What is testicular cancer?
Testicular cancer is a form of cancer that develops in the testicle, also called testes or testicles.
Epidemiology and numbers
Testicular cancer is basically a relatively rare disease, but it is the most common cancer in young men (between 15 and 30 years). Although the disease usually occurs at this age, but it can also occur in older and even in childhood.
In the Netherlands, more and more men get testicular cancer, but it is a mystery why the number is increasing. In 2010 in the Netherlands with 660 men diagnosed with testicular cancer, compared to 500 new cases in 2000. In the period between 1990 and 2000, the number of cases of testicular cancer even increased by 40%. Mortality it increased over the same period from 38 deaths in 1990 to 25 in 2000 and 26 in 2010, which suggests that the cure rate is very high.
Testicular cancer usually arises in germ cells, the cells in the testis to produce the seed.
When testicular cancer are two main types are distinguished:
- Non-seminoma, is once again divided into:
Teratoma
Choriocarcinoma
- Seminoma
Metastases from seminoma usually move through the lymph nodes; metastases of non-seminoma usually move through the bloodstream. An intermediate form is also possible.
Testicular cancer symptoms
Usually discover men whose testicular cancer, itself changes to a testicle. Sometimes this consists of a, usually painless, increase in size of the testicle, sometimes from a lump or lumps in the testicles. Very occasionally, there is a clear sharp pain in the affected patients often report an indefinite feeling ball. in addition, in the lower abdomen, behind or in the scrotum, fatigue for no apparent reason or declining libido.
In some men is testicular cancer metastases because of complaints established-giving, thought should be given to abdominal or back pain. Also there might be a swelling of the mammary gland or of the area around the nipple, with or without pain.
Early detection and timely treatment of testicular cancer is very important. Basically, the smaller the tumor is discovered, the better the outlook. Testicular or testicular cancer is often detected late. Usually men only go to the doctor if there is already metastases. If the doctor is consulted the risk that thinks this earlier epididymitis, which then antibiotics are prescribed.
Stages of testicular cancer
Metastases of testicular cancer occur particularly in the various lymph nodes (at the back of the abdominal cavity, at the height of the kidneys and of the lower vertebrae, above the collar, in the area between the lungs). In addition, tumor cells may spread via the blood, and may cause metastases in the lungs, the liver and other organs.
For many types of cancer has been established one stage format, with which the extent to which the disease has spread in the body, is shown. For testicular cancer, the following format:
- Stage I: the tumor is confined to the testicle (so there are no metastases)
- Stage II: the tumor is confined to the testicle and lymph nodes below the diaphragm
- Stage III: the tumor is confined to the testicle and lymph nodes, both above and below the diaphragm
- Stage IV, the tumor has extended to other organs
Testicular cancer prognosis
Of all men who get testicular cancer is 95% after 5 years is still alive. If the cancer has spread not yet at the time of discovery, it is 99% survival rate, even if it only has spread to the lymph nodes is still 96%. If it has spread further and this figure drops to 72% in men with a high risk profile ' to 40-45%. Risk profile is a term that doctors use and the height thereof depends on several factors, including the size and location of the metastasis and the value of the tumor markers in the blood. These markers are beta-HCG and AFP.
Testicular cancer treatment
Only after an operation in which tumor tissue is obtained (often is that the testicle), can finally be confirmed whether there is testicular cancer. The testicle is usually removed surgically through the inguinal Canal as first treatment step. Often this is followed by adjuvant treatment. Components may include:
- Chemotherapy, standard is the BEP-chemo treatment, consisting of bleomycin, Etoposide and cisplatin; other options include the EP-, VIP, TIP-or CTC-Spa
- Radiation therapy (radiotherapy)
- Lymph node surgery
In general the seminoma very very well on radiation therapy, and chemotherapy are not always necessary to have.
At a non-seminoma is usually directly treated with chemotherapy; radiation plays no (major) role.
Risk factors
On the causes of testicular cancer is virtually unknown, but there are, however, some risk factors known;
- Undescended testes or testicle at birth (cryptorchidism);
- A ineengeschrompelde testicle;
- A previous testicular tumor;
- Testicular cancer in the family (especially if a father or brother has had testicular cancer;
- Cannabis use;
- Radiation of cell phone although this is not yet proven beyond doubt.