The testes comprise primitive cells that mature to become cells that make spermatozoa or sperm that are important in sexual reproduction. There are also supporting cells that make enzymes and other fluid that enable the sperm to function properly. These primitive cells may become cancerous. These tumours are called testicular germ cell cancers.

How common is Testicular Cancer?

 

Testicular cancer represents only about 1-2% of all cancers in males, but is one of the most common cancers in young men.

Age of Onset

 

It occurs predominantly in males aged 20 - 40 years.

Ultrasonography of the testes will locate and delineate the size of the testicular lump.

 

Blood tests are taken for tumour markers comprising of alpha-fetoprotein (AFP) and beta-human chorionic gonadotrophin (HCG), and lactate dehydrogenase (LDH). CT scan of the chest, abdomen, pelvis and occasionally, the brain, is also performed to find out the extent of cancer.

 

Testicular cancers may be seminomas or non-seminomatous germ cell tumours, depending on what cell type is found at examination of the cancer under the microscope. An orchidectomy (removal of the testis) or biopsy is done to obtain the diagnosis.

Orchidectomy is performed to remove the affected testis if the cancer is localised. If there is advanced cancer, this may be done after chemotherapy in order to shrink the tumour first. Following surgery for early testicular cancer, chemotherapy or radiotherapy may be required to reduce the risk of recurrence. Chemotherapy is used if there is advanced cancer involving other organs such as the lungs or liver¹. Side effects of chemotherapy which are injected into veins include temporary nausea and vomiting, mouth ulcers, hair loss, loss of appetite and tiredness.

Prognosis of Testicular Cancer

 

Clinical examinations, scans and pathology reports all help the medical team decide what is the stage of the germ cell tumour. The appropriate course of treatment may then be recommended. The treatment strategy will vary from person to person. Prognosis of testicular cancer is generally very good. It depends on the extent of the disease, the state of health of the individual as well as response to treatment. With appropriate treatment, cure rates of up to 80% have been reported even for patients with advanced testicular germ cell tumour. Patients with early stage testicular cancer have reported cure rates of more than 95% with appropriate treatment. Close monitoring of blood markers together with radiological assessment is essential to detect early recurrence of cancer.