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By Dr. Noorali Bharwani
Two things happened recently: a local personality went public about
his recent encounter with testicular cancer and a pamphlet,
published by the Canadian Testicular Cancer Association (TCTCA),
arrived in my mail box. I thought it was a good topic to discuss
and put the subject in a nutshell (no pun intended).
shaw.ca
Testicular cancer is rare but it is the
most common cancer in young men between the ages of 15-35, says the
TCTCA pamphlet. A young man has a one-in-300 chance of developing
it sometime in his life. In the last 30 years, rates in Ontario
have increased by 60 per cent. The incidence of this disease has
been increasing in developed countries throughout the world for
several decades. We should not forget that testicular cancer can
occur in older men as well.
According to a document released by
Alberta Cancer Board (Cancer in Alberta: A Regional Picture 2007)
the incidence of cancer of male genital organs (testicles, scrotum
and penis) in 2004, excluding prostate cancer, was 8.2 per 100,000
population. Total number of cases was 124 for all three male
genital organs compared to prostate cancer the total number was
1,986 (138.8 per 100,000 population). The document does not give a
separate figure for testicular cancer. But these statistics give
you an idea that the number of testicular cancer is not very
high.
Who gets testicular cancer?
There are several risk factors. These are:
delayed drop of the testicles into the scrotum at birth, a family
history of testicular cancer, abnormal testicular development, some
rare genetic condition or one testicle is significantly smaller
than the other. But some men get the disease with none of these
risk factors.
Early detection of cancer is important.
And this can be done by self-examination after a hot shower when
the scrotum is completely relaxed. Check for any swelling on the
scrotum. Examination of the testicles should not be painful. You
should feel the size and weight of each testicle. It is common for
one testicle to be slightly bigger than the other and one may hang
lower than the other. Examine yourself at least once a month.
What are the signs and symptoms of
testicular cancer?
If you notice any change in size, shape or
consistency of the testicle then you should talk to your doctor.
Quite often (but not always) there is a painless hard lump. You
should be concerned if there is any swelling or pain in the
scrotum, if you notice any heaviness or dragging in the lower
abdomen or scrotum or a dull ache in the lower abdomen and groin,
unusual backache that doesn't go away or you have unexplained
weight loss. Any soreness or sudden unexplained enlargement of the
breast should be checked out. It could be secondary to testicular
cancer. TCTCA warns that some males get testicular cancer without
any of these signs or symptoms.
First line of investigation for a
suspected lump in the scrotum is an ultrasound. If cancer is
suspected then additional blood tests are done to look for tumour
markers. The tumour markers for testicular cancer are AFP
(alpha-fetoprotein), beta-HCG (beta-human chorionic gonadotropin)
and LDH (lactate dehydrogenase).
A definitive diagnosis of testicular
cancer is made by removing the testicle and sending it for biopsy.
Then the cancer is checked for any spread to lymph glands or other
organs. Treatment may include surgery, radiation therapy or
chemotherapy. The cure rate for testicular cancer is greater than
90 per cent for all stages. In men, whose cancer is diagnosed in an
early stage, the cure rate is nearly 100 per cent. Even those with
advanced disease have a cure rate of greater than 80 per cent.
For more information visit:
www.tctca.org.
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Dr. Bharwani is a general surgeon,
freelance columnist and author of A Doctor’s Journey. For his
video blogs and more information please visit: www.nbharwani.com.
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