Testicular cancer

Diagnosis

It is highly recommended for men to perform testicular self-examination (TSE) to check for lumps. The lumps could also be detected during the routine physical examination with the specialist.

To properly diagnose the testicular cancer, the following procedures may be recommended:

• Ultrasound: A painless procedure that uses sound waves to create an image of both the scrotum and the testicles. Ultrasound imaging also can used to locate and evaluate tumor (solid or fluid-filled) in the testicle or the scrotum.
• Computerized tomography (CT) scan: Uses X-ray images of the abdomen, chest, and pelvis to determine the extent of the cancer.
• Blood tests: to determine the amount level of substances that is linked to a specific cancer type, this substance is called tumor markers. High level of tumor markers at the blood could not possibly indicate cancer; however, the test could help determine the diagnosis.
• Inguinal orchiectomy and biopsy. If the lump at the testicle could be cancerous, then surgical procedure to remove the testicle is recommended, and the sample will be sent to the laboratory to evaluate for any sign of cancer. The biopsy result will also help determine the cell type involved.

Staging

Once the specialist confirmed the diagnosis of the testicular cancer, the following step is to know the extent (stage) of the cancer. The stages of cancer are indicated by Roman numerals ranging from 0 to III. The lowest stage indicates a cancer is confined at the limited area around the testicle. The highest stage – stage III – indicates that the cancer had spread and advanced in other areas of the body.

Treatment

The type, location and stage of cancer are some of the factors which can affect the type of treatment to apply as well as general health and personal choice of treatment. The treatment options are as follows:

Surgery

Surgery could be recommended to remove the affected testicle considering the size, location, and stage of the testicular cancer.

• Radical inguinal orchiectomy: This is the surgical procedure to remove the affected testicle. This is used for both seminoma and non-seminoma testicular cancer. During the procedure, an incision will be made at the groin area to remove the testicles with the tumor. This can be the only treatment needed for early stage of testicular cancer.
• Retroperitoneal lymph node dissection (RPLND): This is the surgical removal of the abdominal lymph nodes to treat testicular cancer and may also be used for cancer staging. During the procedure, an incision will be made at your abdomen and removes the lymph nodes behind the abdominal organs.

The doctor might monitor closely after surgery. The appointment may include blood test, CT scan and other procedures to check for early sign of the cancer relapsing.

Chemotherapy

The use of specific drugs to kill cancer cells. Chemotherapy enters the bloodstream and travels throughout the body. The chemotherapy could be done either before or after the removal of the lymph nodes. Infertility is a common side effect during chemotherapy and radiation therapy.

Radiation therapy

Tumors are eliminated by radiation therapy using high-energy radiation. Radiation therapy is an option that can be combined with chemotherapy when surgery cannot be done to totally remove the cancer cells. This treatment is recommended for seminoma type of testicular cancer.