The HEALTH | OCTOBER , 2018

SOME blood sample can help diagnose testicular cancer .

Pantai Hospital Kuala Lumpur Consultant Urologist Dr S A Balan highlighted that three things are usually done as a set for testicular tumours – alpha-fetoprotein ( AFP ), human chorionic gonadotropin ( HCG ) and lactate dehydrogenase ( LDH ); but this does not go for everyone .

“ We must understand that there can be risk in some individuals if it is within the normal range . So , again , we have to take it in a normal clinical situation .”

“ This test is done when we know that there is a swelling in the testicular . So , this test is done as a prognostic indicator . There would be a value prior to the surgery and three weeks after the surgery – we would repeat a similar test to see what the value is – whether there is a drop or whether there is an increase in the levels .”

“ If there is a drop , then we know that there is respond or there is no microscopic tumour or no tumour at the opposite testicle as well . This level is also used by the oncologist to monitor the response to the chemo .”

“ Meanwhile in a CT Scan , there are 70 to 80 per cent chance of identifying retroperitoneal nodes . Testicular cancer - what it does is from the testis , it goes up along the cord and follows the blood vessels and comes along back of the abdomen along the main blood vessels . CT scan is best to identify that . However , we do not do a CT scan if you have testicular cancer and the lesion is just localised at the testicular .”

When one or both sides are affected

ESTICULAR cancer basically

“ Most individuals think that just because there is visible swelling on one side , the other is clear . However , when examined , both sides would have tumours .”

“ Among testicular cancers , predominantly we see germ cells type which is 90 to 95 per cent of all the types of cancers from that type of variants .”

Men in 30 ’ s and 40 ’ s more prone to testicular cancer

Testicular cancer occurs at the third decade or the fourth decade of life . Men in their 30 ’ s are affected by non-seminoma variant while men in their 40 ’ s - seminoma variant .

“ This rule can change but in general it is this . The reason why we basically stress about testicular cancer is because this is something that is outside the body .”

Symptoms

“ Abnormalities include swelling and the size of the testis – bigger or smaller on the left compared to the right and the consistency whether it is hard compared to the opposite side . If you have something

“ Among testicular cancers , predominantly we see germ cells type which is 90 to 95 per cent of all the types of cancers from that type of variants .”

Dr SA Balan .

in the right side , all you have to do is compare with the left side .”

“ Most of the time , patient presents with a painful testicular swelling . This is usually after a trauma , an infection , if they are sexually active for the first time and Epididymo-orchitis - an inflammation of the epididymis and the testicle .

“ These individuals are monitored very carefully after a course of antibiotics . If we suspect it is an infection and a tumour hiding behind the infection – an ultra sound is conducted .

“ The prognosis for testicular cancers among all the urological cancers is actually excellent as it is a multidisciplinary approach . This means – the urologist come in first - does the surgery , followed by the oncologist and the infertility team .”

“ The fertility team is consulted as the patients sperm production may stop after chemotherapy or radiotherapy . So , prior to actually having any procedure done , sperm banking is recommended .”

The risk factor

The risk factor for those with testicular cancer are testicular dysgenesis syndrome characterised by the presence of symptoms and disorders such as hypospadias , cryptorchidism and poor semen quality .

A testicle with testicular cancer removed with its cord .

TESTICULAR sparing surgery is done in people who are left with only one testis and in that testis they have a tumour .

Only 30 per cent of the testis is taken . However , if the tumour has spread extensively warranting more than 30 per cent removal , then the whole testis is taken out and the patient is put on hormonal therapy .