Got balls? Or, know someone who does? READ AND SHARE! #medical #testicular #testicle #cancer #surgery

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Got balls? Or, know someone who does?
READ AND SHARE!
#medical #testicular #testicle #cancer #surgery
A youngish (aged 38), white, employed man—one with great health insurance in the USA—first noticed a pea-shaped/-sized nodule in one testicle while doing a manual self-exam over 10 years ago. At that time and for each subsequent year, he kept having that testicle checked by his doctor.
He noticed that that testicle had felt and looked different from the other one almost right away. During these 10 years, that testicle kept shrinking (and he never took steroids, which are known to cause shrinking balls), but otherwise, it didn’t change much.
shrunken testicle
Every doctor he saw told him that this shrinking testicle problem was “nothing to be concerned about.” Some diagnosed it as something like a “varicose vein” problem (varicocele); others said it was a “dysfunctional” or “atrophied” testicle. No one seemed concerned.
NO ONE suggested, nor did this young man know to request, an ultrasound, which is what SHOULD have happened, right away.
The major change that occurred about 6 months ago (over 10 years later) was that this shrunken testicle began to grow, to swell and to hurt. He said it felt as if he had pulled a groin muscle. It also looked even more different from his other testicle, on the outside of the scrotum.
When he went in to his doctor, he was having trouble walking because he was in some pain, but he still thought he may have pulled a groin muscle. That internist again did not suggest an ultrasound and only gave him the most cursory manual exam.
The doctor told him: “If it hurts more or changes again, I’ll refer you to a specialist.”
Six months later, in early November, those types of changes happened: more pain, even more swelling. This time, the young man knew that this was not a pulled muscle.
When he called his doctor, he was referred to and then quickly scheduled an appointment to be seen by a urologist.
why see a urologist
That doctor did a much more thorough manual and visual examination, asked a lot more questions, spent more time. This doctor concluded without hesitation that this testicle was a problem and ordered an ultrasound, to occur a few days later.
The ultrasound (which was painful and that pain lasted several days, BTW), confirmed that the testicle had “multiple masses” internally, something no man wants to hear.
ultrasound testicles
NOT this man’s ultrasound, but similar; from http://www.ceessentials.net/article42.html
The urologist explained the possibilities (none great) and then immediately scheduled for that testicle’s contents to be removed one week later. This inguinal (through the lower abdomen) surgery was to be done in order to find out, by removing and sending the contents for pathological analysis, whether or not these masses were cancerous (probably were), and, if so, what kind.
The surgery took about one hour. Luckily, everything went fine.
Cross-Sectional Diagram of Inguinal Surgery Procedure to Remove Testicular Mass
inguinal surgery for testicular cancer
Post-surgery, the urologist seemed optimistic about the “containment” or “encapsulation” of these masses within the scrotum (best possible outcome). The urologist mentioned that, by his observations of the scrotal contents’ look, color and texture, the masses were likely to be seminomas (also known as pure seminomas or classical seminomas).
Seminoma is “a germ cell tumor of the testicle or, more rarely, the mediastinum or other extra-gonadal [outside the scrotum] locations. It is a malignant neoplasm and is one of the most treatable and curable cancers, with a survival rate above 95%, if discovered in early stages.”  https://en.wikipedia.org/wiki/Seminoma

Seminoma “is a slow-growing form of testicular cancer found in men in their 30s, 40s and 50s. The cancer is in the testes, but it can spread to the lymph nodes. Lymph node involvement is either treated with radiotherapy or chemotherapy. Seminomas are very sensitive to radiation therapy.”  https://medlineplus.gov › Medical Encyclopedia
seminoma-morphology-n
However, the man had to wait for pathology (to be available five – seven days later or sooner) to hear if he had to have any “next steps” (e.g., radiation or chemotherapy), or if he’s “clear” (presumed to be cancer-free).
If he’s presumed to be cancer-free at this first checkpoint,  he and his doctor are on “watch and report frequently” duty, which means that, for about 10 years, the man is to:
1) continue doing monthly self-exams of the other testicle and the empty scrotum and
2) schedule visits for ultrasound or CAT scans every 3 – 6 months.
If, at any time, post-surgery, the cancer seems to have spread or MAY have spread, a treatment regime is proposed, agreed to and then started. This could include radiation, chemotherapy, and/or more surgery, depending upon what is detected.
For THIS man, his story has this “outcome” (for now):
This man’s blood tests were clear: no tumor cancer markers, but the surgeon said there was some “leakage” outside of the testis. There were no signs of any other masses.
The urologist  ordered CT scans to determine if any of these masses had spread (metastasized. which everyone always hopes cancer does not do). he told this man that getting the scans was “not urgent,” but should be done “soon.”
The surgeon also referred him to an oncologist (cancer specialist), who would go over all these results with him and help him understand his options and decide how to proceed at that point. [I will update this saga after all that has occurred.]
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NOTES TO ALL HUMANS between the ages of 15 – 50 who have testicles, DO THESE THINGS:
—Self-exams (manual and visual) are crucial (which is the way this man first found the nodules);
testicle self exam
the above graphic and the video, below, were posted by: Justin Birckbichler on Twitter:

