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What Is Testicular Cancer and How Does It Develop?

Testicular cancer originates in the testicles, the male reproductive glands located in the scrotum. It typically begins when healthy cells in a testicle undergo abnormal changes and grow uncontrollably, forming a tumor. The most common type is germ cell tumors, which include seminomas and non-seminomas. Testicular cancer is relatively rare but is the most common cancer in males aged 15 to 35. Fortunately, it is one of the most treatable and curable forms of cancer, especially when diagnosed early.

What Causes Testicular Cancer and Who Is at Risk?

The exact cause of testicular cancer is not fully understood, but several risk factors have been identified. These include undescended testicles (cryptorchidism), family history of testicular cancer, previous testicular cancer, and abnormal testicular development, such as Klinefelter syndrome. It is more common in white men than in men of other races, and in individuals with certain genetic predispositions. Exposure to environmental toxins or hormonal imbalances may also play a role.

What Are the Symptoms of Testicular Cancer?

The most common symptom of testicular cancer is a painless lump or swelling in the testicle. Some men may also experience a feeling of heaviness in the scrotum, a dull ache in the lower abdomen or groin, or sudden fluid buildup in the scrotum. In more advanced stages, symptoms may include back pain, shortness of breath, or swelling in the legs, depending on where the cancer has spread. Early detection through self-exams and medical evaluation is crucial.

How Is Testicular Cancer Diagnosed?

Diagnosis begins with a physical examination of the testicles by a doctor, followed by an ultrasound to visualize any masses. Blood tests are then performed to detect tumor markers such as AFP (alpha-fetoprotein), hCG (human chorionic gonadotropin), and LDH (lactate dehydrogenase). If cancer is suspected, surgical removal of the affected testicle (orchiectomy) is typically performed for both diagnostic and therapeutic purposes. Additional imaging like CT scans helps determine if the cancer has spread.

What Are the Main Treatment Options for Testicular Cancer?

Treatment for testicular cancer depends on the type and stage of the disease. The most common first step is radical inguinal orchiectomy, which involves the surgical removal of the affected testicle. Depending on the cancer type, further treatments may include radiation therapy (especially for seminomas), chemotherapy (commonly for non-seminomas or metastatic disease), or retroperitoneal lymph node dissection (RPLND) to remove affected lymph nodes. Multimodal treatment approaches often lead to high success rates.

What Is the Role of Chemotherapy in Testicular Cancer Treatment?

Chemotherapy is a powerful systemic treatment used to kill cancer cells that may have spread beyond the testicle. It is often recommended for advanced-stage testicular cancer, especially in non-seminomatous tumors or when tumor markers remain elevated after surgery. Common chemotherapy drugs include bleomycin, etoposide, and cisplatin. While chemotherapy is highly effective, it may also cause side effects such as fatigue, nausea, hair loss, and increased infection risk, all of which are manageable under medical supervision.