Tumore del testicolo: sintomi, prevenzione, cause, diagnosi - La parola all'esperto

The testicles are the organs where sperm and some male hormones are produced in men (they have a similar function to that of the ovaries in women). There are two testicles, located in the scrotum, a sac of skin located directly under the penis. Testicular cancer is a male cancer, in which cancer cells arise from the tissues of one or both testicles. How common is it? Testicular cancers primarily affect young men (generally between the ages of 20 and 40). They are the most common type of cancer in men up to age 50 (accounting for 12 percent of all cancer diagnoses in men). After age 50, the incidence drops by 90 percent. Until the mid-1970s, nine out of 10 men with testicular cancer died within a year. Today, testicular cancer is curable in 95 percent of cases. Who is at risk The causes of testicular cancer remain unknown, although several risk factors can contribute to its development. Among these, the main one is cryptorchidism, which is the failure of one testicle to descend into the scrotum, remaining in the abdomen or groin. This condition increases the risk of malignant transformation of the cells up to 10 times compared to the general population, with the risk varying depending on the location of the cryptorchidism: high if the testicle is in the abdomen and lower if it is in the groin. The risk is further reduced if the anomaly is surgically corrected before the age of six. Another significant risk factor is Klinefelter syndrome, caused by a chromosomal error. Finally, men who have had testicular cancer have a 20-50 times higher risk of developing the same tumor in the other testicle. Also important are: a positive family history of this tumor, exposure to substances that interfere with endocrine balance (for example, occupational and continuous exposure to pesticides), infertility, and smoking, which doubles the risk. Types Testicular tumors are divided into two types: seminomas and non-seminomas. Seminomas account for approximately half of all cases and involve the malignant transformation of germ cells, the cells that give rise to sperm. They are most common in the fourth decade of life and are often associated with a variant that also involves non-seminal cells. Non-seminomas include various forms, including embryonal carcinomas, choriocarcinomas, teratomas, and tumors of the yolk sac, the part of the embryo that contains storage material for its nourishment. The prognosis and treatment vary depending on the tumor type. Symptoms The tumor usually begins with a lump, enlargement, swelling, or a feeling of heaviness in the testicle. Therefore, it is important for men to learn to perform testicular self-examination, palpating the organ periodically to detect any abnormalities early. The sudden onset of severe testicular pain is also typical of this tumor, along with a rapid increase in size, which can be caused by hemorrhage within the tumor. Shrinkage of the testicle can also be a sign of the onset of the disease. Finally, it is important for parents to have their children checked by their pediatrician, as correcting any incomplete descent of the testicle within the first year of life reduces the risk of cancer and facilitates early diagnosis. Prevention There are no organized prevention programs for testicular germ cell tumors. Tumor markers such as alpha-fetoprotein and beta-HCG (substances found in the blood in this type of cancer), which are useful for confirming the diagnosis and monitoring the progression of the disease over time, are not effective for early diagnosis. However, given the young age of the population at risk, the importance of testicular self-examination must be emphasized, with attention paid to any changes in the anatomy or shape of the scrotum. Diagnosis The tumor is diagnosed through an ultrasound of the scrotum and the measurement of certain markers, which are substances present in the blood produced by tumor cells or induced by the presence of the tumor. These markers include alpha-fetoprotein (AFP), beta-HCG, and lactate dehydrogenase (LDH). If the result is suspected, a biopsy is performed in the operating room. If this is also positive, the affected testicle is removed to examine the tumor at its local extent and subject the patient to further tests to determine whether the cancer cells have spread to other parts of the body. This is important for choosing the most appropriate treatment.