Bilateral Testicular Cancer - Causes, Symptoms, Diagnosis, and Treatment

Creator: Dr. Shaivy Dubey
Published: 2023-07-27T18:18:11

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Bilateral testicular cancer is a rare type of neoplasm affecting 0.5 to 1 percent of men. Read the article below to learn more about it.

Written by

Dr. Shaivy Dubey

Medically reviewed by

Dr. Rajesh Gulati

July 27, 2023

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Contents

What Is Bilateral Testicular Cancer?
What Are the Causes of Bilateral Testicular Cancer?
What Are the Signs and Symptoms of Bilateral Testicular Cancer?
What Is the Pathophysiology of Bilateral Testicular Cancer?
How to Diagnose Bilateral Testicular Cancer?
What Are the Treatment Modalities for Bilateral Testicular Cancer?
What Are the Ways to Prevent Bilateral Testicular Cancer?

Introduction

Bilateral testicular cancer, though less common than unilateral testicular cancer, is a significant medical condition that affects both testicles simultaneously or sequentially. It is a rare type of tumor. However, it is commonly seen in men 15 to 35 years old. The risk of getting bilateral testicular cancer is 1 in 500 men. It is crucial to understand the various aspects of this condition, including its definition, causes, signs and symptoms, pathophysiology, diagnosis, treatment options, and preventive measures.

What Is Bilateral Testicular Cancer?

Bilateral testicular cancer can be defined as the presence of cancerous growths in both testicles. It occurs when abnormal cells in the testicles begin to grow uncontrollably, resulting in tumor formation. Bilateral testicular cancer can originate from the germ cells responsible for sperm production and can be categorized as seminomas or non-seminomas.

What Are the Causes of Bilateral Testicular Cancer?

There can be any causative factors leading to the formation of bilateral testicular cancer. Still, the exact reason is under research. However, several risk factors have been identified:

Cryptorchidism: The condition where one or both testicles fail to descend into the scrotum, increasing the risk of developing bilateral testicular cancer.
Family History: Having a close relative or a family history of testicular cancer. This can raise the chances of developing the disease.
Personal History: Men who have previously had testicular cancer in one testicle have an increased risk of developing it in the other.
Age: Testicular cancer is most commonly diagnosed in young and middle-aged men, particularly between the ages of 15 and 40.
Race and Ethnicity: Testicular cancer is more prevalent in white men compared to men of other ethnic backgrounds.

What Are the Signs and Symptoms of Bilateral Testicular Cancer?

As bilateral testicular cancer is a rare cancer. It's very important to understand the associated signs and symptoms of bilateral testicular cancer for early detection and treatment of the tumor.

Presence of a Lump or Swelling: Feeling the presence of a lump or mass in one or both testicles.
Pain or Discomfort: Experiencing pain or aching in the testicles or scrotum.
Heaviness or Aching Sensation: Feeling a persistent heaviness or aching in the lower abdomen or groin area.
Changes in Size or Shape: Noticing changes in the size, shape, or consistency of the testicles.
Fluid Accumulation: Experiencing fluid accumulation in the scrotum.
Advanced Symptoms: In advanced cases where cancer has spread, individuals may experience difficulties like back pain or a persistent cough.

What Is the Pathophysiology of Bilateral Testicular Cancer?

Bilateral testicular cancer originates from the germ cells, which are responsible for sperm production. There are two major types of bilateral testicular cancer: seminomas and nonseminomas.

Seminomas: These are the types of tumors that are generally slow-growing and confined to the testicles. They tend to respond well to treatment and have a high prognosis rate.
Non-seminomas: These are the types of tumors that are typically more aggressive and may spread beyond the testicles. They are further categorized into embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma; these contribute 14 % of testicular germ cell tumors.

How to Diagnose Bilateral Testicular Cancer?

To diagnose and identify the presence of bilateral testicular cancer, healthcare professionals recommend the patient a series of investigations and procedures, including:

Physical Examination: A doctor performs a physical examination like inspections, palpation, and auscultation of the testicles and scrotum to identify any defect or any abnormal growth.
Ultrasound: This imaging test uses sound waves to create detailed images of the testicles, helping to identify the presence and characteristics of any masses.
Blood Tests: Blood tests can help to determine the levels of specific tumor markers.
- Alpha-fetoprotein (AFP).
- Human chorionic gonadotropin (HCG).
- Lactate dehydrogenase (LDH).

