What is testicular cancer?

The testicles are the organs in which sperm formation occurs in humans and some male hormones (they have a function similar to that of the ovaries in women).
The two testes are contained in the scrotum, a bag of skin located directly under the penis.Testicular cancer is a rare form of male cancer, where cancer cells are formed from the tissues of one or both testicles.top

How widespread
Testicular tumors are about 1 percent of the total and 3-10 percent of those affecting the male urogenital apparatus. According to the epidemiological surveillance network of the United States over the past 30 years there has been an increased frequency of testicular cancer by about 45 percent, but mortality has fallen by 70 percent, reflecting the significant progress achieved in the therapy of this specific tumor in 1970, 90 percent of patients with testicular cancer died, while the nineties, thanks to the introduction of new drugs, the situation was reversed, and today 90 percent of men with cancer can be spread treated.top

Who is at risk
The causes of testicular cancer remain unknown, although several risk factors may favor him. Among these the principal is cryptorchidism, ie, undescended testes in the scrotum of one of which remains in the abdomen or groin. 
This condition increases the likelihood of malignant transformation of cells up to 40 times the general population, the risk varies depending on the seat of cryptorchidism: if the testis is high in the abdomen and lower if it is in the groin. The chances are further reduced if the fault is corrected surgically before the age of six.
Another important risk factor is Klinefelter syndrome, a defect of the chromosomes. Finally, men who have had testicular cancer have a 2 to 5 percent chance of developing cancer in the other testicle in the same 25 years after its diagnosis.top

TypesTesticular tumors are divided into two types: seminomas and non-seminomas.
The former are about half the cases and then turned consist of malignant germ cell, ie those which give rise to sperm, are frequent in the fourth decade of life and are often associated with a variant that also involves non-seminal cells (in this case one speaks of mixed germ forms).
The other, non-seminomas, including four different forms: embryonic carcinomas, the choriocarcinoma, teratomas and yolk sac tumors, associated with that part of the embryo that contains material reserves for its nourishment.
The prognosis and treatment are different depending on the type of cancer.top

Symptoms
The tumor usually begins with a nodule, an increase in volume, a swelling or a feeling of heaviness in the testicle.
For this reason it is important that people learn to do self-examination of the testis (as women do breast self-examination) palpating the organ from time to time to discover any faults in time.
Even the sudden appearance of a sharp pain in the testicle is typical of this tumor, together with a rapid increase in the volume that can be caused by a hemorrhage into the tumor. Conversely, even the shrinking of the testicles can be a sign of disease onset.
Finally, it is important that parents monitor the children's pediatrician, as a correction of any incomplete descent of the testis within the first year of life reduces the risk of cancer and facilitate early detection of cancer.top

Prevention
For germ cell tumors of the testis, there are no organized prevention programs.The same tumor markers such as beta-HCG and alfafetoproteina (ie substances that can be found in the blood in the presence of this type of cancer), which help confirm the diagnosis and to follow the time evolution of the disease, no use in early diagnosis .
However, given the young age of the population at risk, we must emphasize the importance dell'autopalpazione testis, with attention to any modification of the anatomy or shape of the scrotum.
Adults and children should know the size and appearance of their testes, examining them at least once a month after a warm bath, that is relaxed with the scrotal sac. Each testicle should be examined by rotating it between thumb and forefinger to find abnormal lumps, which should be immediately reported to the doctor. This arrangement may allow early diagnosis.
It is important to teach children this maneuver because often the only visit to which they are subjected and which provides for the examination of the testes is for the lever, which was abolished by the decline of the conscription.top

DiagnosisThe diagnosis of cancer is made by an ultrasound of the scrotum and the dosage of some markers, ie substances in the blood produced by cancer cells or induced by the presence of cancer. These markers are alpha-fetoprotein and beta-HCG.
After the confirmation will be necessary to remove the testicle to examine the tumor in its local extent and subject the patient to further evaluation to see if cancer cells have spread to other parts of the body.
This is important for choosing the best treatment.top

Evolution
Testicular cancer is classified into the following stages:
The stadium, with tumors confined to the testis;
stage II, cancer spread to lymph nodes in the abdomen;
stage III, when the cancer has spread beyond the lymph nodes with metastases in organs such as lung and liver.top

How is
Thanks to advances in recent years, now 9 cases of testicular cancer are treated successfully in 10.
When the tumor is diagnosed at an early stage and is limited to the testis, surgery with or without radiation therapy is the first choice. In more advanced, however, it is necessary to resort to the chemotherapy, whereas this type of cancer is very sensitive to the effects of drugs, which will then get good results.
With medication also heals for 60-70 percent of cases of disseminated disease already, to which is added 10-20 percent of patients permanently cured after the removal of tumors shrunk with chemotherapy previously. In both cases, however, you must take control several years after treatment.
In practice, in early disease is indicated surgical removal of the testicle and spermatic cord (both seminomas and nonseminomatous forms).
In stage I seminoma is appropriate to complete the treatment with radiation. In later stages, however, with metastases to lymph nodes or other organs of the abdomen, chemotherapy allows good control of the disease. After removal of the testicle is inserted a prosthesis that allows you to maintain the appearance of the scrotum.