Testicular cancer starts when healthy cells in a testicle mutate and grow out of control, generating a lump termed a malignant tumour. The term “malignant” signifies that the tumour can spread to other sections of the body.
Testicular cancer is also known as testis cancer.
About the testicles
There are typically two testicles located underneath the penis in a sac-like pouch known as the scrotum. Testicles may also be termed testes or gonads. The testicles are part of the reproductive system and generate sperm and testosterone. Testosterone is a hormone that has a function in the development of male reproductive organs and other masculine features.
Testicular cancer and its types
The majority of testicular cancers begin in the sperm-producing cells known as germ cells and are sometimes referred to as germ cell tumors.These are the cells responsible for the production of sperm. Seminomas and non-seminomas are the two most common forms of germ cell tumours (GCTs) in the testicles.Seminomas and non-seminomas coexist in many testicular tumours. Because they develop and spread like non-seminomas, these mixed germ cell tumours are treated as non-seminomas.
Seminomas develop and spread at a slower rate than non-seminomas. These tumours are classified into two types: classical (or typical) seminomas and spermatocytic seminomas.
Certain seminomas can cause a rise in blood levels of a protein known as human chorionic gonadotropin (HCG). HCG is a tumour marker for some kinds of testicular cancer and can be detected with a simple blood test. It can be utilised for diagnosis as well as monitoring the patient’s response to therapy.
The typical age range for these germ cell tumours in men is between their late teens and early 30s. Embryonal carcinoma, yolk-sac carcinoma, choriocarcinoma, and teratoma are the four most common non-seminoma tumour types. The majority of non-seminoma malignancies are treated the same way despite the fact that most tumours are a mixture of different types (and occasionally seminoma cells as well).
How testicular cancer can be diagnosed ?
Consult your primary care physician as soon as you notice a testicular lump or swelling or anything else that might be testicular cancer. Your doctor could suggest that you see a urologist for additional testing after this visit. A urologist is a medical professional who focuses on treating problems of the urinary tract and testicular cancer.
Even if testicular cancer has progressed to other bodily areas, many men may not immediately exhibit symptoms. However, some men may experience a few of the following:
- Cancer that has progressed to the lymph nodes (small collections of immune cells) at the rear of the abdomen is causing low back pain.
- Cancer that has progressed to the lungs may cause chest pain, coughing up blood, or shortness of breath.
- belly pain that may be caused by enlarging lymph nodes or liver cancer spread
Usually, a physical examination and an ultrasound are the initial procedures carried out. Blood tests are conducted if they reveal an anomaly that looks to be a tumour. In order to check for malignancy, the testicle may also need to be surgically removed.
If cancer is discovered, more testing will be required to establish the stage of the disease and whether it has spread to other regions of the body. Typically, clinicians prescribe abdominal, pelvic, and chest imaging examinations. Images of the interior of the body are produced via imaging tests. Images of the brain or bones are less common, although certain patients may require them. Patients with cancer that has spread widely, those with choriocarcinoma, and those with very high tumour marker levels of AFP or beta-hCG are all examples of this.
So, the tests which can help in detection of the disease include Chest X-ray, Computed tomography (CT or CAT) scan, Magnetic resonance imaging (MRI) scan, Positron emission tomography (PET) or PET-CT scan, and Biopsy.
Treatment of Testicular cancer
Depending on the stage of your cancer and your treatment options, you may have several types of doctors on your treatment team. These physicians may include medical oncologist, urologist and radiation oncologist.
Some common treatments that can be done in case of Testicular Cancer
- Testicular Cancer Surgery
- Testicular Cancer Radiation Therapy
- Chemotherapy for Testicular Cancer
- High-Dose Chemotherapy with Stem Cell Transplantation
- Complementary and alternative methods
Testicular Cancer Surgery: The primary treatment for testicular cancer is usually surgery to remove the affected testicle, known as a radical inguinal orchiectomy. This procedure involves removing the entire testicle and most of the spermatic cord, which contains the blood supply and sperm channel. In rare cases where cancer develops in both testicles, a bilateral orchiectomy may be necessary, although testicle-sparing surgery on one side can be an option. Orchiectomy is used to diagnose and treat both early-stage and later-stage seminoma and non-seminoma. Before the surgery, a blood sample will be collected to test for serum tumor markers, which can help in planning treatment and follow-up care. If the cancer has spread, chemotherapy may be necessary.
