Testicular Cancer

Testicular Cancer is a cancer arises in the testicles (testes), which are located inside the scrotum, part of male reproductive system, responding to the production and reproduction of male sex hormones and sperm. It tends to develop in the age groups of twenties and thirties.

Types of testicular cancer
1. Seminomas (Cancers of sperm producing cells)
Seminomas are originated from the sperm producing cells and accounted for 40% of all cases, seminomas tend to slower growing cancer, but it can spread to the lymph nodes in a quarter of patients. In most cases, it can be cured by radiotherapy and chemotherapy.

2. Non-seminomas (Cancers of embryonal type of cells)
Non-seminomas are originated from the embryonal type of cells and accounted for 40% of all cases of testicular cancer. Non-seminomas are aggressive and tend to spread quickly, including a. Embryonal carcinomas
Embryonla carcinomas are very aggressive tumors and tend to grow quickly and spread to distant parts of the body including the lungs and liver.

b. Teratoma carcinomas
Teratoma carcinomas tend to develop in young boys more then adult men and are generally benign and rarely spread to nearby tissues and distant parts of the body.

c. Yolk-sac tumors
Yolk-sac tumors is a rare type of testicular cancer
c.1. If it affects in children, it can be treated successfully in most cases
c.2. if it affects adult men, it can be treated by chemotherapy, even if they have spread.

d. Choriocarcinomas
Choriocarcinomas, a rare type of testicular cancer, affects mostly younger men and responds poorly to radiation and chemotherapy and carries high mortality rate.

Causes and risks factors
1. An undescended testicle (cryptorchidism).
Men with birth defects of undescended from the abdomen into the scrotum, are at a higher risk even if the testicle is moved down surgically.

2. Family history
Increased risk of the disease, if one of your direct member family has history of the cancer.

3. Heredity
Men with genetic defect of Klinefelter syndrome. due to at least two X chromosomes and, in rare cases, as many as three or four are at risk of testicular cancer.

4. Infertility due to abnormal semen
In a study of Risk of testicular cancer in men with abnormal semen characteristics: cohort study by Rune Jacobsen, Erik Bostofte, Gerda Engholm, Johnni Hansen, Jørgen H Olsen, Niels ESkakkebæk, Henrik Møller, the result indicated that men in couples with fertility problems were more likely to develop testicular cancer than other men (89 cases, standardised incidence ratio 1.6; 95% confidence interval 1.3 to 1.9).
The risk was relatively constant with increasing time between semen analysis and cancer diagnosis.
Analysis according to specific semen characteristics showed that low semen concentration (standardised incidence ratio 2.3), poor motility of the spermatozoa (2.5), and high proportion of morphologically abnormal spermatozoa (3.0) were all associated with an increased risk of testicular cancer.
The only other cancer group that showed increased incidence was “peritoneum and other digestive organs” (six cases; 3.7, 1.3 to 8.0). Of these, two cases were probably and two cases were possibly extragonadal germ cell tumours.

5. HIV infection
Researchers found that men infected with the human immunodeficiency virus (HIV) are at higher risk of testicle cancer.

6. Race/Ethnicity
Accordingly to statistic, testicular cancer is more common among white men than other race.

7. Personal history
Risk of testicular cancer increases if you have previous testicular cancer in one testicle.

8. Etc

Symptoms
1. A painless lump or swelling
Due to abnormal cells growth in either testicle
2. Enlargement of a testicle
May be a result of inflammation or infection, not necessary cancer
3. Pain or discomfort in the testicle
Uncommon sign of the testicular cancer
4. Dull ache or pain in the groin or abdomen
Uncommon sign of the testicular cancer
5. Lump in the neck
Cancer has spread
6. Shortness of breath
Cancer has spread to the lung
7. Etc.