—Get better-informed internists, so that early detection via ultrasound is routine.
If you know a or you are a human under 50 with testicles (self-identified as “male” or not), spread the word!
ANY nodules, masses, pain, changes in size or texture of a testicle MUST be reported to a doctor AND that doctor should refer to a urologist and/or should request immediately to have an ultrasound, for diagnostic purposes. 
Unless scans can prove a mass/nodule is only a fluid-filled cyst (epididymal cysts, which are quite common, painless and harmless), the affected testicle will probably be emptied out from within (an inguinal surgery, which this man, above, had), or the testicle itself is to be removed completely, ASAP.
This surgery generally works very well and urologists do it frequently, so they have the procedure down. This does involve having general anaesthesia and cutting, and, therefore, has associated risks, but most do fine with this procedure.
The surgery is usually done as an “outpatient” procedure, meaning, the person goes home that same day/night.
Depending on several factors—the general health of the person and the type of surgery done as well as the pathology results—full recovery may take 4 – 6 weeks or longer. During this time, the recovery may have restrictions (no heavy lifting or pulling, no airline travel, limited sitting, lots of rest vs. work or ordinary schedule) but walking and other non-strenuous exercises are encouraged right away.
Success and recovery rates for this type of cancer are quite high:
99% if the cancer has not spread;
96% if it has.

STILL: early detection is key.

 

testicular-cancer-prevention

FMI: 

Signs and symptoms of testicular cancer include:
  • A lump or enlargement in either testicle.
  • A feeling of heaviness in the scrotum.
  • A dull ache in the abdomen or groin.
  • A sudden collection of fluid in the scrotum.
  • Pain or discomfort in a testicle or the scrotum.
  • Enlargement or tenderness of the breasts.
  • Back pain.


There are several causes of testicular lumps and swellings:

  • varicocele – caused by enlarged veins in the testicles (may look like a bag of worms)
  • hydrocele – a swelling caused by fluid around the testicle
  • epididymal cyst – a lump caused by a collection of fluid in the epididymis
  • testicular torsion – a sudden painful swelling that occurs when a testicle becomes twisted (this is a medical emergency and requires surgery as soon as possible)
  • epididymitis – a chlamydia infection in the epididymis can cause inflammation, swelling and tenderness inside the scrotum (ball sack); a few men will notice that the whole of the scrotum is red and tender (this is called epididymo-orchitis)
  • testicular cancer – an estimated 4 in 100 lumps are cancer, so this is an uncommon cause of lumps

Types of testicular cancer

The different types of testicular cancer are classified by the type of cells the cancer begins in.
The most common type of testicular cancer is “germ cell testicular cancer,” which accounts for around 95% of all cases. Germ cells are a type of cell that the body uses to create sperm.
There are two main subtypes of germ cell testicular cancer. They are:

  • seminomas – which have become more common in the past 20 years and now account for 50 to 55% of testicular cancers
  • non-seminomas – which account for most of the rest and include teratomas, embryonal carcinomas, choriocarcinomas and yolk sac tumors

Both types tend to respond well to chemotherapy.
Less common types of testicular cancer include:

  • Leydig cell tumors – which account for around 1 to 3% of cases
  • Sertoli cell tumors – which account for around 1% of cases
  • lymphoma – which accounts for around 4% of cases
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Think you or someone you know needs a monthly reminder to do a self-exam?
If you/they have a texting phone, show them this:
Text 81010 to @selfexam to receive a monthly text message reminder!
self-exam reminder text
checking balls app

Our Ball Checker mobile app provides a few facts every guy and girl should know about testicular cancer as well as how to do a testicular self exam. If you have testicles or know someone that does, then you should get this app.

With early detection testicular cancer is almost 100% survivable but lack of awareness leads to late diagnosis and unfortunate outcomes. The lack of awareness and education is one of the biggest challenges we have in the fight against testicular cancer.

Make sure you and the men in your life have the knowledge that could end up saving their life.

A Moment of Awkwardness Could Save A Lifetime. Talk About Testicular Cancer.

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Best of luck and good health to you all!
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Some other info and worst-case scenarios information:

“Dr Turnbull and her team uncovered new genetic mutations in testicular germ cell tumours, which make up the vast majority of testicular cancers. They found new chromosome duplications and other abnormalities that could contribute to the development of this cancer, as well as confirming a previous association with a gene called KIT.