Surgeries that can be done
- Laparoscopic surgery
- Retroperitoneal lymph node dissection (RPLND)
- Radical inguinal orchiectomy
Side effects of the Surgery: Surgery for testicular cancer can have short-term risks such as reactions to anesthesia, bleeding, blood clots, and infections. Orchiectomy, the removal of one or both testicles, can result in infertility and decreased testosterone levels, which can affect sex drive and erections. However, these side effects can be managed with testosterone supplements and a testicular prosthesis can be surgically implanted to restore a more natural look. Lymph node dissection to remove retroperitoneal lymph nodes can also have short-term complications such as infection or bowel obstruction. It can potentially damage nerves that control ejaculation, causing retrograde ejaculation, which can make it difficult to father children. However, nerve-sparing surgery can be done to preserve ejaculation function, and sperm banking can be considered before treatment.
Testicular Cancer Radiation Therapy: Radiation therapy is a treatment for testicular cancer that uses high-energy rays or particles to destroy cancer cells or slow their growth. It is typically used to kill cancer cells that have spread to lymph nodes. The treatment involves a machine that sends radiation to a specific part of the body, much like getting an x-ray, but with stronger radiation. It is mainly used for patients with seminoma and can be used after orchiectomy to kill any tiny bits of cancer in lymph nodes that can’t be seen. It can also treat small amounts of seminoma that have spread to the nodes, as determined by changes seen on CT and PET scans.
Side effects of the Radiation Therapy: Both the cancer cells and adjacent healthy tissue may be harmed by radiation therapy. Doctors carefully calculate the precise amount you require and direct the beams on the tumour in an effort to minimize the risk of negative effects. In comparison to other cancers, testicular cancer is frequently treated with lower radiation doses.
Typical negative impacts may include:
- Fatigue Nausea
- Men occasionally experience skin changes like redness, blistering, or peeling.
After the radiation treatment is over, these adverse effects gradually improve. A special shield is placed over the remaining testicle to assist protect it from radiation since radiation exposure to the healthy testicle can decrease fertility (sperm counts).
Chemotherapy for Testicular Cancer: Chemotherapy is the use of medications to eradicate cancer cells, often by preventing cancer cells from growing, dividing, and proliferating. Chemotherapy is administered by a medical oncologist, a doctor who specialises in the medical treatment of cancer.
Chemotherapy for testicular cancer is administered through a vein, where it enters the circulation and reaches cancer cells throughout the body. There are chemotherapy drugs that can be given orally, but they are rarely used to treat testicular cancer.
Side effects of Chemotherapy: Testicular cancer can be effectively treated with chemotherapy, but it also has risks and drawbacks. Fatigue, nauseousness, tingling and numbness, hearing loss, and ringing in the ears are a few typical adverse effects. Additionally, there is a chance of serious infections and potentially harmful lung inflammation, especially while using the medication bleomycin. Blood clots, which can cause chest pain, swelling in the limbs, and shortness of breath, are more likely to affect testicular cancer survivors. Late consequences, such as persistent weariness, heart problems, and further malignancies, might develop after treatment is finished. A shorter life expectancy and a higher risk of heart and vascular disease have been associated with chemotherapy and radiation therapy.
