Testicular Cancer - Different Stages and Treatment Option

Testicular Cancer Treatment

Testicular Cancer can occur in males of all ages, including infants & elderly men. Normally more than half of testicular cancer cases occur in males between 20 to 34 years of age. Nevertheless, this type of cancer is quite uncommon, with a lifetime chance of acquiring it being 1 in 263. The risk of death from testicular cancer is 1 in 5000. Usually, testicular cancer can be effectively treated & cured, especially if detected in early stages. It would be wiser to see a doctor immediately in case you experience any possible signs or symptoms of testicular cancer. Even though you may not be having testicular cancer, but the sooner you start treatment for your ailment the better.

What is Testicular Cancer?

This type of cancer occurs in one or both testes or testicles which are an important organ of the male reproductive system. These are positioned under penis in a loose sac-like feature known as the scrotum & function to produce the male hormone testosterone that plays an integral role in defining physical characteristics of men. Testicular cancer majorly is found in young men between the age group of 20 to 34 but can even attack older men with signs & symptoms.

There are many different types of cells in the testicles & each one of them can develop into cancer of one or more types. It is important to differentiate between these different testicular cancers because of their treatment & prognosis is different. The two main classification of this type of cancer is Seminomas & Non-Seminomas. Seminomas can be further distinguished into Classic, Anaplastic or Spermatocytic types whereas non-seminomas are classified into Yolk Sac Carcinoma, Embryonal Carcinoma & Choriocarcinoma.

Signs & Symptoms of Testicular Cancer

Problem with testicular cancer is that it is painless at first & hence difficult to detect. However, a person with testicular cancer may experience many different kinds of signs & symptoms. Sometimes there may be no symptoms at all & on other instances these symptoms may be due to some other medical condition & not testicular cancer. So it is always advisable to confirm medical conditions once any or some of these following symptoms are detected.

  • Most common symptom is enlargement of one or both testicles
  • Small lump or hardened area on testicle
  • Painless swelling in testicles
  • Pain or discomfort in scrotum or testicle
  • Dull pain in groin or lower abdomen
  • Sudden build up of fluid in scrotum
  • Tenderness or growth in breast, although this is a rare symptom
  • Pain in lower back, shortness of breath, chest pain & bloody sputum
  • Swelling of one or both legs

In the early stages this tumor could be the size of a pea or marble but it can become much larger. If you experience any lump, hardness, enlargement, pain or tenderness in testicles, you should seek immediate medical help. If you don’t get the same feeling as always in testicles or scrotum or if there is heaviness, it is good to see a doctor.

Diagnosis of Testicular Cancer

There are some blood tests which can detect testicular cancer. However, the main sign & basis for diagnosis is symptoms. Once you suspect that you have testicular cancer the next step is to be examined by a doctor who will feel the testicles & check for tenderness, lumps or swelling. Abdomen, lymph nodes & other parts of the body will also be examined so as to check if cancer has spread to other parts. If there is any physical symptom of cancer then a test needs to be performed.

  • First test done to diagnose testicular cancer is often an ultrasound. This is an easy test & there is no radiation involved.
  • Blood tests for tumor markers are also useful as cancer cells produce a high level of alpha fetoprotein & beta HCG (Human Chorionic Gonadotropin) that are known as tumor markers. If these tumor markers are found in blood it is an indication of testicular cancer.
  • Surgery for removing a small piece of tumor & inspecting it with a microscope is also a method for diagnosing cancer. This method is known as biopsy & is usually avoided because there is risk of spreading cancer.
  • Imaging tests in which X rays, sound waves, magnetic fields or radioactive substances are used to create pictures of inside of the body.
  • CT scan or an MRI scan can also be used to detect testicular cancer.

Treatment for Testicular Cancer

Treatment of testicular cancer mainly depends on surgery, radiation therapy, chemotherapy & stem cell transplant. However, these procedures are applied after thorough analysis & confirmation on the type & stage of cancer.

Stage 0 Germ Cell Tumors

Testicle is often removed in this stage & no other treatment is required. Sometimes doctors may also suggest no treatment right away. Instead a close watch is kept on patient with regular physical exams, ultrasound of testicles & blood tests for tumor marker levels.

Stage 1 Germ Cell Tumors

  • Stage 1 Seminomas – these cancers are cured in most of the patients. First the testicle is removed along with spermatic cord & after surgery radiation or chemotherapy can be resorted. Radiation is used in low doses because seminoma cells are very sensitive to radiation. About 10 to 15 treatments are given over a period of 2 to 3 weeks. Chemotherapy on the other hand gives 1 or 2 cycles with a drug called carboplatin after surgery.
  • Stage 1S Seminomas - In this condition the level of one or more of tumor markers is high even after removing tumor & in this case radiation is used. This condition is very rare.
  • Stage 1 Non Seminomas - Treatment of these cancers is different from seminomas. Of course testicle is removed at first & then there are two choices – careful observation by doctors & retroperitoneal lymph node dissection. Observation by doctors may be time consuming but you can avoid side effects of surgery. Initially there have to be 2 doctor visits & lab tests done every 2 months for the 1st year & a CT scan every 4 to 6 months. After that, time between visits & tests become longer. For stage 1B (T2, T3 or T4) there are up to 3 options – retroperitoneal lymph node dissection, chemotherapy with BEP regimen for 2 cycles, careful observation which requires frequent doctor visits & tests for several years.
  • Stage 1S Non Seminomas - If level of tumor markers is still high after removing testicle, then Chemotherapy is recommended.

Stage 2 Germ Cell Tumors

  • Stage 2A Seminomas – Testicle is removed & then radiation is given to retroperitoneal lymph nodes.
  • Stage 2B Seminomas – These have spread to larger lymph nodes or to many nodes. After testicle is removed chemotherapy is applied.
  • Stage 2C Seminomas – Radical inguinal orchiectomy is used to treat these cancers followed by chemotherapy with 3 to 4 cycles of BEP.
  • Stage 2 Non Seminomas – Testicles are removed using radical inguinal orchiectomy depending upon the level of tumor markers found in blood. There are two options - RPLND & chemotherapy.

Stage 3 Germ Cell Tumors

Although tumors have spread by the time they are diagnosed, they can still be cured. Both stage 3 seminomas & non seminomas are treated with surgery to remove the testicles & then chemotherapy with either EP for 4 cycles or BEP for 3 to 4 cycles.

ALSO READ: Artificial Testicular Implant

Survival Rate of Testicular Cancer

Overall survival rate is 95% & if cancer is diagnosed early it is 99%. Survival rates are often based on earlier outcomes of a large number of people, but they cannot predict what will happen in each individual case. Many other factors like age & how well cancer responds to treatment also make a lot of difference. For localized cancer in which cancer is confined to testicles, the survival rate is 99%. Then there is regional cancer in which survival rate is known to be around 96%. While for distant cancers survival rate is about 73%.

Low Cost Testicular Cancer Treatment in India

Getting treated in JCI accredited Travcure associated cancer surgery hospitals in Delhi, Mumbai, & Chennai is a good option for young men who are diagnosed with testicular cancer. Travcure affiliated cancer surgery facilities provide a variety of affordable low cost treatments for all stages of testicular cancer without any prolonged waiting period. Moreover, when you choose Travcure Medical Tourism as your service provider, you get the most ideal state-of-the-art medical facility in India.

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