What are the Symptoms of Testicular Cancers?
Symptoms of testicular cancers usually present as unilateral painless swelling or stiffness. Approximately 20% of patients consult a doctor because of pain in the scrotal area. However, a painless scrotal mass should be considered as testicular cancer and treated accordingly, especially if there is no history of an inflammatory condition. Rarely, symptoms such as back and side pain, bloody cough due to metastatic mass, nausea, vomiting, seizures or bone fractures may also be seen. In addition, breast enlargement (gynecomastia) can be seen in 7% of patients.
How is Testicular Cancer Diagnosed?
In suspicious cases, the hardness of the testicles is detected by physical examination and the patient is considered to have testicular cancer. During the examination, lymph nodes and organs are also scanned, as there may be spread to other parts of the body. It is important to distinguish between testicular cancer and acute epididymoorchitis (inflammation of the testicles and epididymis), but this is not always clear. To support the diagnosis, tests for the testicular tumor markers AFP, β-HCG and LDH should be performed and imaging should be supported by scrotal ultrasonography.
What is a Definitive Diagnosis?
Physical examination, tumor markers and ultrasonography are highly diagnostic. If the diagnosis cannot be confirmed or if there is doubt, surgical removal of the testicle and pathologic examination is recommended.
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Although there is no known preventive method for testicular cancer, the importance of early diagnosis and treatment is emphasized. Men between the ages of 15-35 are at risk for testicular cancer and should regularly perform testicular self-examinations. People with undescended testicles should be evaluated and, if necessary, surgical or drug treatment should be applied.
The treatment and follow-up of testicular cancer is usually determined by the type and stage of cancer and the patient's general health. In general, however, testicular cancer treatment consists of three main modalities: surgery, chemotherapy and radiotherapy. Follow-up includes regular check-ups to assess the effectiveness of the treatment and monitor the risk of disease recurrence.
- Surgical Intervention: Surgery is usually the first treatment option when testicular cancer is diagnosed. Surgery is usually done through a procedure called orchiectomy. Orchiectomy involves completely removing the affected testicle. Surgery may also involve removing lymph nodes, depending on the stage and type of cancer.
- Chemotherapy: After surgery, or in some cases before surgery, chemotherapy may be given to prevent or reverse the spread of cancer. Chemotherapy consists of drugs used to kill cancer cells or stop their growth. The chemotherapy regimen is usually given periodically over several weeks or months.
- Radiotherapy: In some cases, radiotherapy may be used, especially if the cancer has spread to the lymph nodes or if surgery is not possible. Radiotherapy uses high-energy beams to destroy or control cancer cells. However, the use of radiotherapy for testicular cancer is limited and is generally not preferred to other treatment options.
After treatment, it is important that patients are followed up regularly. Follow-up usually includes blood tests, imaging tests (for example, CT scan or MRI) and physical examinations. These follow-up visits are used to evaluate the effectiveness of treatment, identify possible relapses and monitor the progression of the disease. During follow-up, the patient is provided with the support and care needed to improve their health status and quality of life.
Testicular sparing surgery may be considered in patients with a single testicle and in patients with suspected cancer in both testicles, depending on the size and condition of the mass. However, if the mass is smaller than 2 cm or if testicular cancer is diagnosed, removal of the testicle comes to the fore. Close follow-up of patients in this situation is important after the operation.
Physical examination, tumor markers and ultrasonography are highly diagnostic. If the diagnosis cannot be confirmed or if there is doubt, surgical removal of the testicle and pathologic examination is recommended.
In suspicious cases, the hardness of the testicles is detected by physical examination and the patient is considered to have testicular cancer. During the examination, lymph nodes and organs are also scanned, as there may be spread to other parts of the body. It is important to distinguish between testicular cancer and acute epididymoorchitis (inflammation of the testicles and epididymis), but this is not always clear. To support the diagnosis, tests for the testicular tumor markers AFP, β-HCG and LDH should be performed and imaging should be supported by scrotal ultrasonography.
Symptoms of testicular cancers usually present as unilateral painless swelling or stiffness. Approximately 20% of patients consult a doctor because of pain in the scrotal area. However, a painless scrotal mass should be considered as testicular cancer and treated accordingly, especially if there is no history of an inflammatory condition. Rarely, symptoms such as back and side pain, bloody cough due to metastatic mass, nausea, vomiting, seizures or bone fractures may also be seen. In addition, breast enlargement (gynecomastia) can be seen in 7% of patients.