of urine, the development of hydronephrosis and pylonephritis,
  • enhanced hair growth on the body and face before puberty,
  • as a result of metastases in the brain, the psyche changes, and neurological disorders occur,
  • with the appearance of metastases in the bone tissue, fractures and pain syndromes occur,

It should be noted that the appearance of symptoms of testicular cancer depends on the location of the tumor, the period of the disease, the presence of metastases, as well as on the state of the body as a whole. Thus, in someone they manifest themselves distinctly, while in someone they proceed unnoticed.

It is impossible to reliably say what causes the development of testicular cancer. Nevertheless, there are some patterns and risk factors in the course of this cancer, they include:

  • Genital diseases: cryptorchidism, testicular torsion, congenital underdevelopment of the testicles and others.
  • History of testicular tumor.
  • Injury of the scrotum, its systematic overheating.
  • Pathology of the endocrine system.
  • Exposure to radiation and radiation, hypothermia.
  • The human immunodeficiency virus increases the likelihood of developing cancer, as well as other viruses and infections.
  • Unlike African Americans and Asians, in men of the white race, this pathology occurs 10 times more often.
  • Tall and thin men are more prone to testicular cancer.
  • Prolonged smoking, alcoholism, drug addiction.
  • In rare cases, the development of such a pathology due to Down syndrome or Klinefelter is possible.

If testicular cancer is detected at an early stage of the development of pathology, a complete recovery is possible in 90% of patients. But according to statistics, most of the men who have found signs of the disease do not immediately see a doctor, but only after the advanced stages occur. Treatment in these cases usually does not bring success and may have some consequences.

So, when a testicle affected by tumor cells is removed, basically, an inferiority complex begins to develop in a man.Although physiological, the second testicle does an excellent job. This problem is most often solved by implantation of a prosthesis instead of a testicle that has been removed.

If the treatment required chemotherapeutic or radiation exposure, then this can lead to certain complications:

  • Infertility resulting from large doses of radiation.
  • Lack of sperm (azoospermia) as a result of cisplatin chemotherapy. It is completely eliminated within 5 years.
  • Toxic damage to the kidneys as a result of antitumor drugs (ifosfamide, cisplatin).
  • Violation of the bone marrow structure.
  • Nausea and vomiting, hair loss and other manifestations during irradiation or chemotherapy.
  • It is important to understand that testicular cancer progresses very quickly and delaying treatment, contributes to its development, the formation of extensive metastases that disrupt the functioning of various organs, which leads to death.

If you suspect the development of testicular cancer, you should immediately seek help from a specialist (urologist-andrologist) who can correctly examine and palpate the scrotum.

Sometimes already at this stage there are suspicions of a malignant tumor, which is usually distinguished by a dense formation in the scrotum.

In addition, the doctor will conduct a study of lymph nodes in the groin, abdominal cavity, mammary glands and supraclavicular, and will also take into account the presence of complaints if there are signs of testicular cancer in a man, history and heredity.

Upon completion of the examination by the doctor, the patient is sent for the following instrumental diagnostic tests:

In full, the diagnosis helps the doctor choose the most appropriate therapy.

How to detect testicular cancer early on?

For this, it is important to conduct a self-diagnosis. For this, men need to carefully monitor their health, systematically independently examine the testes.

To carry out this procedure, it is necessary to feel the entire area of ​​the testicles to detect any seals (nodules).

If you experience pain during the examination or if seals are found on the testicle, you must urgently contact a medical institution for additional tests.

With competent and timely treatment of testicular cancer, it is possible to completely get rid of it. Therapy is selected based on the type of tumor and the stage of development of the cancer, and it is based on the surgical, radiation and chemotherapeutic effects.

Surgical intervention involves the removal of the tumor along with the testicle, and it is also possible to remove the affected lymph nodes and metastases in the organs.