High-Dose Chemotherapy with Stem Cell Transplantation
Chemotherapy is a common treatment for testicular cancer, but higher doses that may work better are not given because they can severely damage the bone marrow. Stem cell transplant allows doctors to use higher doses of chemotherapy by collecting blood-forming stem cells from the patient’s bloodstream and storing them before high-dose chemotherapy is given. After chemotherapy, the stem cells are infused into a vein like a blood transfusion, and they settle in the bone marrow to start producing new blood cells. Stem cell transplant is typically used to treat testicular cancers that have come back after chemotherapy. However, the treatment is complex and can cause life-threatening side effects, so it should be done at a hospital with experience in managing the recovery phase. The treatment can also be expensive, so it’s essential to find out what the insurance will cover before deciding on a transplant.
Side effects of Stem Cell Transplantation: Some issues and side effects may not show up for several months or even years after the transplant, depending on how long they last. These may consist of:
- Damaging of heart or lungs
- Thyroid or other hormone-producing gland issues
- Difficulties with fertilization
- Bone damage or complications with bone growth
- Years later, the appearance of yet another disease, including leukaemia
Complementary and Alternative methods (CAM):
Alternative and complementary methods, such as vitamins, herbs, special diets, acupuncture, and massage, may be mentioned as cancer treatments or symptom-relievers. Alternative therapies are not the same as complementary approaches. While complimentary techniques are intended to be used in conjunction with and to supplement regular therapies, alternative methods are utilized in place of traditional treatments. People may use the term “natural,” “holistic,” “home remedy,” or “Eastern Medicine” to refer to CAM
Complementary treatments are used alongside standard medical care, whereas alternative treatments are used instead of medical treatment. While some methods may help relieve symptoms or improve well-being, many lack scientific evidence and may even be harmful. Before considering any alternative or complementary method, it is important to discuss it with your cancer care team to understand its potential risks and benefits.
People with cancer may consider utilising Complementary techniques for a variety of reasons, including:
- They want to do all possible to battle cancer.
- They are looking for a therapy method with fewer negative effects.
- They want to have some say over how their cancer is handled.
- They prefer alternative health and illness theories, as well as alternative therapies.
- They may have seen material that appears to be useful online or elsewhere.
Alternative medicine refers to untested or disproven techniques of cancer prevention, diagnosis, and treatment that are utilised instead of mainstream medical therapies. They were either not properly evaluated in clinical trials or were tested and proved to be ineffective against cancer. Alternative approaches include special diets, specific supplements and herbs, high vitamin dosages, homoeopathy, laetrile, and Rife devices. Many alternative medicine practitioners recommend a combination of these therapies. This method has different methods which can help the patient suffering from Cancer.
- Nutritional method: This covers all diets, nutritional supplements, probiotics, and herbal remedies utilised in complementary and alternative medicine.
- Physiological method: This includes non-traditional forms of therapy including hypnosis and meditation.
- Physical methods: These techniques include massages and acupuncture.
- Physiological and physical therapies that work together: These treatments influence the mind and body at the same time. They range widely and include dance therapy, tai chi, and yoga.
Some of the most widely practiced are discussed below.
- Ayurveda is an ancient Indian practice that uses herbs, massages, and dietary techniques to treat various conditions. The treatments usually involve purification, herbal remedies, yoga, special diets, massage, and meditation.
- Meditation has been a practiced for centuries and aims to help individuals focus their attention and achieve a state of calm and relaxation. It has been shown to effectively treat symptoms of mental health conditions such as high blood pressure, depression, and anxiety, among others. Through various meditation techniques, individuals can improve their overall health and well-being.
- Acupuncture is a traditional Chinese medicine technique that involves sticking finely pointed needles in areas of your body known as acupuncture points. This practice has historically been used as a natural pain-relieving technique. It’s believed that the needles stimulate specific nerves and muscles, which in turn release natural pain-relieving hormones in your body.
- Massage therapy is primarily aimed at alleviating physical symptoms, such as pain in specific body areas. This is achieved by manipulating the soft tissues of the body through kneading and other techniques, resulting in a sensation of relief. There are various types of massages available, and the type that is most suitable for you depends on the specific goal you wish to achieve through it.
