Treatment of testicular cancer abroad
Testicular cancer is a rare malignant tumor of the corresponding organ. Disease incidence in different countries is from 1 to 3 cases per 100,000 people a year. Average age of the patients is about 30 years old.
This illness has a favorable prognosis for the majority of patients on the condition of timely treatment. Full recovery is possible even if the metastasis are present.
Causes of Testicular cancer
It is assumed that the main cause of the testicular cancer development is the anomaly in the organ’s tissue. This leads to the testicular function failure.
The pituitary gland starts to secrete large amounts of gonadotropin hormones to enhance the production of androgens.Continuous stimulation is considered to be a trigger factor for the development of malformation.
Risk factors of the testicular cancer are:
- Cryptorchidism (undescended testicles) is the main risk factor detected among the 10-15% of patients with testicular cancer
- History of infections
- History of traumas or other surgical interventions
- Diethylstilbestrol intake by the mother during the pregnancy (increases the risk of the testicular cancer in child 3 times)
Testicular cancer - Symptoms
Illness has the asymptomatic course among 15% of patients and it is detected only on the advanced stages after the tumor metastasis. For the rest of the patients the main early clinical symptom is an induration of the testicle and appearance of the palpable formation from 1 to 10 centimeters in diameter.
Pain comes later and has a constant monotonous character. Pain can irradiate into the thigh or the groin.
Other symptoms of the testicular cancer that are observed only indiscrete patients are:
- Pain in the groin and back if metastases are spread into the regional lymph nodes
- If the hormone producing tumors are present in the early age– it might be the early puberty
- If the tumor is hormone-producing in the mature age, the gynaecomasty (mammary feminism) can be observed (the male’s breast increase due to the female type)
- If the tumor occurs in the abdominal cavity (on the cryptorchidism background), the symptoms ofintestinal obstruction, acute appendicitis, and bowel cancerare developing
- If the tumor is located in the inguinal canal (with cryptorchidism), there is swelling in the groin, and some patients’ testicles descend into the scrotum
Extragonadal tumors from the testicle cells can develop. They are located in the mediastinum or the retroperitoneal space, causing corresponding clinical manifestations associated with the compression of nearby organs.
If the tumor is located in the mediastinum there is the chest pain, shortness of breath, cough, and pain in the heart. If the testicular cancer is located in the retroperitoneal space,the renal duct is compressed. Clinical sign of it is the decrease in the urine volume with the following anuresis (absence of urine).
Testicular cancer - Diagnostics
Doctor can suspect the testicular cancer after the detecting palpable formation. Palpation with the rolling helps to distinguish the tumor from the dropsy.
Further, non-invasive diagnostics methods are done:
- Diaphanoscopy (transillumination of the scrotum with the light beam)
- Scrotum and pelvic organs ultrasound
- Chest X-ray (for the extragenital tumor detection in the mediastinum)
Invasive diagnostics methods (testis puncture) are rarely used, only in case of the doubtful diagnosis, if the formation is not decreased after 2 weeks of treatment.
In this case, though, the vessels in the inguinal canal are necessarily occludedto avoid the dissemination of the tumor cells.
Laboratory research is aimed at identifying levels of the following components tohelp to detect the testicular cancer:
- β-chorionic gonadotropin
- Lactic dehydrogenase
These markers of the testicular cancer help to determine the therapeutic tacticand assess the life and reproductive function prognosis.
Testicular biopsy is only performed intraoperatively. It allows identifying the histological tumor type which influences on the choice of the therapy.
Treatment of Testicular cancer abroad
Surgery is the main way of the testicular cancer treatment. Patients undergo the high orchiectomy when his testicle, its appendage, the shell, and the spermatic cord up to the deep inguinal ring are removed.
Further treatment tactic is chosen by the doctor on the basis of the histological type of the tumor and the illness stage. Seminoma (testicular germ cells tumor) and nonseminomatous tumors are treated differently.
Treatment methods that are used:
- Radiation therapy (applied if the patient has a seminoma) – lymph nodes are irradiated on one side of the tumor; scrotum is also irradiated in some cases
- Retroperitoneal lymphadenectomy (removal of lymphnodes) is always done if the patient has a nonseminoma to us tumor
More and more of the new treatment methods are being developed for the patients with poor prognosis.
One of the latest achievements is the development of the scheme when the high doses of chemotherapy are used to suppress the metastasis of the testicular cancer.
This type of treatment inhibits the bone marrow, that’s why the patient demands the further treatment with the stem cells for the hemopoietic function recovery.
One of the American research groups hasproved that this way of treatment of the patients suffering from the testicular cancer allows to reach the two-year remission in 63%.
Testicular cancer - Prognosis
Life prognosis is favorable for the majority of patients with the testicular cancer. With the help of the combined treatment full recovery can be reached.
Five-year survival of the patients, depending on the prevalence of the tumor process is:
- Local cancer – 99%
- If the metastasis are spread into the regional lymph nodes – 96%
- If the distant metastasis are present – 73%
The prognosis for the reproductive function is conditionally favorable. Spermatogenesis is restoredamong approximately half of the patients after 12 months.
All patients are recommended to save semenin the Cryobank before the treatment started.