Diagnosis and tests
1. Blood test
Blood withdrawn from your vein will be tested for tumor markers (Alpha fetoptotein (AFP), beta human choionic gonadotrophin (HBCG) and lactate dehydrogenase (LDH)) to determine the type of the cancer

2. Orchidectomy and biopsy
In biopsy, a sample from the affected testicle is withdrawn to review under microscopy to check for any abnormality cells growth. In orchidectomy, usually done done in general anesthesia with the removal of the affected testicle to check for type of the cancer, if cancer has spread. In case of cancer is in the early stage or has not spread outside of the test, it is only treatment needed.

3. Chest X ray
Check X ray is to check if cancer has spread to the chest.

4. CT Scan (computerized tomography)
A CT scan generates a large series of two-dimensional X-ray images taken around a single axis of rotation, to create a three-dimensional picture of the inside of the body in details.The pictures are viewed by your doctor to see the extent of the tumors abnormalities, such as spreading of cancer to the nearby structure and lymph nodes such as admen. CT scan can only review the existence of cancer, but it can not tell it is a primary or secondary cancer.

5. Ultrasound scan of the liver
Ultrasound allows your doctor to visualize and assess the size of your liver and to check for any abnormality and surrounding area of the liver with image taken from the test.

6. MRI (magnetic resonance imaging)
MRI (magnetic resonance imaging) is one of many advanced technology used to visualize internal structures cross sectional imaging of your body used effectively in providing the better details of the metastasis of cancer in the lymph nodes and surrounding areas.

Etc.

Grades

The Grades of testicular cancer are depending to the tendency of spreading. Low grade cancers usually grow more slowly and are less likely to spread while high grade cancer indicates otherwise.

Stages
Testicular cancer is classified as 5 stages
1. Stage 0
If the cancerous cell have not penetrated in deeper tissue but in the surface of the testicular lining.

2. Stage I
In stage I, The cancerous cells are no longer in the surface but have invaded into deep testicular lining, but still completely inside the testicles.
Stage IA1

The cancer is not ≤ 3 mm (1/8 inch) deep and ≤ 7 mm (1/4 inch) wide.
a.1. Stage IA1:
The spreading is not less than 3mm(1/8 inch) deep and & less than 7mm (1/4 inch) wide.
a.2. Stage IA2: The invasion area is ≥ 3 mm but ≤ 5 mm (about 1/5 inch) deep and & less than 7 mm (about 1/4 inch) wide.

b. Stage IB:The cancer in this stage have invaded the connective tissue, & less than 5mm (1/5 inch).
b.1. Stage IB1:
Cancer is 4 cm large (1 3/4 inches).
b.2. Stage IB2:Cancer is ≥ 4 cm (1 3/4 inches) but & less than 5cm (1/5 inch)

3. Stage II
In stage II, the cancerous cells have spread to distant tissues, but is still within the testicles.

4. Stage III
In this stage, cancerous cells has spread to the tissues immediately surrounding the testicles

5. Stage IV
In this stage, cancerous cells has spread to the tissues immediately outside of the testicles, other distant parts of the body.

Preventions
A. What to avoid
There is no effective way to prevent testicular cancer, but experts suggest
1. Self exams
Self exams to check for any abnormality such as unexplained swelling and lumps.

2. Avoid exposure to certain chemicals
In a study of Testicular cancer, occupation and exposure to chemical agents among Finnish men in 1971-1995. by Guo J, Pukkala E, Kyyrönen P, Lindbohm ML, Heikkilä P, Kauppinen T. researchers found that risk of testicular cancer increased only in four occupations. Pesticides, textile dust, and some organic solvents may be related to an excess risk of seminoma.

3. Practice safe sex to prevent infected by HIV virus
Researchers found that men infected with the human immunodeficiency virus (HIV) are at higher risk of testicle cancer.

4. Nitrosamines
In a study of Carcinogenic N-nitrosamines in the diet: occurrence, formation, mechanisms and carcinogenic potentialby German Cancer Research Center, Institute of Toxicology and Chemotherapy, Heidelberg F.R.G. researchers found that extensive experimental, and some epidemiological data suggest that humans are susceptible to carcinogenesis by N-nitroso compounds and that the presence of these compounds in some foods may be regarded as an aetiological risk factor for certain human cancers including cancers of the oesophagus, stomach and nasopharynx.

