Testicular Cancer



What is Testicular Cancer?

Testicular cancer starts in the testicle or testis and is often found in men aged 15 to 44 years. It is relatively rare but treatable. The prognosis is good if diagnosed early when the tumors are small and have not spread.

The first sign of testicular cancer is a lump on the testicle which looks swollen or larger than usual. Usually, both testes are different in size and for one to hang lower than the other. Normal testicles contain blood vessels, supporting tissues and tubes that carry sperms. However, an enlarged testicle can also be due to other reasons besides cancer. For instance, fluid that collects around the testicle to form a hydrocele or veins in the testicle that dilate can cause enlargement and lumpiness around the testicle. However, some testicular cancers might not cause symptoms until they have reached an advanced stage. 

Testicular self-exam is the easiest and most basic way for men to detect early cancer. The best time is during or after a bath or shower when the skin of the scrotum is relaxed.
 

What are the symptoms of Testicular Cancer?

  • Feeling of heaviness in the scrotum  
  • Pain or a dull ache in the testicle, scrotum, or groin
  • Painless lump in the testicle  
  • Swelling of the testicle
  • Tenderness or changes in the male breast tissue


In advanced testicular cancer, some of the symptoms are lower back pain from cancer that has spread in the lymph nodes and respiratory difficulty if it has spread to the lungs. 
 

How do you perform a Testicular self-examination?

A Testicular Self-Examination can be done in a minute and from the comfort of your home. You are recommended to perform it once every month. The aim of a Testicular Self-Examination is to familiarise yourself with the look, feel and shape of your testicles, this will help you notice abnormalities should there be any.

  1. The Testicular Self-Examination is best performed after showering and in front of a mirror.
  2. Gently roll one testicle using the fingers and thumb of both hands
  3. Feel along the underside of your scrotum to find the epididymis that sits at the back of the testicle. It should feel like a little bunch of tightly curled tubes.
  4. Perform the self-examination one testicle before moving on to the other. 


What are the risk factors of Testicular Cancer?

  • Having an undescended testicle (Cryptorchidism): The testes is formed during fetal development and typically descends into the scrotum before birth. If you have an undescended testicle, your risk of Testicular Cancer increases. The risk remains even if you have had surgery to move the testicle into the scrotum
  • Family History: You may have an increased risk if there is a history of Testicular Cancer in your family.
  • Age: While Testicular Cancer can happen at any age, it is more common among those aged between 15 - 45.
  • Ethnicity: Testicular Cancer is more prominent among caucasians.


How is Testicular Cancer diagnosed?

Blood Test
Cancers produce proteins which are tumor markers. If they are present in the blood, it is positive for cancer. The tumor might also increase the levels of an enzyme called lactate dehydrogenase (LDH), which often (but not always) indicates widespread disease. However, some non-cancerous conditions may also increase the LDH levels. In this case, other detailed examination by your doctor will be necessary.
 

Examination
During the process, the doctor will feel the testicles for swelling, tenderness as well as the size and location of any lumps. If there is a lump or other sign of testicular cancer detected, further testing will be needed to look for the cause.


Ultrasound
From the images produced by the sound waves, your doctor can see if the change is due to a benign condition or a solid tumor that could be cancer. If the lump is solid, it is more likely to be cancer. The doctor will then recommend additional tests to be done or even surgery to remove the testicle.

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Dr. Chong Kian Tai
张建泰医生

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