Testicular Cancer Case Studies

Testicular Cancer Case Studies

The testicles are male sex glands. They are located behind the penis in a pouch of skin called the scrotum. The testicles produce and store sperm, and they are also the body’s main source of male hormones. These hormones control the development of the reproductive organs and other male characteristics, such as body and facial hair, low voice, and wide shoulders.Testicular Cancer Case Studies
Cancer is a group of more than 100 diseases. Although each kind differs from the other in many ways, every type of cancer is a disease of some body ?s cells. Testicular cancer is a disease in which cells become malignant (cancerous) in one or both testicles.
Testicular cancer is one of the most common cancers in young men between the ages of 15 and 35, but the disease also occurs in other age groups, so all men should be aware of its symptoms. While testicles cancer is common among young men, young men typically do not get a lot of cancer, so overall testicular cancer is a relatively rare disease.
In the year 2000, an estimated 7600 cases of testicular cancer are diagnosed in the United States, and a little less than 400 of them died. Caucasians are more likely to get it than Blacks or Asians. Disturbingly, the incidence of testicular cancer around the world has basically doubled in the past 30 to 40 years.
Testicular cancer can be broadly classified into two types: seminoma and nonseminoma. Senomas make up of 30 percent of all testicular cancers. Nonsminoma are a group cancers that include choriocarcinoma, embryonic carcinoma, teratoma, and yolk sac tumors. A testicular cancer may have a combination of both types.Testicular Cancer Case Studies

2. Causes
So far, research has not shown a connection between testicular cancer and any particular habits, activities, or lifestyle, there is evidence that the risk of testicular cancer is higher in whose testicles did not descend normally- that is, move down from lower abdomen into the scrotum, for this reason, surgery is often performed to correct this problem before the testicle has been left undecided for very long. It has even said that the risk o testicular cancer may by higher in men infected with HIV, the virus that causes AIDS, but evidence for this is weak.Testicular Cancer Case Studies
Although the exact causes are not known, there several predisposing factors may place some men higher risk, these include past medical history of undescended testicle, mumps orchitis, ingunal hernia during childhood, or previous testicular cancer on other side. Frequently, testicular tumors are noted after an episode of trauma however, trauma is not believed to be a causative or predisposing factor.
Testicular cancer is not contagious, no one can catch it form another person. Exactly what cause this disease is unknown and seldom can it be explained why one person gets it while another doesn’t. Research does show that some men are more likely than other to develop cancer. For example, the risk is higher than average for boys born with their testicles in the lower abdomen rather than in the scotrum. The cancer risk for boys with these conditions is increased regardless of whether the condition is corrected, and in fact, the risk exists even in the normal testicle. The theory is that the increased risk of testicular cancer is due to whatever caused the descended testicles, not just by the fact that the testicles was undescended.
Some men whose mother took a hormone called DES (diethylstilbestrol) during pregnancy to prevent miscarriage have testicular abnormalities. But scientists have never proven that prenatal exposure to DES (or any other female hormone) increases the risk of testicular cancer. Some patients with testicular cancer have a history of injury to the scrotum. But again, no one whether such an injury can cause cancer. Many doctors think such an injury simply calls attention to a tumor that was already growing.Testicular Cancer Case Studies

Testicular cancer develops in the tissues of either one or both the testicles in men. Testicles are the male reproductive glands and are located in the scrotum (ADAM Medical Encyclopedia, 2011). Men between the age groups of 15 and 35 are found to be more prone to this disease. Though it is more common among young or middle-aged men (National Cancer Institute, 2012), its incidence in older men and younger boys cannot be ruled out. Around 8,000 men are diagnosed with testicular cancer each year in the United States and around 2,000 each year in UK (Cancer Research UK, 2009). Studies also suggest that Caucasian men are at a larger risk of developing testicular cancer. Testicular cancer is one of the few topics that are rarely talked about. Every hour a man is diagnosed with testicular cancer (Testicular Cancer Awareness foundation, 2009). This could be avoided to a large extend if proper awareness is created among men especially young adults. This review is an attempt to understand the degree of awareness that is present and identify ways to improve awareness among young adults. Testicular Cancer Case Studies

Compared to other types of cancers, the chances of a man developing testicular cancer is very less, roughly 0.4%. Though the exact causes of this cancer is still a mystery there are certain factors are believed to increase a person’s chance of developing this disease. Some of these factors are discussed below.

