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Cancer of the testis

AGE  Most common between the ages of 20 and 40GENDER  
LIFESTYLE  Not a significant factorGENETICS  Sometimes runs in families

A cancerous tumour that develops within a testis, which although rare, is one of the most common forms of cancer diagnosed in men between the ages of 20 and 40.

Cancer of the testis
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Cancer of the testis is also one of the most easily cured cancers if discovered at an early stage. However, cancer of the testis may spread to the lymph nodes and eventually to other parts of the body if left untreated, and it may ultimately be fatal. The condition usually affects only one testis.

Most testicular tumours develop in the sperm-producing cells of the testis. There are four types of tumour: seminoma, embryonal carcinoma, teratoma, and choriocarcinoma. Seminomas are the most common type of testicular tumour, and they are usually found in men between the ages of 35 and 45.

What are the causes?

The causes of cancer of the testis are not known, but certain factors increase the risk, such as having a family history of the condition or having had an undescended testis, a condition in which a testis fails to descend into the scrotum before birth.

What are the symptoms of cancer of the testis?

You may not notice the symptoms unless you examine your testes regularly (see Examining your testes). The symptoms may include:

  • Hard, painless lump in the affected testis.
  • Change in the usual size and texture of the testis.
  • Dull ache in the scrotum.
  • Rarely, a sudden, sharp pain in the affected testis.

In some cases, fluid may accumulate in the scrotum (see Hydrocele). If you find any changes, consult your doctor immediately.

How is cancer of the testis diagnosed?

Your doctor will examine the affected testis and may arrange for you to have ultrasound scanning of the testes. A special blood test may also be arranged to look for cancer. If a tumour is found, further blood tests, CT scanning, and MRI will be performed to determine whether the cancer has spread to other parts of the body.

What is the treatment?

If cancer of the testis is diagnosed, the affected testis will have to be surgically removed. If the cancer has not spread beyond the testis, no further treatment may be needed. However, even after the testis has been removed, blood tests to check tumour marker levels are usually carried out every 6 months to make sure that the cancer has not spread.

If the cancer has spread beyond the testes, you may be required to have further treatment, which may include surgery, radiotherapy, and chemotherapy. If the cancer has spread to the lymph nodes in the abdomen, surgery may be required to remove the nodes that are affected. Of the four types of testicular tumour, seminomas are the type most easily treated by surgery and radiotherapy.

What is the prognosis?

The outlook depends on the type of cancer and the stage at which it is diagnosed. Cancer of the testis has a very high cure rate. Most affected men are cured, even those in whom the cancer has spread outside the testes.

Surgical removal of a testis is not likely to affect sexual function or fertility if they were normal before surgery. However, both chemotherapy and radiotherapy reduce sperm production, and fertility may be temporarily or permanently affected by these treatments. For this reason, some men choose to have semen containing normal sperm frozen before treatment is started.

Posted 30.06.2010

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