Cancer of the testicles
Published:Sunday | June 12, 2011 | 12:00 AM
Heather Little-White, PhD, Contributor
Cancer as a scourge respects no part of the body and men should know that cancer can develop in their testicles. As we celebrate Men's Health this month, it is critical that men and their spouses understand cancer of the testicles, also known as testicular cancer and how it could impact on their sex lives.
The oval-shaped testicles, about 1.5 by 1.0 inch, are an important part of the male external sex organs and serve two major functions. The male hormone, testosterone, is produced in the Leydig cells in the testicles. Testosterone is needed to create male genitals causing the penis, scrotum, testicles and other male organs to grow. Without testosterone, for example, the embryo's undeveloped genital organ, genital tubercle, becomes a clitoris instead of a penis.
Sperm production
Also of importance to a man's sex life is the production of sperm in the testicles which takes about two months on a continuous basis. Sperm production starts at puberty and, under normal conditions, continues throughout the male's entire life. When sperm are produced, they are briefly stored in the epididymis in the testicles and then transported into the body by tubes known as the vas deferens to be combined with the nutritive and lubricatory sections of the bulbourethral glands, seminal vessels and prostate gland to be ejaculated as semen.
How then could such a vital part of the male sex organs become cancerous? Most cases of testicular cancer are detected by men themselves but when men get a routine check-up, they are usually examined by their doctors. Men may notice something unusual about their testicles and should immediately talk with a doctor.
Symptoms
Unusual symptoms include:
A painless lump in any testicle.
Pain or discomfort in the testicle or in the scrotum.
Enlargement of a testicle or any changes in the way it feels.
Heavy feeling in the scrotum.
A dull ache
A sudden collection of fluid in the scrotum.
In evaluating the symptoms, the doctor will assess a man's general health through a physical examination and a range of laboratory and diagnostic tests. Blood tests will be necessary to measure tumour markers which are substances often found in higher-than-normal amounts when cancer in the form of a testicular tumour is present. The cancer may be so small that it cannot be detected by a physical exam or imaging test.
Sonogram
An ultrasound can also be done. High-frequency sound waves are bounced off internal organs and tissues and their echoes produce a picture known as a sonogram. If there is cancer in the testicles, it would show up as a mass in the testicle. A biopsy may also be done if cancer is suspected. In most cases, the entire affected testicle is removed in a procedure known as radical inguinal orchiectomy. If testicular cancer is found, more tests are conducted to determine if the cancer has spread to other parts of the body and to prescribe the appropriate treatment to match the stage of the disease.
Treatment
In testicular cancer, seminomas and non-seminomas grow and spread differently and treatment is applied by a team of surgeon and oncologists. Like any other cancer, early detection will make treatment more successful and less aggressive with fewer side effects. The procedures for testicular cancer include surgery to remove the affected testicle. This still makes a man able to have sexual intercourse with a normal erection and sperm production. The ability to ejaculate may be impaired though if the cancerous lymph nodes located deep in the abdomen are removed without using the nerve-sparing surgical procedure.
Radiation therapy may be used to kill cancer cells and shrink tumours in the affected areas through external radiation aimed at the lymph nodes in the abdomen and is usually given after surgery. Radiation affects normal and cancerous cells. Side effects depend on the treatment dose and may include loss of appetite, nausea and diarrhoea and may cause infertility for one to two years.
Chemotherapy
Chemotherapy uses anticancer drugs to kill cancer cells and is given after surgery to destroy cancer cells remaining in the body. The drugs travel through the bloodstream and affect normal and cancerous cells. Side effects include hair loss, fatigue, diarrhoea, vomiting, fever, chills mouth sores or skin rash. Other effects include dizziness, loss of reflexes, hearing difficulty and reduction in sperm production. High doses of chemotherapy can kill cancer cells but may also destroy bone marrow which makes and stores blood cells.
Critical to the treatment of cancer of the testes is men's sexual function and fertility which should be discussed with a doctor. If a man really wants to revive his fertility function, he may want to opt for sperm banking, that is, freezing sperm before treatment for insemination use in the future if chemotherapy caused loss of fertility.
Self-examination
Men can take some responsibility to check for testicular cancer. The best to time to perform the self-test is after a warm bath or shower. Heat relaxes the scrotum, making it easier to spot anything abnormal. The National Cancer Institute recommends following these steps every month:
1. Stand in front of a mirror. Check for any swelling on the scrotum skin.
2. Examine each testicle with both hands. Place the index and middle fingers under the testicle with the thumbs placed on top. Roll the testicle gently between the thumbs and fingers. Do not be alarmed if one testicle seems slightly larger than the other. This is normal.
3. Find the epididymis, the soft, tube-like structure behind the testicle that collects and carries sperm. If you are familiar with this structure, you will not mistake it for a suspicious lump. Cancerous lumps usually are found on the sides of the testicle but can also show up on the front.
4. If you find a lump, see a doctor immediately as only he or she can make a positive diagnosis. The abnormality may not be cancer, but if it is, by early detection and treatment you can reduce the chances of it spreading. (C-Cancer.com).
Send feedback/questions to: heatherl@cwjamaica.com.