Cryptorchidismand Its Causes

Cryptorchidism also known as undescended testicle is a condition where in some males, the testicles do not move from inside the abdomen in to the scrotum. Normally this process happens before birth. There are surgical procedures to rectify this condition but still the risk of developing testicular cancer remains. Congenital abnormalities are another factor. These refer to abnormalities of penis, testicles, kidneys as well as hernia in the groin area. Testicular cancer is also believed to be hereditary. Men with a history of testicular cancer face a higher risk of developing cancer in the other testicle also (“Testicular Cancer,” 2012).

One of the most common symptoms of testicular cancer is a lump or swelling in the testicle. This lump is usually painless. Some people develop pain in the affected area and some develop back ache specifically in the lower abdominal area. A feeling of heaviness and the testicle becoming swollen and tender are also specified by some patients. Not every lump is a cancer. It is quite common for men to have small crystal like swellings in testicles which are not harmful. Proper diagnosis and confirmation can be done by a doctor. There are procedures like biopsy and ultrasound tests that can help the doctor look inside the scrotum (American Cancer Society, 2011).Testicular Cancer Case Studies

It Is Important To Create Awareness on How Testicular Cancer Can Spread


Testicular cancer can spread to other parts of the body if left untreated. The most common type of testicular cancer is the germ cell tumor. Germ cells are the cells responsible for making sperms. Seminomas and non-seminomas are two types of germ cell tumors. The seminomas are slow-growing form of cancer while the non-seminomas are quicker and the more common type of testicular cancer seen (ADAM Medical Encyclopedia, 2011). Cancer that develops in the stroma of the testicles is called gonadal stromal tumor. Stroma is the hormone-generating supportive tissue of the testicles. Stromal cancer is of two types – the Leydig cell tumors and the Sertoli cell tumors. Leydig cell tumors develop in the leydig cells that are responsible for making male sex hormones. These tumors can produce an excess of estrogen or androgen in the patient. Estrogen-producing tumors results in loss of sexual desire and excessive growth of breasts. The symptom of androgen-producing tumors is excessive hair growth in the face and body at an early age. Sertoli cell tumor which is another type of stromal cancer develops from the sertoli cells which are responsible for supporting and nourishing the germ cells. These tumors do not generate hormones and often are not cancerous (ADAM Medical Encyclopedia, 2011). Cancer which has spread to other parts is called metastatic cancer. Most often testicular cancer spreads to lymph nodes and lungs. Though rare, this spreads to other organs like liver, bones and brain (NHS Choices, 2010). The symptoms of metastatic cancer include persistent cough, spitting of blood while coughing, shortness of breath, enlargement of breasts accompanied by swelling in the breast area, swelling or lump in the neck and lower back ache.

Treating Testicular Cancer

There are surgical and non-surgical methods for treating testicular cancer. The surgical procedure removes the affected testicle. An artificial testicle can be inserted in the scrotum if needed to give it a normal appearance. Testicular cancer diagnosed during the early stage can be completely cured by surgery. Chemotherapy and radiotherapy are the non-surgical treatments used. These methods are more effective in treating cancer that has spread to other parts. In chemotherapy, medicines are used in several doses over several weeks to destroy the cancer cells (Bupa’s Health Information Team, 2011). Chemotherapy is also recommended by doctors after surgery to reduce the risk of the cancer returning and before surgery to reduce the size of the tumor. Radiotherapy uses radiations to destroy cancer cells.Testicular Cancer Case Studies

