Testicular Cancer - Medical Malpractice Lawyers
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Testicular Cancer - Medical Malpractice
Testicular cancer occurs when a single cell in the testicles becomes cancerous and grows out of control. The testicles are the male sex glands. They make sperm for procreation and store the sperm for future use. The testicles also make testosterone, which is the male hormone. There is a pair of testicles harboured within in the male scrotum beneath the penis. The testosterone made by the testicles creates the male sex characteristics.
Testicular cancers are of two types: seminomas and non-seminomas. The seminomas must be of three separate types: spermatocytic, anaplastic or classic. There are several types of non-seminomas: choriocarcinoma, teratoma, embryonal carcinoma and yolk sac tumours. A specific testicular tumour can contain a mixture of seminoma and nonseminoma cells.
Testicular cancer isn't common. It accounts for about one percent of all male cancers in North America and about 8000 men are diagnosed with testicular cancer in the US (with 390 deaths) each year. It affects mostly men between the ages of 20 and 39 and is actually the most common form of cancer in men between the ages of fifteen and 34. It is increased in incidence in those of Scandinavian descent. It is much more rare in black men although the incidence is rising. The rate of testicular cancer has gone up about 100 percent in the last forty years.
The major risk factors for testicular cancer include having been born with an undescended testicle. If the undescended testicle is not repaired early in life, the chance of cancer is high. Some men born with congenital abnormalities of the testicles, kidneys or penis can develop testicular cancer. A previous history of testicular cancer means you can get a new testicular cancer in the other testicle. A family history of testicular cancer gives you an increased risk of developing the disease yourself.
The main symptoms of testicular cancer include having a painless lump or localized swelling of one testicle. There can be pain in the testicular or scrotal area. Men often notice these things themselves and are encouraged to do testicular self exam to detect such cancers early. The scrotum can feel enlarged or very heavy and men can notice a dull aching pain in the back, lower abdomen or groin areas. Fluid can build up in the scrotum, giving a larger than normal scrotum. It is important to see the doctor if any of these symptoms develop to make sure it is not due to testicular cancer.
Doctors diagnose testicular cancer through a thorough history and physical examination, particularly of the groin and scrotum. There are tumour markers, including alpha-fetoprotein or AFP, LDH (lactic dehydrogenase) and HCG (human chorionic gonadotropin) that can be suggestive of having testicular cancer. An ultrasound test can show a solid tumour in the scrotum versus a cystic tumour. The biopsy can show exactly what kind of tumour is in the scrotum and it can be done under ultrasound guidance. If the biopsy shows cancer, an orchiectomy can be performed, which is removal of the testicle.
Doctors must determine the stage of cancer. They check to see if the testicular cancer has spread to nearby lymph nodes or to distant body areas by doing a physical examination and possibly a CT scan or MRI scan of the abdomen and groin areas.
Testicular cancer is treated relatively easily with a 95 percent cure rate. It is easier to treat the cancer when it is detected earlier. The mainstays of treatment of testicular cancer include surgery to remove the testicle, radiation therapy and chemotherapy. It turns out that seminomas and non-seminomas are spread and grown differently so they are treated differently. Non-seminomas grow more quickly and metastases must be looked for. Seminomas grow more slowly and are treated relatively easily with surgery and radiation therapy. If the tumour is a mixed type, it is treated as a nonseminoma.
Surgery usually removes the entire testicle with every attempt to spare the other testicle to retain fertility. Infertility is a complication of treatment for testicular cancer, especially if chemotherapy and radiation therapy are done. An artificial testicle can be replaced into the space left by the missing testicle in order for the area to look good cosmetically.
Radiation therapy is best used for those with seminomas. Non-seminomas are not very sensitive to radiation so it is not often used in such cases. Side effects include nausea, loss of appetite and diarrhoea. Fertility is affected for the short term with fertility returning within a couple of years.
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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here