In addition to the removal of the testicle, at the first stage, the administration of antitumor drugs is prescribed, and in some cases, chemical and radiation therapy is performed before surgery, to reduce the size of the tumor.

At the second and third stages of the development of the disease, after removing the testicle and the affected lymph nodes, several courses of chemotherapy or radiation and the administration of anti-tumor drugs are carried out.

Consider treatment methods in more detail. Five types of standard therapy are usually used:

Upon completion of the treatment procedure, it is important to continue close monitoring by a specialist, not to miss a single appointment, to carry out the necessary tests and procedures to detect the possible consequences of the disease and timely detection of cancer recurrence.

Methods of prevention and treatment of the disease:

  • diet, nutrition must be balanced: eliminate fried foods and fatty foods, eat more fresh fruits and vegetables,
  • give up various bad habits,
  • increase physical activity
  • refuse to wear tight underwear,
  • Avoid injury to the scrotum
  • timely treat genital diseases,

Several factors influence the successful treatment of testicular cancer:

  • A positive prognosis for this oncology is possible only at an early stage in identifying the disease, and in this case is about 90-95% of survival,
  • If the disease was detected at 2 or 3 stages of development, which are characterized by the presence of metastases, then a complete change is not possible, but the probability of five-year survival is 50%,
  • To plan for future paternity, cryopreservation of seed material is carried out before treatment.
  • For the prevention of testicular cancer, the timely elimination of cryptorchidism, the prevention of scrotal injuries, the exclusion of the likelihood of irradiation of the genitals, their overheating, and a healthy lifestyle are necessary. A systematic self-examination and timely access to a specialist if any symptoms are detected contribute to the timely detection of cancer.

Testicular cancer in men: symptoms, photos, causes, diagnosis, consequences, treatment and prognosis

Testicular oncology is relatively rare, however, this does not detract from its aggressiveness, because under the influence of such cancer a man can burn out on average in three years. Therefore, men need to take a more responsible attitude to health in order to notice signs of testicular cancer in a timely manner and take the necessary measures.

Concept of disease

  • Testicular cancer is a malignant tumor process, which is characterized by the unpredictability of the development and growth of pathological cancer cells.
  • A tumor is formed and develops directly in the genital glands, but soon it begins to spread throughout the body (usually in the brain and bone structures, liver and lungs) through hematogenous and lymphogenous pathways.
  • According to statistics, a malignant tumor of the testicle is considered the most common cancer among men 15-35 years old.
  • Such a cancer pathology is predominantly one-sided, although bilateral forms of the tumor process are also found (in 1.5-2%).

Varieties

Testicular cancer is classified into mixed, germ cell and non-germ cell tumors.

  • Germinogenic tumors are formed from seminal germinal cell structures and occupy about 95% of cases.
  • Non-germinogenic tumors form from testicular stroma.
  • Mixed Tumors contain cells of both germinogenic and non-germogenic formations.

Photo shows sectional testicular cancer in men.

In turn, germ cell tumors are divided into:

  1. Seminomes
  2. Neseminomas (embryonic cancer, chorionic carcinoma, teratoma, etc.).

Non-normative formations occur in less than 5% of cases and are represented by tumors such as leidigomas, sertoliomas, dysgermomas.

Reasons for development

It is rather difficult to say for sure what causes the development of testicular cancer. However, there are several patterns and risk factors in the development of such oncology:

  • Often exposed to testicular cancer are men of tall and thin physique,
  • The presence of a tumor of another testicle in the past,
  • If there is an immunodeficiency virus, the likelihood of such cancer increases,
  • Belonging to the white race increases the risk of developing testicular cancer tenfold, and African Americans and Asians suffer from such a pathology ten times less
  • Cryptorchidism or undescended testicle
  • Traumatic damage to the scrotum,
  • Endocrine pathology,
  • Radiation and radiation exposure,
  • Hereditary factors
  • Congenital underdevelopment of the testicles,
  • Nevuses and moles, prone to malignancy, can also provoke testicular cancer,
  • Early puberty,
  • In infertile men, the risk of developing testicular cancer is tripled,
  • Lack of exercise,
  • Regular overheating of the scrotum, etc.,
  • Testicular torsion,
  • Nicotine addiction, manifested by daily smoking a pack of cigarettes for 10 years or more, doubles the likelihood of developing genital cancer in men,
  • Hypospadias - a similar disease is associated with impaired development of the male genital organs, when the outlet of the urethra opens below the head of the penis or on the scrotum.