These specific tumor markers are measured. Elevated levels of these markers can indicate the presence of testicular cancer.

Biopsy: If an abnormality is detected, a biopsy may be performed to analyze the tissue and confirm the presence of cancer cells.

What Are the Treatment Modalities for Bilateral Testicular Cancer?

The treatment for bilateral testicular cancer typically involves a combination of surgery, chemotherapy, and radiation therapy. The specific treatment plan depends on factors such as the type and stage of cancer, as well as the patient's overall health and medical history.

Surgery: The removal of the affected testicles is named – radical inguinal orchiectomy. It is usually the first step in treating testicular cancer. In some cases, nearby lymph nodes are also removed.
Chemotherapy: This treatment involves the use of powerful drugs to kill cancer cells. Chemotherapy may be administered before or after surgery, depending on the stage and type of cancer.
Radiation Therapy: High-energy X-rays or other forms of radiation are used to kill cancer cells and shrink tumors. It is typically used in cases where cancer has spread beyond the testicles.
Hormone Replacement Therapy: It should be recommended to treat the patient's potential androgen insufficiency, which might result in the development of bilateral or partial orchiectomy.
Surveillance: In certain cases, when the cancer is in its early stage and slow-growing, doctors may recommend close monitoring without immediate treatment. This approach is known as active surveillance.

What Are the Ways to Prevent Bilateral Testicular Cancer?

While the exact cause of testicular cancer is unknown, certain preventive measures can be taken. Self-examination and regularly examine the testicles for any abnormalities or changes in size, shape, or consistency. If an individual notices any concerns, seek medical attention promptly.

Early treatment of cryptorchidism is one of the best ways to prevent bilateral testicular cancer. If the child has an undescended testicle, consult a healthcare professional for appropriate treatment options. Early intervention reduces the risk of developing testicular cancer in the future.

Conclusion

Bilateral testicular cancer, though less common than unilateral testicular cancer, is a serious medical condition that requires prompt diagnosis and treatment. Regardless of the increasing incidence of bilateral testicular cancer in recent years, it still has a good prognosis. Understanding the causes, signs and symptoms, pathophysiology, diagnosis procedures, treatment options, and preventive measures is essential in managing this disease effectively. By raising awareness and promoting early detection, it is possible to improve outcomes and increase the chances of successful treatment for bilateral testicular cancer.

Frequently Asked Questions

1. Is Testicular Cancer Treatable With a High Likelihood of Success?

Treatment options for testicular cancer are excellent, particularly for early diagnosis. Many patients have a good prognosis with timely medical intervention, which frequently leads to effective treatment and long-term survival. However, the precise course of therapy and prognosis may differ depending on the kind and stage of the cancer as well as personal health preferences. To address any long-term consequences of therapy and keep an eye out for any symptoms of recurrence, regular follow-up care is crucial.

2. What Is the Prevalence of Bilateral Testicular Cancer?

Although very uncommon, bilateral testicular cancer does happen. Although the frequency varies among populations, it usually corresponds to a small percentage of instances of testicular cancer. Bilateral testicular cancer is uncommon; thus, in order to achieve the best possible results, therapy may need to be customized, and close observation is necessary. When treating bilateral instances, multidisciplinary treatment from urologists, oncologists, and other experts is frequently required.

3. What Is the Typical Recovery Period Following Treatment for Testicular Cancer?

The length of time patients recover after testicular cancer therapy varies based on the disease's stage and the particular treatment techniques employed. After therapy, many patients can anticipate returning to their regular activities in a few weeks to months. It is essential to monitor any potential problems or cancer recurrence closely throughout the recovery phase by keeping a close eye on healthcare professionals. Programs for rehabilitation may also be suggested to assist patients in regaining their strength and mobility.

4. Is It Possible to Lead a Normal Life After Undergoing Treatment for Testicular Cancer?

Absolutely, with testicular cancer therapy, a regular life is achievable. Many people are able to return to their regular activities, such as job, hobbies, and relationships, with the right medical attention and follow-up. Nonetheless, some patients may have long-lasting psychological or physical side effects from their treatment, in which case assistance from loved ones, friends, and support groups can be helpful in coping with life after cancer.

5. What Is the Likelihood of Testicular Cancer Recurrence Post-Treatment?

The stage and kind of the disease, as well as the efficacy of the first treatment, all influence the chance of testicular cancer returning after treatment. Surveillance and follow-up sessions are crucial to monitoring and identifying any symptoms of recurrence. In order to guarantee rapid action in the event of a recurrence, patients should notify their healthcare team as soon as they notice any new symptoms or concerns.

