It is the most common form of cancer among young men, those between 15 and 40 years old, and every year there are about 2,500 new cases in Italy. We are talking about testicular cancer, a rather rare neoplasm, but whose incidence has increased in recent decades. Above all, however, it is a disease from which it is possible to heal and for this reason it is important to know how to recognize it promptly. So here are 10 things to know, since childhood, about this male tumor.
1 – The signs not to be underestimated
Testicular cancer usually presents with a lump, usually not painful, or with a swelling or even a feeling of testicular heaviness. In addition to lumps and swellings, attention should be paid to the appearance of asymmetries between the two testicles and acute pain.
2 – Who risks the most?
There are some factors that can increase the risk of getting testicular cancer. An important factor is the cryptorachism, i.e. failure to descend into the scrotum of a testicle (or both), which remains in the abdomen or groin: an abnormal development caused by other diseases, such as Klinefelter’s syndrome, and for which there is familiarity (i.e. the presence of other cases in the family). From epidemiological studies it appears that even those who have difficulty having children associated with a reduced sperm count (i.e. the production of few spermatozoa), those who have testicles with a volume of less than 12 ml and a high level of FSH (the follicle stimulating hormone produced pituitary associated with the reproduction and development of ova in women and spermatozoa in men) has a higher risk.
3 – Self-examination without taboos
Today for testicular cancer, screening programs or preventive strategies are not yet available, the only weapon available for an early diagnosis is self-examination: for this reason, children should learn to do this simple self-examination regularly, without taboos.
4 – What to do if in doubt
If doubtful signs are noted on self-examination, the thing to do is to immediately contact a urologist. The specialist performs a physical examination and prescribes an ultrasound of the scrotum, thus detecting the possible presence of the tumor. This examination also allows to identify other problems that do not have to do with the oncological disease, such as hydrocele, varicocele or testicular torsion.
5 – How the diagnosis is made
In addition to the examination and testicular ultrasound, other important tests are blood tests to search for markers, that is, substances that circulate in higher quantities in the presence of the disease. The main markers of testicular cancer are 3: alpha-fetoprotein, beta human chorionic gonadotropin and lactic dehydrogenase. These markers provide information on the prognosis of the tumor and its extension, and allow the early identification of a possible recurrence. Finally, to check for the presence of any metastases, the patient undergoes a total body CT scan.
6 – What is the orchiectomy
The orchiectomy surgery consists in the removal of the testicle, usually by incising the skin at the level of the groin. It is an important intervention not only for the diagnosis but also for the removal of the tumor. If the disease has not spread to other sites and if the risk of recovery is low, the orchiectomy could also be decisive, that is, it represents the only treatment for the tumor. To maintain the aesthetic appearance of the scrotum, a silicone prosthesis is inserted in place of the removed testicle during the same surgery or even later. The prosthesis has the shape, size and texture of the healthy testicle.
7 – Do you become impotent or sterile after surgery?
Removing a testicle does not affect the ability to have and maintain an erection during sexual intercourse. The testes are the male gonads and perform two important functions: producing sperm and synthesizing testosterone. Both functions, when only one testicle is removed, are maintained by the other testicle. Although the risk of infertility following unilateral orchiectomy (i.e. the removal of only one testicle) is very low, as a precaution, doctors may advise patients planning to have children to go to a semen cryopreservation bank before undergo other possible treatments, such as chemo or radiation therapy.
8 – Healing in 9 out of 10. But it is important to arrive early
Testicular cancer is cured and with excellent results, so much so that about 9 out of 10 cases recover completely. The therapeutic path depends on the staging of the disease, that is, on the degree of spread and the size of the mass, on the age and general condition of the patient. If the tumor is diagnosed at an early stage and the risk of recurrence is very low, after the surgery to remove the diseased testicle it is possible to set aside the pharmacological treatments, undergoing only periodic checks thanks to which it is possible to find the possible reappearance. of the tumor at an early stage. All three treatments – surgery, chemo and radiotherapy – can be considered, separately or in combination – in the event of a relapse.
9 – When chemotherapy is needed
Whether or not to have chemotherapy depends on the type of tumor, size and stage. This neoplasm responds particularly well to drug treatments that can be administered to prevent relapse and when other organs distant from the testes are involved.
10 – Do not underestimate psychological support
Beyond the good rates of survival and recovery, this cancer can have a negative impact on the psychological and sexual sphere more than others. Also because the patient is often young, sometimes very young, and is hit by the disease just when he begins to know his sexuality and to establish emotional relationships.
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