Sometimes testicular malignant oncology develops against the background of Klinefelter or Down syndromes. The professional environment is also important, since men who work in the leather, gas, oil, coal mining and firefighters are more likely to suffer from pathology.

Symptoms of testicular cancer in men

  1. Such seals can be both painful and painless.
  2. Patients complain of pain in the abdomen and scrotum, swelling in the tissues of the testicle.
  3. General signs of cancer appear, such as excessive fatigue and weakness, sudden weight loss, frequent subfebrile hyperthermia, which is characterized by a temperature of 37.5 ° C

In this case, the scrotum is greatly swollen and becomes much larger. With the further development of the tumor process, respiratory difficulties and shortness of breath, enlarged lymph nodes, back pain, and weakness occur.

The patient feels a noticeable decrease or lack of sex drive, soreness and enlargement of the mammary glands, intensive growth of hair on the face and body long before the onset of mature development. When tumor metastasis, patients observe pronounced right-sided soreness, cough and jaundice, shortness of breath, etc.

With the germination of a tumor in the epididymis, the following symptoms occur:

  • There is a slight painless seal
  • Organ deformation,
  • Testicular enlargement,
  • Pain along the spermatic cord and lower abdomen,
  • There may be pain in the back and chest,
  • Scrotal edema
  • Swollen lymph nodes
  • Difficulty breathing.

Cancer of the epididymis contributes to the development of secondary sexual characteristics and endocrine diseases that can change the patient's appearance.

Staging

Malignant staging is based on international criteria according to the TNM system:

  • T-1 - the formation does not cross the boundaries of the protein coat,
  • T-2 - the tumor is also limited, but there is already deformation of the scrotum and enlarged testicle,
  • T-3 - a tumor penetrates the protein membrane, growing in the adnexal tissues,
  • T-4 - the tumor process extends beyond the borders of the testis, germinating in the spermatic cord or scrotum tissue,
  • N-1 - during X-ray and radioisotope diagnostics, regional metastases to the lymph node structures are detected,
  • N-2 - enlarged regional lymph nodes with metastases are easily palpated upon examination,
  • M-1 - during diagnostic studies, distant metastasis is found in the liver, lung, brain and kidney tissues.

It is used in determining the degree of development of testicular cancer and another staging system:

  • I - the formation is localized within the testicle,
  • II - the tumor process spreads to the lymph nodes of the paraaortic value,
  • IIa - lymph nodes with metastases do not exceed 2 cm,
  • IIb - parameters of lymph nodes of the order of 2-5 cm,
  • IIc - the size of the lymph node structures exceed 5 cm,
  • III-0 cervical and thoracic lymph nodes are involved in the tumor process,
  • IV - metastasis extends to distant organs such as bone tissue, brain, liver and lungs.

Effects

If testicular cancer in men is detected at an early stage, then 90% of patients have every chance of a full recovery.

But the statistics are such that most men, upon detection of signs of pathology, turn to specialists only after a time when the tumor process goes to more advanced stages. In such a situation, treatment is not always successful and has many consequences.

If the patient undergoes an orchiectomy, i.e., removal of the affected testicle, then for many men this becomes the basis for a serious inferiority complex. From a physiological point of view, the remaining testicle is quite capable of coping with its functions in two.

A cosmetic problem is completely eliminated with the help of a correction, when a prosthesis is implanted instead of a removed testicle.

