Testicular cancer

Symptoms

Who is at risk?

Testicular cancer most commonly affects men between the ages of 15 and 40. It is the most common cancer in men aged 20 to 40, while it is relatively rare after the age of 50. The disease occurs most frequently in White men, with the risk being approximately five to ten times lower in Black men.

A number of possible risk factors have been associated with testicular cancer, although not all have been conclusively proven. Around 10% of patients with testicular cancer had an undescended testicle (cryptorchidism) during childhood. Family history also plays a role – if a close relative, such as a father, grandfather, or brother, has had testicular cancer, the risk increases to approximately 3–10%. Other suspected risk factors include previous injuries, infections, and exposure to environmental toxins.

Diagnosis

The initial examination involves a physical examination of the testicles by palpation, which allows the doctor to detect abnormalities in shape or consistency. A scrotal ultrasound is an essential diagnostic tool, as it can identify structural changes within the testicle. If testicular cancer is suspected, blood tests are also performed to measure tumour markers that are commonly associated with this disease.

Treatment

The primary treatment for testicular cancer is the surgical removal of the affected testicle. The procedure is performed through an incision in the groin, allowing the testicle and spermatic cord to be removed together. Because the testicles are paired organs, removal of one testicle usually has little or no impact on fertility or sexual function.

The removed tissue is then examined histologically to determine the exact type of tumour. This information, together with additional tests to detect possible metastases – such as a CT scan of the abdomen, a chest X-ray, or, in some cases, a bone scan – forms the basis of the treatment plan.

In most cases, surgery is followed by chemotherapy. The specific chemotherapy regimen and the number of treatment cycles depend on the type and stage of the tumour.