December 7th, 2015
Testicular cancer has one of the highest treatment success rates among all cancers. However, that survivability depends on timely medical intervention. It’s important to report any unusual signs or symptoms to your physician, allowing early diagnosis and treatment.
Three primary diagnostic methods are used to diagnose testicular cancer. Ultrasound produces an image using sound waves directed through the skin. It can be used to determine the size and shape of any growth or lump on the testicle. Ultrasound can also help determine whether or not the mass is solid or filled with fluid, like a cyst. The results of a testicular ultrasound will guide your doctor in further evaluation of any testicular mass. Analysis of a blood sample is also helpful in diagnosis. There are certain chemical markers associated with different cancers that can help identify the presence of abnormal tissue within the body. If testicular cancer is likely or if the diagnosis cannot be made with these tests, then the testicle must be removed surgically for a biopsy, which is a microscopic examination of the tissue for any abnormal or cancerous cells.
When a diagnosis of testicular cancer is made, then further blood tests and imaging studies are performed to determine if the cancer has spread beyond the testicle. The type of cancer will also influence the treatment plan. There are two primary types of testicular cancer: seminoma and non-seminoma. Seminomas are slow-growing tumors that are responsive to radiation therapy. Nonseminomas spread more rapidly and they don’t respond to radiation. Treatment begins with surgery for all stages of testicular cancer. Removal of the cancerous testicle (orchiectomy) can be curative in early stage testicular cancer. In later stage cancer, it removes some of the disease burden and improves response to further treatment with chemotherapy or radiation.
Patients with Stage I testicular cancer, which refers to cancer that has not spread beyond the testicle, will require no further treatment except regular follow-up. If the cancer has spread to regional (nearby) lymph nodes, the cancer is considered Stage II, and the affected lymph nodes will be removed during surgery. If there are cancerous cells in distant lymph nodes, then the cancer is considered Stage II and treatment will include chemotherapy or radiation therapy to target metastatic disease in other parts of the body.
If testicular cancer is not diagnosed and treated in the early stages, it may spread beyond the lymph nodes, to the lungs, the brain, or the liver. It can still be treated successfully, Stage III cancers are also treated with orchiectomy followed by radiation or chemotherapy, but after treatment, remaining tissue masses may be removed surgically.
Recurrent testicular cancer, when it occurs, can be treated by removing the affected lymph nodes, or with radiation or chemotherapy. Surveillance after treatment will include regular physical examinations, blood tests, and imaging studies. If recurrence occurs, it’s important to begin treatment early. Recurrent testicular cancer can sometimes be successfully treated, particularly if it has not spread beyond the lymph nodes in the pelvic or abdominal region or low back.
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