If the treatment was accompanied by chemotherapeutic or radiation exposure methods, then the likelihood of complications is very high:

  1. Against the background of exposure to large doses of radiation, irreversible infertility occurs,
  2. Chemotherapy with Cisplatin develops azoospermia (lack of sperm), which is often eliminated after about 4-5 years,
  3. Anticancer drugs like Ifosfamide and Cisplatin lead to toxic kidney damage,
  4. All chemotherapy drugs are dangerous for bone marrow structures.

In addition, chemotherapy and radiation, as a rule, are accompanied by nausea-vomiting syndrome, hair loss, etc. If a man pulls with treatment, then the cancer progresses rapidly, metastasizes, disrupts the functioning of all organs and leads to death.

How to identify testicular cancer?

  • Sometimes already at this stage it is possible to suspect the presence of a malignant formation, which most often differs in density and painlessness.
  • In parallel, lymph node locations of the inguinal, supraclavicular and abdominal locations are examined.
  • After a medical examination, the patient is sent for diagnostic tests:
  • Ultrasound diagnostics. Such a study allows us to determine the tumor process with almost one hundred percent accuracy,
  • MRI and computed tomography. These studies have a similar purpose to ultrasound, however, they are more informative, but their cost is much higher,
  • Osteoscintigraphy. This technique allows you to clarify the presence of metastases,
  • Identification of specific tumor markers,
  • Morphological diagnosis of tumor fragments. Such a study is usually carried out after the removal of the affected testicle, since if the integrity of an unremoved tumor is damaged, the risk of local metastasis is high.

Based on the diagnostic results, the most optimal therapy is selected.

Tumor markers

Testing for cancer markers for testicular cancer is invaluable. Tumor markers are specific substances produced by malignant tumors.

Depending on their level, the degree of development of the tumor process is determined. In laboratory blood tests, attention is usually paid to the level of tumor markers such as AFP (α-fetoprotein), LDH (lactate dehydrogenase) and hCG (β-subunit of human choriogonadotropin).

Normally, the indicators of these substances are:

  1. ACE - less than 15 ng / ml,
  2. LDH - less than 2000 U / l,
  3. HCG - less than 5 mU / ml.

ACE increases in 70% of patients with testicular cancer. The value of LDH in the study is low, however, if the level of lactate dehydrogenase rises above 2000 U / L, then this is a direct sign of the tumor process. HCG increases in 10% of patients with seminoma, in 25% with a yolk sac tumor, in 60% with embryonic carcinoma, and in 100% with testicular chorion carcinoma.

Such a study is very useful for diagnostic purposes, staging, choice of therapy and monitoring the response to treatment.

Classification of varieties of testicular cancer

In 95% of cases, tumors in the testes are germinogenic. They develop as a result of malignant degeneration of primary germ cells from the polypotent highly specialized gonadal epithelium. The main features of germinogenic tumors are the young age of patients, the ability of cells to differentiate, favorable prognosis of survival and complete cure.

Depending on the histological features of germinogenic tumors, they are divided into:

  • Seminomes. The proportion of seminomas is about half the cases of development of germ cell tumors of the testis. Most often, a seminoma occurs between the ages of 30 and 40 and proceeds in a less aggressive form than a non-seminoma. Seminoma grows slowly, is not characterized by necrosis and hemorrhage. The method of metastasis is mainly lymphogenous. Hematogenous metastases in the lungs, bones, and other internal organs are formed in fairly late stages of testicular cancer,
  • Neseminomas. Non-seminomic tumors usually develop between the ages of 20 and 30 years from embryonic or specialized cells. These include choriocarcinoma, a yolk sac, embryonic cancer, and teratoma. Non-seminomic tumors are distinguished by the fact that they tend to metastasize rather quickly to regional lymph nodes and lungs.

The remaining 5% of testicular cancer cases are non-germogenic tumors that develop from stromal cells (4% of cases) and lymphomas (1%).

