Testicular Cancer Information [Infographics and Videos]

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Testes (singular: testis or testicle) are paired, oval-shaped, male-reproductive glands, which sit in the scrotum (supporting structure for the testes which hangs beneath the base of the penis) and measure about 5 cm in length and 2.5 cm in diameter.

They normally develop in the abdomen and descend into the scrotum through the inguinal canals during the seventh month of fetus development. The main function of the testes is to produce sperms and the male hormones (androgens) such as testosterone.

The testes are made up of mainly 3 types of cells: spermatogenic cells (germ cells), Sertoli cells, and interstitial (or Leydig) cells. Each of these cells can develop into one or more types of cancer. Germ cell tumors are the most commonly encountered (around 90-95% of all cases) testicular cancer.

Germ cell tumors are classified into following 2 types based on the type of cells involved, growth rate, and type of treatment approach usually followed for such tumors:

  1. Seminomas
  2. Non-seminomas

Testicular Cancer Infographics

Risk Factors

Most common risk factors for testicular cancer are undescended testis (cryptorchidism), white males, previous history of testicular cancer in opposite testis, family history, genetic syndromes (Testicular Dysgenesis, Down’s, Klinefelter’s), etc.

testicular cancer risk factors

Symptoms and Signs

It most commonly presents with testicular lump (mostly painless), change in testicular sensation, pain in abdomen or back, etc.

symptoms and signs

Investigations

Investigations for Diagnosis and Staging

Testicular ultrasound, high inguinal orchiectomy and serum tumor markers help in confirmation of diagnosis, and imaging tests (CT/MRI/PET) are required to stage the disease.

investigations for diagnosis and staging

 

Tumor Markers

If AFP is elevated, it is always a non-seminoma, even if biopsy results show seminoma. Further, very high levels of beta HCG may be seen in choriocarcinoma, so is AFP oin endodermal sinus or yolk sac tumors. LDH may be elevated in any subtype. Embronal carccinoma may have any one or three tumor marker(s) elevated.

testicular germ cell tumor markers

Staging

T Staging

T staging describes the locoregional extent of the tumor. It may be T1 to T4 depending upon being localized to the testis to infiltration into surrounding structures.

T staging based on locoregional extension

 

N and M Staging

N is the nodal staging that may be N0, N1, N2 or N3 depending on the size and number of retroperitoneal lymph nodes involved by tumor. And M is the metastatic staging that can be M0, M1a or M1b depending on the site(s) of distant tumor spread.

N-and-M-staging

 

Stage Grouping

The TNM staging discussed above, when combined with level of tumor markers (S0, S1, S2 or S3), helps to assign an overall stage to the tumor. It may be Stage 1, 2 or 3 as discussed in the image below.

stage grouping based on TNM and tumor markers

 

Treatment

Seminomatous Germ Cell Tumors

Below is a description of treatment of seminomatous germ cell tumors of testis, depending on the stage of the tumor (as discussed above).

seminomatous germ cell tumors treatment

 

Non-Seminomatous Germ Cell Tumors

Below is a description of treatment of non-seminomatous germ cell tumors of testis, depending on the stage of the tumor (as discussed above).

non seminomatous germ cell tumors treatment

 

Testicular Cancer Videos

CancerBro meets Tiesto – Testicular Cancer patient

Watch the video below where CancerBro meets Mr Tiesto, who has recently been diagnosed with testicular cancer.

 

Risk Factors

Risk factors for testicular cancer are explained below.

 

Symptoms and Signs

Symptoms and signs with which testicular cancer presents commonly.

 

Investigations for Diagnosis and Staging

Following video explains the investigations that are required to confirm the diagnosis and stage the disease.

 

Anatomy of Testis

It is important to know the anatomy of testis and surrounding structures to understand the staging in a better way.

 

TNM Staging

TNM staging is explained below in an easy to understand manner.

 

Seminoma Testis Treatment

Treatment of Seminomatous germ cell tumors of testis based on staging.

 

Non-Seminoma Testis Treatment

Treatment of Non-Seminomatous germ cell tumors of testis based on staging.

 

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