testicular cancer

Introduction

Introduction to testicular cancer Testicular cancer refers to a malignant tumor formed by the cancerous cells of the testes. The testes are the two gonads of men. They are responsible for the manufacture and storage of sperm and are also a major source of male androgen. The testes are located within the scrotum structure under the penis. Testicular cancer accounts for 1% of the total number of male carcinoid cancers. Testicular cancer is more common in men aged 15-39 years and is the most common cancer in men between 20 and 34. However, the cure rate of testicular cancer is very high, and the survival rate can reach 95% or even higher. Therefore, in the field of oncology, testicular cancer is a very important malignant tumor. basic knowledge The proportion of sickness: 0.022% - 0.04% Susceptible people: good for adult males Mode of infection: non-infectious Complications: male breast hypertrophy

Cause

Causes of testicular cancer

As one of the high-risk cancers among young men, the cause of testicular cancer is not known. According to statistics, the incidence of male testicular cancer is 100,000 points and is increasing year by year. The reason is usually caused by metastasis of malignant tumors.

Testicular cancer has the following common types of pathogenic factors:

Testicular cancer is mainly divided into two categories: spermatogonia and non-spermatogonia. Spermatogonia cancer accounts for 30% of the total number of testicular cancers. Non-spermatogonia includes choriocarcinoma, germ cancer, teratocarcinoma and yolk sac tumors.

Cryptorchidism (25%):

Normally, the testicles will fall to the scrotum. If the testicles do not fall to the scrotum and remain in the abdominal cavity or groin, the chances of men with testicular cancer will increase significantly. Even if the testicles are moved to the scrotum by surgery, it will not help.

There has been a history of testicular cancer (25%):

Another testicle in men with a history of testicular cancer is susceptible to testicular cancer. The family has a history of testicular cancer: if someone has a testicular cancer, his chances of getting the disease are higher than others.

Testicular dysplasia (15%):

Men with abnormal testicular development are susceptible to testicular cancer.

Genetic factors (15%):

Studies have shown that the occurrence of testicular cancer is related to genetic factors.

Klinefelter's Syndrome (10%):

People with Klinefelter's syndrome (a sex chromosome abnormality with low levels of male hormones, infertility, breast fullness, and small Testes) are predisposed to testicular cancer.

Prevention

Testicular cancer prevention

Tumors are closely related to diet, personality, and environment.

Diet is the most dangerous to grow and breed foods with hormones. Secondly, cooking is not right. Dietary foods such as barbecue, fried, fried, and too greasy are also the root causes of cancer; some foods that are grown with pesticides and fertilizers should also be avoided. Overnight meals should not be eaten, containing carcinogenic nitrites.

Personality has a great influence on the testicles. Because the testis area belongs to the endocrine system, personality is easily affected. Clinical investigations have found that a large number of people with testicular hyperplasia or tumors have a negative personality, are not cheerful, and have long-term depression and depression. On the contrary, there are fewer chances of being in a good mood. Attention should be paid to venting emotions, not suppressing, and being proactive in thinking about problems in life. For example, actively seek the solution of the problem instead of waiting for the solution of the problem.

In terms of the environment, there is less exposure to air pollution or work. In addition, the radiation machine should be properly kept away: for example, computers, induction cookers, microwave ovens, and mobile phones should be kept away from the sleeping area; for places with loud noises, keep them away.

Complication

Testicular cancer complications Complications Male breast hypertrophy

Testicular tumors are mainly lymph node metastasis, which is common in the iliac crest, iliac crest, para-aortic and mediastinal lymph nodes. The metastases can be large, the abdomen can be touched, and the patient complains of waist and back pain. In patients with testicular villus cancer, breast hypertrophy and nipple areola hyperpigmentation may occur.

Symptom

Testicular cancer symptoms common symptoms scrotal swelling testicular pain cystic mass

1. There is a painless mass in the testicles;

2, the scrotum has a heavy feeling;

3. The testicles are swollen;

4. Pain in the lower abdomen, back or groin (joining part of the thigh and abdomen) of the male;

5. The liquid in the scrotum suddenly increases;

6, other testicular symptoms.