Studies show that there is a 97 – 100% survival rate among patients with stage I testicular cancer (Albers et al., 2009). But the after effects of developing testicular cancer and the successful treatment are gruesome. One of the most obvious outcomes is the impact on fertility. Men with testis tumors exhibit sperm abnormalities. Chemotherapy and radiotherapy also has a negative impact on fertility of the patient. Some hospitals offer their patients an opportunity to store their sperm before going ahead with the treatments. Other side effects include psychological issues. The person might start feeling that he is exhibiting low sex drive or reduced sexual function. Men who had to get both the testicles removed are given testosterone replacement therapy. This is needed because testosterone gives men their normal libido. Low levels of testosterone can also cause mood swings and tiredness. Tablets, injections and gels are the normally used methods for testosterone replacement therapy. Tablets are often not absorbed well and hence not used nowadays. Injections are very effective but need to be taken every two weeks. Skin patches or gels are the latest method used for testosterone replacement. Though this is the most preferred method, it causes skin irritation in some men (“Sex and Testicular Cancer’” 2012). Retrograde ejaculation is a side effect seen in men who had undergone a retroperitoneal lymph node dissection where the lymph nodes are taken to the back of the abdomen. This procedure is done if the lymph nodes are enlarged after radiotherapy or chemotherapy. Retrograde ejaculation is nothing but ejaculating backwards. The sperm and semen instead of coming out of the penis goes back into the bladder. The person with this side effect experiences dry orgasms and is infertile.

Another matter of equal concern is the effect the treatment has on the person’s sexual partner. Not much is known regarding the amount of drugs taken during chemotherapy that comes through in the semen. Doctors suggest the use of condom during and for three months after the chemotherapy treatment. Experts also suggest taking precautions to prevent pregnancy during and for a while after chemotherapy and radiotherapy. There is a very high chance that the sperm is affected and the baby will suffer abnormalities. A very important drug used in chemotherapy – cisplatin – causes damage to the kidneys (“Testicular Cancer, After Treatment,” 2012). Less than 10% of men undergoing chemotherapy develop Raynund’s phenomenon. This is a condition where the blood vessels especially in the hands start narrowing and the skin turning white, blue and then red when exposed to triggers like cold. Men undergoing radiation therapy have an increased risk of heart disease.

Research also suggests that men who had received radiation therapy for testicular cancer had twice the chance of being diagnosed with secondary cancer compared to other men and men receiving chemotherapy had 80% chance. Chemotherapy is also believed to cause chemobrain, a condition where the subject has trouble concentrating. This is an area where ongoing research is happening and experts are not clear whether undergoing treatment for testicular cancer indeed increases the chance of developing other cancers and cardiovascular diseases.Testicular Cancer Case Studies

Why Is Early Diagnosis Important?

An early diagnosis of the tumor can help one to stop the advancement of the cancer. The most commonly suggested method is regular testicular self-exam (WebMD LLC, 2010). Self-exams should be done after a warm shower since warmth causes the skin of the scrotum to soften. Change in shape, size or consistency of the testis or the occurrence of lumps can suggest tumors that can develop to cancer. As per a study lead by researchers from the Fred Hutchinson Cancer Research Center in Seattle, Washington suggest that there is a link between the use of marijuana and occurrence of testicular cancer(Catharine Paddock, 2009). Men with HIV is also said to have a 35% increased risk of developing testicular cancer.

Conclusion


There are suggestions regarding the link between diet and the incidence of testicular cancer. Some suggest that diet has an influence on developing of testicular cancer and some suggest obese men are at a higher risk. It is generally agreed upon that a healthy diet which is low in fat and high in fresh fruits, vegetables and whole grains can help prevent different types of cancers that might include testicular cancer.Testicular Cancer Case Studies

Whatever the general view regarding prevention of cancer, a healthy life style is essential to stay healthy. There is a need for proper awareness especially among young boys since they are at a higher risk of indulging in the habits of using drugs, smoking, sex with multiple partners and following an unhealthy diet.

