Ovarian cancer is a type of cancer that begins in the testicle, and testicular cancer symptoms may include cough due to lung involvement.
The female reproductive system contains two ovaries, one on each side of the uterus.
Testicles (male glands) are important reproductive organs that produce sperm for our reproduction in our bags called scrotum under the penis and secrete testosterone hormone to determine secondary sex characters in men.
The male glands are in the abdomen while in the womb and migrate to the eggs close to birth.
Therefore, its veins come from within the abdomen. Testicular cancer is one of the rare cancers seen in approximately 3 men per hundred thousand. It is a disease of young men and is most common between the ages of 25-45. Of course, it can be seen more rarely in childhood and old age.
Testicular cancer develops as a result of uncontrolled proliferation of atypical cells in the testicle. It first invades the egg tissue and creates swelling, then it can spread to the lungs and other organs through the lymph and blood.
What Are The Causes And Risk Factors Of Egg Cancer?
The cause of male gland cancer is not known exactly as it is in other cancers. However, the presence of undescended ovaries in the medical history or surgery for this reason, the history of inflammation in the testicles due to mumps or other microorganisms are important risk factors.
In addition, the presence of a pathological indicator called carcinoma insitu (CIS) in the testicle and the presence of small stones in the testicles (microlithiasis) are stated as risk factors.
If there is cancer in one testicle, the risk of it in the other is higher than normal.
What are the Symptoms of Testicular (Ovarian) Cancer?
Hastalar genellikle bize yumurtasında sert şişlik nedeniyle gelir( Bu gün gelen bir hastamın şikayeti “sol yumurtada pürüzlü diğerine göre kıvamı sert şişlik” şeklindeydi).
Patients usually come to us because of a hard swelling in the egg. (One of my patients, who came to this day, complained of “rough swelling in the left egg compared to the other”).
Pain usually does not occur, but may be painful if there is an advanced or associated inflammation. When we detect a painless hard mass in our testicles, we urgently need to see a urologist. If testicular cancer becomes too large, it may cause compression symptoms.
Since ovarian cancer vessels come from inside the abdomen, it spreads primarily into the abdomen through lymph and blood, and renal tracts may be involved. Side pain may develop on the side it is attached to.
There may be symptoms such as cough and respiratory distress due to lung involvement. If other organs such as bone, brain, liver spread, they may disrupt the functions of those organs and there may be symptoms related to this.
Hard swelling of the eggs seen in patients are among the symptoms of testicular (egg) cancer.
How is Testicular Cancer Diagnosed?
If there is a hard, painless swelling in the testicles, it is assumed that there is cancer until the opposite is proven and additional tests should be requested accordingly.
First of all, a detailed physical examination should be done, including the other testicle and genital area. In addition, the presence of undescended testicular operation and previous infections are very important in the medical history.
Testicular cancer markers including alpha-fetoprotein (AFP), beta human chorionic gonadotropin (B-HCG), lactic dehydrogenase (LDH) and urinalysis are important in blood analysis.
Detailed testicular ultrasound is very important for us to diagnose. At the end of all these processes, when we are convinced that it is egg cancer, we take the diseased egg and send it to pathology. As a result of the pathology, a definite diagnosis is made. Later, lung CT and whole abdominal MRI or CT should be performed to investigate whether distant organ and lymph involvement is present. At the end of all these, staging is done and according to this, it is decided whether the patient will receive additional treatment or not.
How Are Testicular Cancers Treated?
When cancer is detected in the male glands, the first thing to do is to surgically remove the cancerous testicular tissue with its upper connections and send it to pathology for evaluation. After that, the patient is staged and treated accordingly. In addition, it is also important to type the cancer pathologically, that is, which type of cancer it is. Pathologically, the tumor may be seminoma or non-seminoma. Additional treatment varies according to these typing.
In stage I, cancer is limited within the testicle. It did not cause lymph and distant metastasis. Tumor markers may be normal or slightly-moderately elevated. At this stage, there is no need for additional treatment, but strict controls are required. When there are any symptoms in the controls, it is assumed that it has skipped and additional treatment is required.
In stage II, cancer involves lymph nodes other than testis. Tumor markers are mild to moderately high. The first thing to do at this stage is to remove the cancerous testicular tissue. Then chemotherapy is required. Radiotherapy is applied in the seminoma type.
At the end of these treatments, if the lymph nodes are still large and pathological and / or the tumor markers are still not normalized, surgical removal of the lymph nodes in the abdomen, that is, retroperitoneal lymph node dissection (RPLND), is required. We can do this operation both openly and laparoscopically / robotically.
Stage III may have affected the cancer test and the bag we call scrotum. It has also spread to the lymph nodes and lungs. Tumor markers are very high. There may be distant organ metastases.
At this stage, after the tumor tissue is removed, chemotherapy should be taken. If there is still lymph involvement at the end of chemotherapy, the lymph nodes should be cleaned by RPLND surgery. In addition, if there is isolated cancer in the lung after chemotherapy, surgery may be required if it can be surgically removed.
What is the Course of Testicular Cancers After Treatment? How to Follow?
Testicular cancers are cancers that can be treated. If a good staging is done and correct treatments are made, approximately 95-98% of the patients can be treated. Both urology and oncology should take it together. The follow-up, on the other hand, varies according to the type and stage of the tumor, but it is performed every 3 months with tumor markers, chest radiography / CT and a whole abdominal X-ray
Among the ways to prevent testicular cancer, early diagnosis and treatment is very important.
Testicular cancer is one of the most treatable cancers. It is mostly seen on young adults. Usually it affects males from 15 to 45 years old. It is one of the reproductive period cancers.
For this reason, it is very important and usually diagnosed by self-examination. You know how in breast cancer women examine themselves and come to the doctor because there was swelling. Self-examination is very important.
My message here is to examine your own testicles. When you detect any abnormality, make sure to consult a urologist for early diagnosis and diagnosis. This (self-examination) is very important. Then we do ultrasonography of course. Then we do some blood tests that we call tumor markers. After that, our job is easier. But first, self-examination is very important for early diagnosis.
Apart from this, of course, some factors such as genetics and innate factors are effective here. However, I would like to give my message from here in terms of early diagnosis even if we do not get testicular cancer.
There are 3 factors in the staging of testicular cancer. Is one of them a testicular tumor where testicular cancer occurs, isn’t it? Second, is the lymph node involved or not? Third, is there metastases in other organs such as the lung, which we call the distant organ, such as the lymph node? It is important in this respect.
In stage 1, testicular cancer is limited within the testicle. There’s even stage 0. This is known as if no tumor can be seen in the testicle but is suspected. In stage 1, it is limited within the testicle.
Stage 2 has lymph node involvement. In stage 3 and more distant organ metastasis, lung involvement etc. There may be distant organ metastases such as. But when we go according to T staging, stage 1 is limited within the testicle.
In stage 2, if the testis is a little out of the way, in stage 3, there is retention in the part holding the sperm paths, and then all these bags reach the skin, we can also call advanced stage testicular cancer.
In terms of lymph node, it is evaluated according to how many centimeters the lymph node is involved. One of the important factors is the spread of testicular cancer to the abdominal lymph nodes. So the diagnosis is also important in this aspect. Also, is there any lung involvement or not? It is definitely evaluated in this aspect.