Examine

Test for testicular cancer

It is most important to check the testicles during a physical examination. The basic signs are:

1 testicular swelling, some testicles are completely replaced by tumors, although smooth, but the normal elasticity disappears, generally no significant tenderness.

2 testicular tumors are often solid lumps, sometimes the patient's bilateral testicles are similar in size, but the affected side has a significant sense of heaviness compared with the healthy side.

3 The light transmission test was negative and there was no fluctuation. However, a small number of advanced patients develop hematoma due to the influence of the tumor on the sheath, and the effusion or tumor bleeding. In the past, it was advocated that the hydrocele was punctured and then examined carefully. It has not been used yet, and it is advocated for surgical exploration to avoid injury to the tumor. The planting is caused by piercing the layers of the membrane, which affects the therapeutic effect.

In addition to checking the scrotum, other parts of the body should be carefully examined, especially if there is a lump in the abdomen, whether the liver is swollen, there is no edema in the lower extremities, and the lymph nodes in the supraclavicular area are swollen. As long as the examination is careful and careful, there is no difficulty in diagnosis.

1. Determination of tumor markers: The level of tumor markers in blood can be measured. A tumor marker is a substance produced by a tumor cell or a human body in the presence of cancer. Such as alpha fetoprotein (AFP), human chorionic gonadotropin (B-HCG), alkaline phosphatase (AKP) and the like. These tumor markers can help detect testicular tumors.

2, ultrasound: B-ultrasound can accurately distinguish the size of the testis, morphology, with or without a lump, can also distinguish the swollen testis is inflammation, tissue edema, or tumor, but also detect the presence or absence of metastatic tumor after the peritoneum .

3. Biopsy: Biopsy is the only test that can determine the presence of cancer. In most cases, when a biopsy is performed, the doctor cuts the groin and removes the entire affected testicle. This method is called radical inguinal orchiectomy. Sometimes (if the patient has only one testicle), the doctor will use a groin biopsy. During the examination, the doctor first cut a small opening in the groin to obtain a part of the testicular sample, and the orchiectomy was performed only when the cancer was found by pathological examination. If the patient is diagnosed with testicular cancer, some tests are needed to determine if the cancer has spread to other parts of the body, such as B-ultrasound, X-ray, CT, etc. The appropriate treatment can be determined by staging the cancer.

Diagnosis

Diagnosis and differentiation of testicular cancer

The diagnosis of testicular cancer includes laboratory diagnosis, imaging diagnosis and pathological diagnosis:

Laboratory diagnosis : mainly for serum -HCG, AFP and LDH detection, these serum tumor markers are important for treatment, follow-up and prognosis. -HCG is synthesized by syncytiotrophoblast cells with a serum half-life of 24-36 hours, which is elevated in the blood of patients with choriocarcinoma, embryonal carcinoma and spermatogonia. AFP elevation is seen in pure embryonal cancer, teratocarcinoma, yolk sac tumor and mixed tumor, but pure choriocarcinoma and pure spermatogonia do not synthesize AFP. The serum half-life of AFP is 5-7 days. Elevated LDH can be seen in testicular tumors, but its sensitivity and specificity are not high, and the degree of elevation can be used to indicate the severity or extensive extent of the lesion, and the increase after treatment may also suggest recurrence. The time required for LDH to fall to normal can predict the patient's prognosis, especially for intermediate-risk patients, the longer it falls to normal, the worse the prognosis.

Imaging diagnosis : scrotal B-ultrasound can help confirm the mass in the testis, which is the clinical preferred method. Abdominal pelvic CT was used to understand lymph node metastasis, chest radiographs and CT were used to assess the presence or absence of lung metastases. Therefore, abdominal/pelvic CT is an important basis for the staging of all patients. The positron emission tomography (PET) has high sensitivity and specificity for the evaluation of residual tumor after treatment in the follow-up after treatment.

Pathological diagnosis : Although the needle biopsy of the testicular tumor can be clearly diagnosed, there is a risk of tumor metastasis, so the scrotal testicular biopsy should be prohibited.

The differential diagnosis of testicular cancer includes epidermal or dermoid cysts in the testis, testicular torsion, epididymitis, epididymis-orchitis, hydrocele, and the like.

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