Almost half of the risk of developing testicular cancer comes from the DNA passed down from our parents, a new study reports.

The research suggests genetic inheritance is much more important in testicular cancer than in most other cancer types, where genetics typically accounts for less than 20% of risk.

The findings suggest testing for a range of genetic variants linked to testicular cancer could be effective in picking out patients who are at substantially increased risk – potentially opening up ways of preventing the disease.Testicular Cancer Case Studies

Scientists at The Institute of Cancer Research, London, along with colleagues in Germany, Sweden and the US, used two independent approaches to analyze the risk of testicular germ cell tumors – easily the most common type of testicular cancer.

Their research, published in the journal Scientific Reports and funded by the November Foundation, the ICR and Cancer Research UK, is the largest study ever to explore testicular germ cell tumors in detail.

Researchers first used statistical analysis to examine patterns of ancestral testicular cancer in family groups across 15.7 million people from the Swedish Population Registry cancer family database, including 9,324 cases of testicular cancer.

They then looked in detail at the genetic code of 6,000 UK men from two previous testicular cancer studies, 986 of whom had been diagnosed with the disease.

The combined analysis revealed that 49% of all the possible factors contributing to testicular cancer risk are inherited.

It found that the inherited risk comes from a large number of minor variations in DNA code, rather than one faulty gene with a big effect.

Although substantial inroads have been made over the last five years at the ICR into identifying mutations associated with risk of testicular cancer, the study also showed that these known mutations only account for 9.1% of the risk of developing the disease. Therefore the majority of the genetic variants that raise testicular cancer risk have yet to be identified.Testicular Cancer Case Studies

Identifying more of these ‘hidden’ mutations could allow doctors to screen men for testicular cancer risk, increasing the chance of preventing the disease or catching it early.

Dr Clare Turn bull, Senior Researcher in Genetics and Epidemiology at the ICR, said: “Our study has shown that testicular cancer is a strongly heritable disease. Around half of a man’s risk of developing testicular cancer comes from the genes he inherits from his parents – with environmental and behavioral factors contributing to the other half.

“Our findings have important implications in that they show that if we can discover these genetic causes, screening of men with a family history of testicular cancer could help to diagnose those at greatest risk, and help them to manage that risk.

“But our study also shows that much work remains to be done. There are a lot of genetic factors that cause testicular cancer which we are yet to find – so the first step must be to identify the genetic drivers of testicular cancer so we can develop new ways to prevent it.”Testicular Cancer Case Studies

Sam Gledhill, November Foundation Testicular Cancer Program Manager, said: “This is a significant development in the fight for a world where no man dies of testicular cancer. Dr Turn bull and her team at the ICR have generated important evidence to demonstrate that genetic factors might in the future help identify men and boys who have a higher risk of developing testicular cancer. These discoveries help to unlock the mysteries of this relatively poorly understood cancer and may ultimately identify potential treatment targets to fight this disease.

What is testicular cancer?

Testicular cancer occurs when cells that aren’t normal grow out of control in the testicles (testes). It is highly curable, especially when it is found early.

The testes are the two male sex organs that make and store sperm. They are located in a pouch below the penis called the scrotum. The testes also make the hormone testosterone.Testicular Cancer Case Studies

Testicular cancer is rare. But it is the most common cancer among young men.

Most testicular cancers start in cells that make sperm. These cells are called germ cells. The two main types of testicular germ cell cancers are seminomas and nonseminomas. Seminomas grow and spread slowly and respond to radiation therapy. Nonseminomas grow and spread more quickly than seminomas. There are several different types of nonseminomas.

This topic covers seminoma and nonseminoma cancer. It does not cover non-germ cell testicular cancers, such as Leydig cell tumors.

What causes testicular cancer?

Experts don’t know what causes testicular cancer. But some problems, such as having an undescended testicle or Klinefelter syndrome, may increase a man’s risk for this cancer. Most men who get testicular cancer don’t have any risk factors.Testicular Cancer Case Studies

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