6. Can Cancer Develop in Both Testicles Simultaneously?

Cancer can seldom occur in both testicles at the same time. Nonetheless, only a tiny proportion of occurrences of testicular cancer are bilateral, and these cases usually require specialized treatment strategies. In situations with bilateral involvement, early diagnosis and treatment are essential to improving results. Patients may also need to be closely monitored for any consequences or recurrence.

7. Does Testicular Cancer Metastasize to Both Testes?

Although testicular cancer does not usually travel straight from one testicle to the other, it can metastasize to other regions of the body, including the lymph nodes. When staging and establishing a treatment strategy, metastasis to the lymph nodes is a crucial factor to take into account. Imaging investigations may be utilized to determine the degree of metastasis beyond the testicles. To treat metastatic illness, a patient may get radiation treatment, chemotherapy, or surgery.

8. Do Testicular Cancer Nodules Manifest on Both Testicles?

Rather than appearing on the surface of both testicles, testicular cancer nodules typically present as lumps or masses inside the afflicted testicle. For an appropriate diagnosis and course of therapy, a healthcare provider must promptly evaluate the patient. Testicular symptoms that are new or worrisome should be examined right away to rule out any potential cancer and start the right course of treatment.

9. Is Bilateral Testicular Pain a Symptom of Testicular Cancer?

Testicular cancer usually does not present with bilateral testicular discomfort. To rule out any possible underlying diseases, a healthcare professional should assess any persistent or worrisome testicular symptoms. Testicular discomfort can occasionally result from non-cancerous reasons, including infection or trauma, but a complete assessment is required to identify the cause and the best course of action.

10. Can Individuals Lead a Normal Life with One Testicle?

With just one testicle, many people have happy, fulfilled lives. Even while there could be some early emotional and psychological challenges, most people are able to adjust and continue with their regular lives. Counselors, support groups, and medical professionals can all assist people in overcoming any worries or difficulties associated with having one testicle.

11. How Severe Is Cryptorchidism if Not Addressed?

If left untreated, cryptorchidism, or undescended testicles, can result in problems such as an elevated risk of testicular cancer and problems with fertility. It is essential to take action early to reduce these hazards. Early infancy is usually the best time to have cryptorchidism surgically corrected in order to maximize results and lower the chance of long-term problems.

12. What Are the Consequences of Untreated Undescended Testicles?

If left untreated, undescended testicles can have long-term implications such as reduced fertility, a higher chance of testicular cancer, and possibly even psychological issues with self-esteem and body image. For afflicted individuals, minimizing these risks and improving long-term results need early identification and treatment of cryptorchidism.

13. At What Stage Is Surgical Correction of Undescended Testicles No Longer Feasible?

It is usually advised to have surgery to rectify undescended testicles in early childhood, ideally before the kid turns two. The operation may be less successful, and the risk of problems may rise after this age. In older children or adults with undescended testicles, however, surgical intervention may still be considered, especially if there are concerns regarding cancer risk or fertility.

14. What Are the Potential Complications of Surgery for Undescended Testicles?

Surgery for undescended testicles may result in anesthetic hazards, bleeding, infection, and recurrence of the problem. These risks are, however, usually minimal, and the advantages of surgery frequently exceed the possible disadvantages. During the perioperative phase, healthcare practitioners must keep a close eye on patients in order to swiftly detect and address any issues.

15. Can Testicular Cancer Spread to the Lymphatic System?

Testicular cancer has the potential to spread to the lymphatic system, specifically to the pelvic and abdominal lymph nodes. When creating a staging and treatment strategy, this spread, also referred to as lymphatic metastasis, must be taken into account. Treatment choices can be guided by the results of imaging examinations, such as MRIs or CT scans, which can be used to determine the amount of lymph node involvement.

16. Is There a Possibility of Testicular Cancer Transforming into Leukemia?

Although leukemia is not a subtype of testicular cancer, people who have certain kinds of the disease may be more susceptible to secondary malignancies, such as leukemia, as a result of chemotherapy and other therapies. Monitoring closely and receiving the right medical care is crucial for managing any potential long-term therapy side effects. To maximize their long-term results, patients should talk to their healthcare professionals about their specific risk factors and surveillance programs.

Sources

Dr. Rajesh Gulati

Family Physician

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