Testicular cancer is rare but could strike in the prime of youth

Mumbai: Every year, nearly 200 men are diagnosed with a rare form of cancer, testicular cancer, at the city’s Tata Memorial Hospital (TMH). Oncologists say this is just the tip of the iceberg, as for want of awareness, many cases go unreported and this could increase the chance of infertility in men, apart from spreading to other organs, eventually resulting in death.

The group most commonly affected by testicular tumours is males aged between 15 and 40 years. Although this form of cancer is rare, it can be cured with timely treatment. The prognosis for those diagnosed is as follows: approximately 90 per cent of those in Stage 1, 70-89 per cent and 60-70 per cent in Stages 2 and 3 can be cured.

Dr Kumar Prabhash, head of the general Euro medical oncology department at TMH, said since this disease is not so common, doctors do not even recognise its symptoms, as it calls for some detailed investigation -- like sonography and a blood test. “The 15-40 age group is a productive phase, so men should take care if their testicles are swollen or their size has changed. They should contact the doctor immediately,” he recommends.

A doctor from Kanpur, who himself is a survivor, says, despite being a doctor he failed to catch the signs -- he consulted other doctors and was diagnosed with hydrocele and underwent surgery. Only later, he learnt he had cancer of the testicles, which needed to be treated immediately, to prevent it from spreading. “When surgery for hydrocele did not work, my family doctor suggested sonography, which revealed it was cancer. In 2017, I came to Tata Hospital for treatment and now, I am completely cured,” he says.

Dr Gagan Prakash, Euro-Onco surgeon, Tata Hospital, said when the patient is diagnosed with cancer, they first check whether it has spread to other parts of the body. “When we get a patient with testicle cancer, first, we check for a tumour in the testicle. If there is one, it is surgically removed. But if there is a possibility of removing it entirely by chemotherapy, then the patient receives chemo,” says Dr Prakash.

Unfortunately, several cases are detected only when the cancer is in an advanced stage. "Though with effective chemotherapy, we can achieve approximately 50-60 per cent rate of cure. In the west, the scenario is completely different. Approximately 80-90 per cent patients come in Stage 1, whereas in our country, 80-90 per cent come when their condition has reached Stage 2 or 3. This is the biggest challenge in treatment,” he says.

Timely detection increases the chance of cure but patients also face financial constraints. "Our effort is to treat such patients so that they can increase their chances of being cured. The management depends upon the stage of the disease," informs Dr Prakash.

Early stage cancer is treated with a single cycle of chemotherapy, whereas slightly advanced and advanced stages of the disease require three and four chemo cycles respectively. After the cycles are complete, a repeat scan is done verify the patient is disease-free. If residual disease is detected, we then opt for radiotherapy or surgery, depending upon the stage of the cancer originally manifested in the patient.

Possible signs to look for

One of the key signs of this disease is a lump or enlargement in either testicle, which can be detected with self-examination. This test is best carried out in a hot shower when the scrotum is relaxed. By rolling each testicle gently between the fingertips, men can note changes in the anatomy. Swelling or a pea-sized lump might indicate an issue and should trigger a visit to the doctor. Keep in mind that the testicles also have blood vessels and other tubes attached to them, so they won't be perfectly round.

Other signs include a feeling of heaviness in the scrotum, a dull ache in the abdomen or groin, a sudden collection of fluid in the scrotum or pain or discomfort in a testicle or the scrotum. Enlargement or tenderness of the breasts and back pain should also be cause for concern.

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