How is Testicular Cancer Diagnosed?
Determining the true nature of testicular growths
Roughly 10,000 men are estimated to be diagnosed with cancer of the testes each year, out of which roughly 400 are expected to succumb to the disease according to statistical cancer projections. If the prevalence of testicular cancer compared to the overall population appears on the lower side, the ratio of men surviving testicular cancer compared to other cancers is on the higher side – approximating 95 percent. The good news is that survival is guaranteed if testicular cancer is diagnosed early before it has spread to other organs.
The testes are paired, egg-shaped male reproductive organs located beneath the penis. They manufacture human sex cells called, and they also secrete copious quantities of testosterone, the male personality defining hormone. Sometimes, instead of producing sperm cells, the base cells also called germ cells start replicating themselves endlessly. The result is a cancerous lump or tumor that swells and hardens the testes from within.
As long as testicular cancer remains confined to the testes (either one or both), it may pose little problem beyond swelling, pain and positional discomfort. If diagnosed early, this is the stage that enables corrective action and boosts the survival rate. Progression of cancer to stages II and III brings out more serious symptoms when tumor cells migrate to other regions of the body such as the lungs or kidneys through the lymphatic system. As the early diagnosis is crucial to near complete recovery, read on about how you can tread the path of caution via self-examination and medical analysis.
Discussing your personal and family medical history
If you are a firm believer in the adage that prevention is better than cure, do not hesitate to discuss reproductive problems with a qualified medical practitioner, preferably a good urologist. Pain, and swelling in the testes or symptoms of heaviness and fluid accumulation in the scrotum should not be overcome using OTC medications. Self-medication only relieves the symptoms without curing the underlying issue. You really should see a doctor immediately.
If your father or brother or any other male member of the family suffered medical issues associated with the reproductive system, bring it to the attention of the urologist. Certain health issues that are genetically transmitted and also result in physical abnormalities like undescended testes or a dwarfed penis are actually high risk factors for developing testicular cancer. Discussing personal and family history helps the physician identify prominent risk factors and formulate a proper risk management strategy to move you out of danger.
Conducting a physical self-examination
Performing a self-examination on a monthly basis relieves anxiety. The best occasion for self-examination is the period immediately after a warm bath when the testes hang loosely in the scrotal folds and are more amenable to palpation.
- Holding the penis to one side, examine each testicle separately.
- Cup the testicles in one palm while using the thumb and opposing fingers of the other hand to feel the surface as the testes are rolled gently.
- Closely touch and feel the testicles for irregular bumpy protrusions or evidence of swelling. At the same time, do not confuse a ridge like bump of the epididymis for a tumor. It runs along the central portion at the back of the testes.
- Fluid may fill the scrotal sac, swelling the testes appreciably, but this is mostly a benign condition called hydrocele that does deserve medical attention.
- The vein draining the testicles may also enlarge, causing a discomfiting condition called varicocele.
Performing self-examination as a matter of routine enables you to understand what is normal and compare your condition when an abnormality surfaces.
The urologist will be better equipped to deduce your medical condition after physical palpation if he suspects that you have abnormal testicles. Swelling and pain could also be due to a viral or bacterial infection that causes testicular inflammation (orchitis) or swelling of the epididymis (epididymitis). If suspicions of cancer are heightened, the best option would be an ultrasound examination.
1. Ultrasound screening
Using specialized equipment, sound waves are bounced off softer tissues and are reflected back as images of an organ’s internal structure. The procedure is painless and does not expose the patient to radiation. The urologist gets a fairly detailed image of the inner tissues of the testes, and this is useful in detecting tumorous growths.
2. Biopsy of testicular tissue
If an ultrasound screening reveals the contours of a growing tumor, the physician may require further confirmation of malignancy, which is possible by pathological evaluation of a tissue sample. A fine needle is inserted under local anesthesia to take out a sample of the inner lining of the testes tubules. It is possible to confirm the malignancy and the exact stage of growth of the tumor. Since this procedure runs the risk of spreading cancer via the lymph nodes to other parts of the body, it is rarely used in initial stages of evaluation.
3. Blood tests to measure tumor markers
If the needle of suspicion points to a cancerous growth in the testes, further confirmation can be obtained through blood tests. Tumor markers are used to confirm the presence of cancer by identifying certain proteins like alpha-fetoprotein (AFP) and beta human chorionic gonadotropin (ß-HCG) that are released in blood serum in large quantities when tumor cells actively divide and proliferate.
4. Imaging Tests
A computed tomography or CT scan uses radiation for imaging the lymph nodes in the groin, lungs and abdominal area to assess whether testicular cancer has spread to other parts of the body. This is an important tool for diagnosing the stage of testicular cancer.
An MRI scan will be useful in ascertaining whether testicular cancer has spread to the brain and spinal tissue when symptoms indicate their malfunctioning.
A bone scan may be recommended to ascertain if cancer has invaded the bone marrow. In this procedure, a safe radioactive dye is intravenously injected which shows up on a lighted screen as clusters where bone changes are brought about by spreading tumors.
In a PET scan, a radioactive sugar is injected intravenously. The dye shows up on screen as concentrated clusters where active tumor cells use the sugar to grow. This test is useful in locating certain types of testicular tumors.
5. Surgery Assisted Diagnosis and Removal of the Testes
Unlike other cancers, testicular cancer does not allow a risk-free tissue biopsy to confirm a cancerous growth. This is mainly because a testicular biopsy is known to provoke tumor cells to drain out through the lymphatic system and spread to other parts of the body.
This leaves the surgeon no option but to surgically remove the testes through an operation called radical inguinal orchiectomy. Through an incision made in the pubic region, the testicles along with the spermatic chord are pulled out after severing the chord permanently to stop cancer from spreading.
When a diagnosis is inconclusive regarding cancer, the surgeon will pull out the testes without severing the spermatic chord. He takes a sample of the tissue from the suspected tumor for cytological analysis. If evaluation confirms cancer, the testes and chord are removed. If the results rule out cancer, the testes can be reinserted back in the scrotal sac after removing the growth or swelling, and the procedure is followed up with medication.
When cancer is detected, the surgeon may order repeat scans after the surgery to ascertain whether cancer has spread to the lungs or other organs.