5. Etc.

B. Diet
1. Green tea
Green tea is always the first choice in diet to prevent cancer. In some clinical studies researchers suggested that the polyphenols in green tea, may play an important role in the prevention of cancer by killing cancerous cells and stopping their progression.

2. Garlic
An analysis of several case-controlled studies in Europe suggests an inverse association between garlic consumption and risk of common cancers.

3. Cruciferous vegetables
Cruciferous vegetables such as cauliflower, broccoli, cabbage, etc. beside contain high amount of antioxidants, but also phytonutrients that have been shown to help prevent the onset and halt the progression of certain cancers.

4. Soy
In laboratory studies, saponins have shown the ability to inhibit the reproduction of cancer cells and slow the growth of tumors in several different tissues.

5. Tomato
Many studies showed that antioxidant lycopene in tomato inhibits cancer cell growth and exhibit apoptosis, causing cell death.

6. Etc.


For healthy foods diet you are directed to my previous 100+ healthy food list for in-depth information

C. Nutrition supplements
1. Vitamin A, C, E
Vitamin A, C, E are free radical scavengers enhanced the immune system against the forming of free radicals and prevent the alternation of cell DNA cause of abnormal cell growth. For more information of how antioxidants help to treat cancer, click here

2. Selenium
Research showed that selenium has a protective effect on various stages of cancer, including both the early and later stages of the disease. In a study in large groups of people, researchers found that in areas of the world where selenium levels in the soil are high, death rates from cancer are significantly lower than in areas where selenium levels are low.

3. Phytochemicals
Phytochemicals are under active research for possible benefits immune system, and as anti-cancer agents. Flavonoids found abundant in berry, inhibit caner cell in vitro study.

4. Modified citrus pectin
In a study of researcher found modified citrus pectin may help block the growth and metastasis of solid tumors.

5. Quercetin
In study of effects of quercetin on human laryngeal cancer Hep-2 cells, researchers found that Quercetin could effectively inhibit the proliferation of Hep-2 cells and its mechanism is probably related to the apoptosis

6. etc.

Treatments
A. In conventional medicine
A. 1. Treatments
Treatments of testicular cancer is to cure but depending to the types, stage, grade and size of the tumors. If cancer in the early stage and if the blood test for marker is normal, after surgery no further treatment will be required. In many case, after surgery to remove the tumor, options of radiotherapy or chemotherapy or combination of both and sometime with clinical trials drugs used in chemotherapy.
1. Surgery
Orchidectomy is a type of testicular cancer surgery, usually performed in general anesthesia with the removal of the affected testicle to check for type of the cancer and if cancer has spread. In case of cancer is in the early stage or has not spread outside of the test, it is only treatment needed.

2. Radiotherapy
a. By using high-energy x-rays or other types of radiation, radiation therapy kills lung cancer cells and keep them from growing or regrowing. Depending to stage or grade there are two types of radiation therapy.
b. Side effects
b.1.. Fatigue
b.2. Chest pain
b.3. Heart problem
b.4. Short of breath
b.5. Skin discoloration or pinkness, irritation.
b.6. Etc.

3. Chemotherapy
a. Chemotherapy is most use to treat with advance stage of indolent lymphomas, as it has spread to a distant parts of the body by using drugs, such as etoposide, bleomycin, platinum, etc. taken by mouth or injected into a vein or muscle of the patient to stop the growth of or to kill cancer cells.
b. Side effects
b.1. Nausea
b.2. Vomiting
b.3. Hair loss
b.4. Fatigue
b.5. Anemia
b.6. Mouth sores taste and smell changes
b.7. Infection
b.8. Etc.