“Their study also found defective copies of a DNA repair gene called XRCC2 in a patient who had become resistant to platinum-based chemotherapy. They were able to support the link between XRCC2 and platinum resistance by sequencing an additional platinum-resistant tumour.

“’Although generally testicular cancer responds well to treatment, resistance to platinum-based chemotherapy is associated with a poor long-term survival rate,’ explains Dr Turnbull. ‘The repercussions of these findings could be significant for men suffering with this disease. In the future, men who are destined to fail platinum treatment— currently around 3% of cases—could be identified before they endure courses of chemotherapy and be offered different treatments, more suited to their particular type of tumour.’”

from: https://www.icr.ac.uk/news-features/latest-features/understanding-why-some-men-still-die-from-testicular-cancer

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“If the cancer has spread, the patient may get treatments like radiation or chemotherapy. The cancer will come back in about 15% to 20% of patients, most often as spread to lymph nodes , but if it does, radiation or chemo can still usually cure the cancer.”
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Seminomas

Stage I

“These cancers can be cured in nearly all patients. You first have surgery to remove the testicle and spermatic cord (called a radical inguinal orchiectomy). After surgery, you have many treatment choices:

“Careful observation (surveillance): If the cancer has not spread beyond the testicle, the plan most experts prefer is that you be watched closely by your doctor for up to 10 years. This means getting physical exams and blood tests every 3 to 6 months for the first year, and less often after that. Imaging tests (CT scans and sometimes chest x-rays) are done every 3 months for 6 months, and then once or twice a year.

“If these tests do not find any signs that cancer has spread beyond the testicle, no other treatment is needed. If the cancer has spread, you may get treatments like radiation or chemo. The cancer will come back in about 15% to 20% of patients, most often as spread to lymph nodes , but if it does, radiation or chemo can still usually cure the cancer.

“Radiation therapy: Radiation aimed at para-aortic lymph nodes is another option. These nodes are in the back of your abdomen (belly), around the large blood vessel called the aorta. Because seminoma cells are very sensitive to radiation, low doses can be used and you’ll get about 10 to 15 treatments over 2 to 3 weeks.

“Chemotherapy: An option that works as well as radiation is 1 or 2 cycles of chemotherapy with the drug carboplatin after surgery. Many experts prefer chemo over radiation because it seems to be easier to tolerate.”

Survival by stage

“There are no UK-wide statistics available for testicular cancer survival.

“Survival statistics are available for the different stages of testicular cancer in one area of England. These figures are for men diagnosed between 2002 and 2006. They don’t provide information about the type of testicular cancer or tumour marker level.

“The [data] below are for 4 stages of testicular cancer. Your doctor may use a different system that only has 3 stages.

Stage 1

“Almost all men survive their cancer for five years or more after diagnosis.

“Stage 1 means the cancer is only in the testes.”

Stage 2

“Almost 95 out of 100 men (almost 95%) survive their cancer for 5 years or more after diagnosis.

“Stage 2 means the cancer has spread to nearby lymph nodes.”

Pure seminoma

“Pure seminoma means that there are no teratoma cells in the tumour. You will have normal Alpha fetoprotein (AFP) marker levels if you have pure seminoma.

“There are two categories of outlook for pure seminoma testicular cancer – good prognosis and intermediate prognosis. No one with pure seminoma is classified as having a poor prognosis.”

Good prognosis

“Almost 90 out of every 100 men (almost 90%) survive for 5 years or more after they are diagnosed.

“Most men have a good prognosis. Good prognosis means that the seminoma has spread only to the lymph nodes or the lungs. It has not spread anywhere else.”

Intermediate prognosis

“More than 70 out of every 100 men (more than 70%) survive for 5 years or more after diagnosis.

“Intermediate prognosis means that the seminoma has spread beyond the lung or lymph nodes to other parts of the body, such as the brain or liver.”

Survival for all stages of testicular cancer

“The outlook for testicular cancer is one of the best for all cancers. Nearly all men survive their disease.” [NOTE: in the 1970s, this statistic was almost the opposite: 90% DIED from it!]

“In England and Wales:

  • almost all men will survive their cancer for 1 year or more after they are diagnosed
  • almost all men (98%) will survive their cancer for 5 years or more after diagnosis

“Unlike some other cancers, it is rare for testicular cancer to come back more than 5 years later.”

from: https://www.cancer.org/cancer/testicular-cancer/treating/by-stage.html

and from:
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“First Targeted Cancer Drug Approved Based on Mutation Rather than Tumor Type”
Please read and share this detailed, informative article about new ways to treat cancer, especially unusual types, particularly in those individuals with specific mutations.
from: