Keep your family jewels safe man!

Abrupt Testes Spurts

Testicular cancer usually raises its head due to the growth of abnormal cells in one or both testicles of a man. The testicles are responsible for the production of the hormone testosterone along with sperms that help fertilize a female egg cell, thereby initiating the process of pregnancy. Although testicular cancer can occur at any age, it is believed to be more prevalent in younger adult men (15 to 40 years) constituting less than 1%. Dr Tarun Jindal, Senior Consultant, Uro oncology & Robotic Surgery at Apollo Multi-specialty Hospital, Kolkata says, “The exact cause for testicular cancer isn’t fully understood.” There could be a plethora of potential reasons. “Men with a family history of testicular cancer are at a higher risk,” Dr Tarun says, suggesting that genetic predispositions too, play a role here. Testicular cancer is more common among Caucasian men compared to men of other races. However, Dr Tarun says that the reasons for this disparity are yet not entirely known.

Potential Rise

While there has been a global rise in the number of cases of testicular cancer, India too, is not an exception. “In India, the number of cases is less as compared to the West, but there has been an increase in cases in recent times,” says Dr Aman Gupta, Clinical Director, Urology, Robotic Surgery & Kidney Transplant, Marengo Asia Hospital, Gurgaon. This, however, is likely due to increased and improved detection techniques and reporting options available today. Dr Aman explains, “The peak incidence for testis cancer is unfortunately anywhere between 15 and 40 years.” But there have been above 40 who have been affected by testicular cancer.
Lumps & Bumps

Boys and men yet need to be better aware in terms of self-examinations held. Dr Aman opines that boys and men should never ignore ‘painful or even painless’ lumps in the testis. He says, “Often men would attribute a lump in the testis area to some trauma or sports activity, ignoring it and even assuming it to be either hernia or any infection.” Such lumps are only then noticed by a family member, more specifically a partner.

Any kind of enlargement, no matter how small or large, no matter what its consistency seems or feels like, could serve as a major cause for worry. Dr Tarun says, “Humps, bumps or lumps is an easy way to remember the symptoms!”Dr Prashant Kumar, MCh Urology & Uro-oncologist, Department of Urology and Renal Transplant, Fortis Hospital, Greater Noida shares further on how only one-third of patients diagnosed with testicular cancer usually have symptoms of dull pain. He explains, “Other unusual presentations involve abdominal swelling (lymph nodes), back pain (Psoas muscle or nerve involvement), lower limb swelling (IVC compression) or shortness of breath and cough etc.”

Detection & Treatment

While detection is usually a self-examined process by men, in some cases, it could be detected by a doctor during a routine physical check-up. The lumps are examined via ultrasound tests along with blood tests to look out for signs of tumour markers in the blood.

Dr Prashant explains that this is usually followed by a high inguinal orchidectomy to detect the stage of the disease. With yet other scans like CT or MRI adding up. He explains, “Testicular tumours can be divided into germ cell tumours and non-germ cell tumours.”

Germ cell tumours aka GCT (believed to be most common) could further be bifurcated into Seminoma and Non-seminomatous GCT. Seminomas usually tend to be more sensitive to radiation, hence orchidectomy is needed to further check for the kind of tumour one is looking at.

According to an article in the American Cancer Society journal titled “Testicular Cancer in 2023” states there has been significant progress in the management of Testicular germ cell tumour from 25% in 1970 to nearly 80% in 2023. The survival rate of testicular cancer is exceptionally high. Patients who are diagnosed with localized cancer that hasn’t spread beyond the testicle have a 99% five-year survival rate. That is to say, 99% of patients will certainly live for a surety of five years post-diagnosis. Those diagnosed with regionalized cancer (cancer that has spread to nearby lymph nodes & tissues) yet have a favourable survival rate of 96%.

Precaution & Cure

Many men think that testicular cancer can never happen to them. “The problem starts when men start ignoring their symptoms and start attributing everything but the possibility of cancer,” adds Dr Aman Gupta. If at all surgery is required it would require the removal of one testis. This makes men feel insignificant. There are myths that surgery makes you impotent or infertile. Dr Aman says, “One functional testis is enough to produce male hormones and sperms to carry out normal reproductive functions.” While it is true that testicular cancer comes with a decent survival rate, early detection and prevention seem to be the need of the hour.