Despite a large number of medical studies, the exact causes of testicular cancer remain unknown. However, experts identified a number of factors that increase the risk of developing this type of tumor:

  • Hereditary
  • Cryptorchidism (undescended childhood testicle from the abdominal cavity to the scrotum). A cancerous tumor occurs in 20-30% of men with this pathology,
  • Congenital pathologies of the testicles, liver, kidneys, as well as the presence of inguinal hernia,
  • Smoking marijuana
  • Body constitution (high skinny men at risk),
  • Infertility (infertile men are also more likely to have testicular cancer)
  • Pig, the result of which is orchitis,
  • Viral infections
  • AIDS,
  • Young age
  • The presence of a cancerous tumor in one of the testicles increases the risk of developing a tumor in the other testis. Even if it is successfully removed, there is a risk of damage to the disease and the second testicle.

Testicular cancer

Testicular cancer (testicular cancer) develops from the tissues of the testicles (male sex glands), which occupy the inner space of the scrotum and produce male hormones and seminal fluid. A malignant tumor of the testicles occurs, by and large, rarely, but more often - in white-skinned young men of 20-40 years old, although it occurs at different ages.

Testicular cancer accounts for about 1.5% of the total number of malignant tumors in men, for 1 year from 3 to 6 cases of diagnosing this disease per 100,000 men are possible. Unfortunately, the number of patients with testicular cancer is increasing annually, but the survival rate of those suffering from this diagnosis remains quite high.

Testicular cancer in the early stages of the disease can manifest as painless inflammation of the scrotum. As a rule, a tumor process develops in one testicle, for example, cancer of the right testicle occurs, and only after a few years the tumor can affect the second testicle. The simultaneous development of malignant neoplasms in both testicles occurs in almost 3% of cases.

The statistics of the disease with this type of cancer in Russia are small - approximately 0.6% of the total number of patients with cancer, and according to WHO statistics, 48,300 men in the world per year have testicular cancer.

Causes of Testicular Cancer

The causes of testicular cancer have not been investigated and are unknown. Based on clinical observations, assumptions of this kind have been advanced:

  • the incidence is more often observed in men who had an undescended testicle in the scrotum (cryptorchidism) in infancy, which may be a consequence of the mother taking estrogen during pregnancy,
  • genetic (hereditary) predisposition,
  • the harmful effects of the environment on the development of normal germ cells,
  • chemical carcinogenesis,
  • alcoholism, smoking cigarettes and marijuana,
  • male infertility, trauma or testicular atrophy,
  • "mumps" transferred in childhood with complications to the testes, HIV and other viral and infectious diseases,
  • hypothermia and inflammatory processes (children's orchitis),
  • cancer of the urethra, bladder, penis, etc., carcinoma insitu.
  • race (the negroid race has testicular cancer extremely rarely, unlike the Caucasian race).

It is noted that in most cases, testicular cancer affects men aged 35-55 years, as well as high growth and lean physique, although this pattern is completely incomprehensible.

However, men who note at least one of these factors should be more attentive to their health and immediately pay attention to the slightest manifestations of the symptoms of testicular cancer.

Scientists have found in testicular cancer patients 12 sites on the chromosomes of tumor cells that can be inherited, which means that testicular tumors have a family element.

The risk of developing testicular cancer of the next generation can be up to 25%.

This discovery will enable scientists with the help of modern genetic engineering to create drugs that can block defective genes, which will provide new opportunities for patients with testicular cancer to completely overcome a dangerous ailment.

Testicular cancer classification

The testicle consists of many membranes from various tissues, tumors can develop from each of them, which explains the variety of types of testicular malignant tumors. According to the clinical classification, the following types of testicular cancer are noted:

  • germ cell tumors forming from the epithelium of germ cells, 90-95% of testicular cancer,
  • tumors of stroma of the genital cord,
  • tumors from germ cells and stroma cells of the sex cord,
  • mixed tumors
  • tumors from lymphoid and hematopoietic tissues,
  • secondary tumors
  • unclassified neoplasms.