- Chiropractic medicine is a type of alternative therapy that involves the practice of a chiropractor. Its objective is to alleviate pain and enhance the overall functioning of the body. The practice involves specific techniques that manipulate the skeletal system, spine, and joints to achieve proper alignment of the body. Chiropractic medicine is similar to traditional medicine in that chiropractors review your medical history, conduct various tests and interviews, and provide an official diagnosis before devising a treatment plan.
- Reiki is a traditional Japanese method of alternative therapy that focuses on the idea that you possess a vital energy force within your body, and when it’s depleted, you can fall ill. By laying hands on various parts of your body, Reiki aims to replenish this energy, thereby addressing physical and psychological issues. It’s classified as a type of energy therapy.
Integrative health integrates traditional and complementary methods in a coordinated manner. Integrative health also emphasises multimodal interventions, which are two or more interventions such as conventional health care approaches (such as medication, physical rehabilitation, and psychotherapy) and complementary health approaches (such as acupuncture, yoga, and probiotics) used in various combinations, with an emphasis on treating the whole person rather than just one organ system. Integrative health seeks to achieve well-coordinated care across various providers and organisations by combining traditional and complementary approaches to care for the complete person.
Integrative approaches to health and wellbeing are increasingly being used in care settings around the United States. Integrative health researchers are now investigating the potential advantages of integrative health in a range of scenarios, including pain treatment for military members.
You need to continue seeing your doctor after finishing treatment for testicular cancer. For a number of years, tests may be performed to check for evidence that the cancer has returned or spread. Other testing is not advised by experts to check for secondary malignancies in those who are asymptomatic. However, be sure to inform your doctor of any new symptoms or issues as they might be brought on by the cancer returning, a new illness, or a second malignancy.
In order to check for malignancy in the residual testis, survivors can perform routine testicular self-exams.
All testicular cancer survivors should abstain from tobacco usage and tobacco smoke. Many malignancies are more likely to develop in smokers.
Survivors should additionally do the following to maintain their health:
- Achieve and maintain a healthy weight
- Limit the amount of time you spend sitting or lying down and continue to be active.
- Eat a diet rich in fresh produce, whole grains, and lean protein while limiting or avoiding red and processed meats, sugary drinks, and highly processed meals.
- Don’t consume alcohol. If you do drink, limit your intake to no more than one drink for women or two for men per day.
- The risk of several additional health issues may be reduced as a result of these actions.
Prevention of cancer
Cancer prevention is a critical aspect of maintaining good health, and there are several ways to
reduce the risk of developing cancer. A healthy lifestyle, including a nutritious diet and regular exercise, can help prevent cancer, along with avoiding tobacco and excessive alcohol consumption. Ayurveda, a traditional Indian medical system, also offers insights and practices for cancer prevention.
An anti-cancer diet emphasizes whole, plant-based foods such as fruits, vegetables, legumes, and whole grains. These foods are rich in fiber, vitamins, minerals, and antioxidants, which can protect cells from damage and reduce the risk of cancer. Certain foods, such as cruciferous vegetables (e.g. broccoli, cauliflower, kale) and berries, have been shown to have anti-cancer properties.
Additionally, avoiding processed and red meats, high-fat foods, and sugary drinks can lower the risk of cancer. Limiting alcohol consumption and avoiding tobacco use are also important in reducing cancer risk.
In Ayurveda, cancer prevention is linked to balancing the three doshas: vata, pitta, and kapha. Ayurvedic principles emphasize a diet rich in fresh, whole foods, and herbs with anti-inflammatory properties, such as turmeric, ginger, and garlic. A balanced Ayurvedic diet also includes adequate hydration and regular exercise, as well as stress reduction practices such as meditation and yoga.
Overall, a healthy diet and lifestyle, along with Ayurvedic practices, can help prevent cancer by reducing inflammation, protecting cells from damage, and maintaining a healthy balance of the body’s systems. However, it is important to note that cancer prevention is not a guarantee, and regular cancer screenings are still necessary for early detection and treatment.
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