Why is it important to know about this disease?
In the overall structure of malignant tumors, testicular cancer occupies a small share, so little is said about it. But among young men it is the most common malignant tumor - precisely at that period of life when they least think about cancer.
The second reason for attention to this topic is its very high curability with timely treatment. Even with a widespread process, modern treatment allows for recovery in a significant proportion of patients. Time remains the decisive factor.
Unfortunately, young men often postpone the visit: they are embarrassed, hope that the lump will resolve, or treat it as an inflammation. It is this delay, and not the disease itself, that worsens the prognosis.
Symptoms
- A firm, painless lump or nodule in the testicle is the most common first sign.
- Enlargement of the testicle or change in its shape and consistency
- Feeling of heaviness in the scrotum
- Dull nagging pain in the lower abdomen or groin
- Pain in the testicle itself - occurs less frequently, in approximately some patients
- Enlargement and tenderness of the mammary glands - with hormonally active tumors
- Sudden onset varicocele, especially on the right
- Lower back pain with enlarged retroperitoneal lymph nodes
- Shortness of breath and cough with metastases to the lungs
- General weakness and weight loss with a common process
How to do a self-examination
A simple procedure that should be performed once a month, best after a warm shower when the skin of the scrotum is relaxed.
- Осмотрите мошонку перед зеркалом, обращая внимание на изменение размеров и асимметрию
- Аккуратно ощупайте каждое яичко по отдельности, перекатывая его между большим и остальными пальцами
- Нормальное яичко гладкое, однородной плотности, слегка эластичное
- Придаток прощупывается по задней поверхности как мягкий валик — это нормальная структура, а не образование
- Обращайте внимание на любые твёрдые узелки, участки уплотнения и изменение формы
- Небольшая разница в размере яичек и их расположении обычно является вариантом нормы
- При обнаружении уплотнения — не ждите и запишитесь к урологу
Risk factors
- Cryptorchidism - undescended testicle in childhood; the risk remains even after successful surgery and affects both testicles
- Testicular tumor in father or brother
- Previous tumor of the second testicle
- Age from fifteen to forty years
- Developmental disorders of the genital organs
- Infertility and pronounced changes in spermogram
- Klinefelter syndrome and other genetic conditions
It is important to understand: trauma to the scrotum does not cause swelling. However, it is after the injury that a man feels the testicle and often discovers a pre-existing lump for the first time.
Diagnostics
- Examination by a urologist with palpation of both testicles and inguinal lymph nodes
- Ultrasound of the scrotum with Doppler sonography is the main method: it accurately distinguishes a tumor from a cyst, hydrocele and inflammation
- Blood tumor markers: AFP, beta-hCG, LDH are important both for diagnosis and for subsequent treatment monitoring
- CT scan of the abdomen, pelvis, and chest to assess prevalence
- MRI if necessary for clarification
- Histological examination of the removed testicle - final confirmation of the diagnosis and determination of the type of tumor
- Spermogram and cryopreservation of sperm before treatment
Treatment
- Orchidectomy - removal of the testicle along with the spermatic cord through the inguinal approach; performed both as a therapeutic and as a diagnostic operation
- Chemotherapy is highly effective for germ cell tumors, depending on the type of tumor and stage
- Radiation therapy - mainly for some stages of seminoma
- Retroperitoneal lymphadenectomy - removal of affected lymph nodes
- Active surveillance in early stages in some patients according to a strict protocol
- Installation of a testicular prosthesis at the request of the patient
- Cryopreservation of sperm before treatment is a mandatory discussion for all men of reproductive age
Fertility and life after treatment
- When one testicle is removed, the second one usually ensures sufficient testosterone and sperm production
- Chemotherapy and radiation therapy temporarily and sometimes permanently inhibit spermatogenesis - therefore cryopreservation of sperm before treatment is fundamentally important
- Regular monitoring of testosterone levels after treatment
- Follow-up schedule with tumor markers and CT for several years
- Self-examination of the second testicle - the risk of a tumor in it is higher than in the general population
- Prosthetics can solve cosmetic issues and reduce psychological discomfort
Where to get examined in Tashkent
If a lump is detected in the testicle, an urgent consultation with a urologist, ultrasound of the scrotum and analysis for tumor markers are needed - these studies are performed quickly and provide an answer within one to two days.
In Tashkent, such an examination is carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic; Once the diagnosis is confirmed, further tactics are determined together with oncologists.
If you feel a lump, don’t wait until it “goes away on its own” and don’t start treating the inflammation yourself. With this disease, the weeks gained directly affect the amount of treatment and prognosis. Clinic contacts are below.
