Oncology

Testicular cancer accounts for 1% of all cancers in men with between 3 and 10 new cases per 100,000 men per year. It is more common in developed countries and usually occurs in a relatively young age, being more frequent between 20 and 40 years. The management of this tumour has 2 main objectives; first of all curing the tumour trying to preserve as much as possible both fertility and hormonal function of the testicles, and secondly, in men with increased risk for this cancer, establishing monitoring protocols for early detection of this tumor at curable stages. From this clinic we offer our wide experience gained by heading one of the few units that have implemented an early detection program for testicular cancer.

In early stages, the only finding is the presence of testicle enlargement, which may be accompanied by pain in the area or be completely asymptomatic. In more advanced stages, flank pain or palpable masses in various parts of the body may occur.

The diagnosis is usually suspected by exploring the testicle and generally is confirmed by an ultrasound. A blood test for levels of testicular tumor markers usually complete the assessment. To assess the extent of the tumour and whether it affects other parts of the body, a CT scan that includes chest, pelvis and abdomen is required in most of the cases.

The initial treatment is the removal of the affected testicle. If the tumour is located in that area, it is usually curative. If the tumour affects other organs outside the testicle, adjuvant chemotherapy is often needed and even new surgeries if the reponse to this last treatment has not been complete.

There is a higher risk for developing a testicular tumour in those men with prior cryptorchidism, ie those whose testicles at birth had not fully descended into the bag. Also men who have relatives with testicular cancer and those with fertility problems.

In men who are considered to be at risk for this tumour it is recommended to start a close follow-up protocol directed by a urologist to make an early diagnosis and thus cure this disease with fewer associated consequences.