Testicular cancer is the most common malignancy in young men (between 20 and 35 years of age). The common term "testicular cancer" covers the whole group of cancers that are divided into germinal and non-germinal tumors. The vast majority of testicular tumors (95-99%) are germ cell tumors. Considering clinical features, they can be divided into seminomas and non-seminomas. Almost all germinal cancers (with the exception of mature teratoma) are characterised by high histological malignancy and aggressive clinical course. They are also one of the few "solid tumors" that can be cured even in advanced stages (with distant metastases). The chance of curing patients with germinal tumors is due to the high sensitivity of these tumors to chemotherapy and radiotherapy. There are two tops of morbidity: the first one concerns men aged 19-29, the second involves men aged 60-75 years.
Testicular tumor is easy to find by palpation (i.e., by touching the testicle), therefore young men are advised to self-check once a month, analogously to self-control, which should be conducted by women at risk of breast cancer. Typical early symptoms of the disease are a perceptible tumor within the scrotum or enlargement of the entire testicle, a feeling of "weight" in the scrotum. Pain or discomfort in the scrotum should also be worrisome. However, in most cases the disease is painless, which results in the fact that patients often ignore the early symptoms and report to the doctor after many weeks (or months). At this point, instead of a simple surgical procedure, they require intensive chemotherapy treatment, and the effects of treatment are often uncertain. It also happens that the patient is aware of the presence of a tumor in the testicle, but due to various psychological defense mechanisms (repression, denial, procrastination) he deceives himself, telling himself that it is a completely different disease. Testicular cancer very quickly gives metastases, and each subsequent week can reduce the chances of healing.
With any suspicion of a testicular tumor, one should visit an urologist, oncologist or surgeon as soon as possible, or undergo testicular ultrasonography. Diagnosis is made on the basis of a scrotal ultrasound, which is able to visualise testicular tumors in almost 100% of the cases. In addition, the concentrations of marker hormones (Alpha fetoprotein, Beta HCG and lactate dehydrogenase) are determined, which allow initial assessment of the advancement of the disease. It is necessary to perform a chest and lung X-ray, because the distant metastases are usually located there.
The first stage of treatment is orchidectomy, i.e. removal of the affected testicle together with epididymis and spermatic cord from inguinal approach. This is a simple procedure performed under general or ductal anaesthesia and requires staying in the hospital for 1 to 3 days. The results of the histopathological examination are available after about 2-3 weeks. Postoperative management depends on the severity of the disease, which should be determined before or immediately after surgery. In addition, the patient's qualification to one of the prognostic groups and the presence of risk factors also play a significant role. All patients after the surgical treatment of testicular tumors remain under constant urological and oncological care and, if necessary, undergo additional treatment.
Qualifications for the procedures are carried out by Dr Piotr Dzigowski at the Hospital Consultation Centre, the visit lasts 20 minutes and the cost of the visit is 190 PLN.