The most common of them are germ cell tumors that form from the seminal ducts:

  • Seminoma (seminoma),
  • embryonic carcinoma (embryonalcarcinoma),
  • teratoma (teratoma),
  • swelling of the yolk sac (endodermalsinustumor),
  • choriocarcinoma (choriocarcinoma).

Testicular cancer by the type of seminoma is more common in young men aged 15-30. Non-seminominal tumors appear in men from 25 to 55 years old. The growth of non-Hodgkin lymphoma in the testicles is extremely rare.

Testicular cancer in men (with the exception of seminoma) is a fairly aggressive malignant tumor, doubling its mass in 10-30 days. However, modern chemotherapeutic treatment methods have significantly reduced the death rate from this disease.

About 60% of tumors are mixed and non-seminomic, and 40% are seminomas.

The developmental classification of testicular cancer is based on the extent of the disease. Serious factors are damage to the retroperitoneal lymph nodes and metastasis of other organs (most often the lungs and liver).

  • Stage I testicular cancer - a malignant tumor without the development of metastasis,
  • II stage of testicular cancer - a malignant tumor with a lesion of the retroperitoneal lymph nodes,
  • Stage III testicular cancer - a malignant tumor with damage to the lymph nodes of the mediastinum or with the development of distant metastasis of the liver, bones, lungs, brain.

The main thing for the clinician is the competent division of all germ cell tumors of the testis into seminomas and nonseminomas, as the choice of effective treatment tactics depends on this. Further classification of non-seminomic testicular tumors does not play such an important role.

Symptoms of Testicular Cancer

Testicular cancer in men, whose symptoms at the early stage of the disease are mild and may not cause problems for a long time, has the most characteristic manifestations in the future:

  • an increase or decrease in the size of one of the testicles,
  • filling the scrotum with liquid,
  • swelling, swelling of the testicle with simultaneous pain on palpation,
  • a feeling of heaviness in the scrotum,
  • the development of nodules, tumors, seals, etc.
  • pains in the lower abdomen, radiating to the legs or lower back, which may indicate the presence of metastases in the regional lymph nodes,
  • decreased libido
  • swelling of the mammary glands,
  • increased hair growth on the body and face (especially in young men),
  • the attachment of inflammatory processes,
  • nausea, vomiting, a significant increase in lymph nodes in the groin and neck indicate metastasis.

General oncological signs of testicular cancer are weakness, lack of appetite, sudden weight loss, fatigue and other symptoms characteristic of cancer patients with the progression of the disease.

The above symptoms will not necessarily appear in full and in all men without exception, but solely depending on the type of cancer and the stage of its development.

With the development of only testicular cancer, its signs will appear gradually: from an increase in the scrotum, its swelling, the appearance of nodules, and everything else. It is clear that for one symptomatology it is impossible to establish the type of testicular cancer and stage, for this the most painstaking and reliable diagnosis is necessary.

Prediction and prevention of testicular cancer

Unfortunately, the development of testicular cancer cannot be prevented, but surgical measures should be taken in case of cryptorchidism. All men need to undergo periodic examination of the testicles to detect swelling or lumps.

For men with undescended testicles or testicles that have previously undergone cancer, it is best to do a biopsy to rule out CIS. Carcinoma insitu, the precursor of testicular cancer, is successfully treated with radiation therapy when detected. Radiation, destroying CIS, preserves the hormonal function of the testicles.

Testicular cancer, the prognosis of which corresponds to the statement “the sooner treatment is started, the better the result will be”, respectively, will either be cured or lead to death.

Testicular cancer is fast-growing, so every man who has discovered a suspicious swelling in his testicles should immediately seek professional help.

Watch the video: Testicular Cancer. FAQ (February 2020).

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