B. 2. Recurrent treatments
After treatments, if the cancer recurs, treatment options include surgery, chemotherapy, or high-dose chemotherapy, surgery and clinical trials testing new chemotherapy drugs.

B.3. Fertility
In some cases, treatment may cause you infertile, therefore, you may be recommended to perverse a sample of your sperm to sperm banking before treatments start. Unfortunately, most men with testicular cancer has low sperm count due to cancer and unsuitable for banking. In a study of fertility after testicular cancer treatments: results of a large multicenter study by Huyghe E, Matsuda T, Daudin M, Chevreau C, Bachaud JM, Plante P, Bujan L, Thonneau P., researchers concluded that the outcome of this study, which included the largest series reported to date, showed that fertility in patients with testicular cancer decreased by 30% after treatments and that radiotherapy seemed to have the most deleterious effect on fertility.
Please make sure you understand fully the fertility issue before treatments.

B. Herbal medicine
1. Absinthe
Absinthe is also known as Wormwood, a distilled, highly alcoholic beverage flowers extracted from leaves of the herb Artemisia absinthium. In a study, researchers at the University of Washington found that wormwood can be used as a promising potential treatment for cancer.

2. Aloe
in some studies, researchers suggest that some chemical compounds of aloe, such as acemannan, aloeride, and di(2-ethylhexyl)phthalate (DEHP) may have immunomodulating and anticancer effects.

3. Fenugreek
Fenugreek is used both as a herb (the leaves) and as a spice (the seed), genus Trigonella, belonging to family Fabaceae. Vitro studies have shown that fenugreek exhibits chemopreventive properties against certain cancers.

4. Pau D’Arco
Pau D’Arco is also known as Pink Lapacho, genus Tabebuia, belonging to family, native to the America. It contains high levels of alpha-lapachone, beta-lapachone and xyloidone demostrated anti cancer effects. An article published by Dr. Daniel B. Mowrey on Pau d'Arco stated that "Lapacho has produced clinical anti-cancer effects without side effects."

5. CurcuminIn a study conducted by S. Uddin and colleagues at the Department of Human Cancer Genomic Research at King Faisal Specialist Hospital and Research Center in Saudi Arabia, researchers found that Curcumin in turmeric may inhibit the proliferation of lymphoma cancer by modulating cell cycling and inducing apoptosis.

6. Etc.

C. Traditional Chinese medicine
1. Bai Hua She She Cao
The Sanjiv Kumar YADAV, Shao Chin LEE(Yong Loo Lin School of Medicine, National University of Singapore researcher results showed that the ethanol extract from Bai Hua She She Cao effectively evokes cancer cell apoptosis, possibly through burst-mediated caspase activation.

2. Pu Kong Yin (Dandelion Root)
In a study of the efficacy of dandelion root extract in inducing apoptosis in drug-resistant human melanoma cells, researchers found that treatment with this common, yet potent extract of natural compounds has proven novel in specifically inducing apoptosis in chemoresistant melanoma, without toxicity to healthy cells.

3. Wu Ling Zhi
Wu Ling Zhi is also known as Trogopterus Dung. A report from China Journal of Chinese Materia Medica 2006-07 showed that Radix ex Rhizoma Ginseng and Trogopterus Dung inhibit the proliferation and induce the apoptosis of tumor cell.

4. Huang Qi
In study of Astragalus-Based Chinese Herbs and Platinum-Based Chemotherapy for Advanced Non–Small-Cell Lung Cancer: Meta-Analysis of Randomized Trials, researchers found that astragalus may increase effectiveness of platinum-based chemotherapy when combined with chemotherapy. These results require confirmation with rigorously controlled trials.
According to the American Cancer Society, the substances, licochalcone-A, licocoumarone and glabridin, which are present in licorice root, may prevent mutations in the DNA and kill existing cancer.

5. Xia Ku Cao (Selfheal Fruit-Spike)
Researchers found that cyasterone in Xia Ku Cao showed anti tumor activity.

6. Etc.

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