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Testicular Cancer Awareness: Symptoms, Early Detection, and Treatment Through Insurance

Testicular cancer is a prevalent malignancy in men. It predominantly affects men between 15 to 45 years of age. However, it is relatively rare. In fact, authoritative statistics suggest that testicular cancer makes up approximately 1% of all male cancers globally[1].

Despite being a relatively rare cancer form, it is noteworthy for its higher incidence amongst younger-aged males in contrast to other cancers. This article seeks to uncover the nuances that pertain to this urological malignancy that’s only specific to men— whilst also detailing how to detect, manage and treat it effectively.

What is testicular cancer?

Testicular cancer occurs when cells in a male’s testicle grow to form a tumour. For the most part, this relatively rare type of cancer originates in the testicles, also known as testes.

The testes are a part of the male reproductive system located within the scrotum, where sperm and testosterone production occur. In fact, approximately 90% of testicular cancer incidences start[2] in the germ cells specifically tasked with producing sperm.

Testicular cancer symptoms

Common symptoms of testicular cancer may include, but are not limited to:

  • A painless lump or swelling on the testicles (may appear the size of a pea, though it could grow much larger).

  • Chronic fatigue

  • Discomfort, pain or numbness in a testicle or the scrotum (with or without swelling).

  • A feeling of heaviness in the scrotum.

  • Dull ache in the groin or lower abdomen.

  • Sudden build up of fluid in the scrotum.

  • Lower back pain.

 

During late-stage testicular cancer, a patient may experience chest pain and shortness of breath.

It’s commonplace for adult men to avoid talking with their doctors whenever they experience any of the above systems. However, any delay may cause an escalation of testicular cancer. Yet, for the most part, testicular cancer is highly curable. 

Testicular cancer causes

The precise cause of testicular cancer is unknown. However, this urological condition is associated with several complex environmental and genetic risk factors. For example, cryptorchidism, age, ethnicity, and family history of testicular cancer. 

Risk factors for testicular cancer

The principal genetic and environmental risk factors for testicular cancer may include the following:

  • Boys born with undescended testicles (cryptorchidism) may have a higher risk of developing testicular cancer.

  • Abnormal cells in the testicle (germ cell neoplasia in situ[3]) may also be a risk factor for testicular cancer.

  • Having a sibling who has had testicular cancer may increase the risk of one developing testicular cancer.

  • Relatedly, males with a personal history of testicular cancer may have an augmented risk of developing cancer in their other testicle.

  • Males with HIV or AIDS may have an increased risk of testicular cancer.

 

How to diagnose testicular cancer?

Testicular cancer is traditionally diagnosed through a combination of physical examinations, laboratory tests and imaging tests, namely:

  • A physical examination may be conducted to look for any testicular cancer signs, like lumps, discolouration, or swelling in the scrotum.

  • Ultrasound imaging may be deployed to help identify abnormalities within the testicles.

  • An MRI may be ordered to provide detailed images of the reproductive organs to supplement any efforts to detect tumours.

  • A CT scan may be leveraged to provide detailed images of the abdomen, pelvis, and chest to identify cancerous growths.

  • Blood tests can be utilised to check for tumour markers[4] i.e., substances released by cancer cells. In practice, elevated levels of tumour markers may indicate the presence of testicular cancer.

 

Testicular cancer stages

The stage of testicular cancer is critical in determining the appropriate treatment and prognosis for the patient. It provides valuable information about the extent of the disease, enabling doctors to plan the best treatment action.

Testicular stages range from 0 to III, namely:

  • Stage 0 (Germ Cell Neoplasia In Situ): This is the earliest stage of testicular cancer. During this stage, abnormal cells are found in the seminiferous tubules inside the testicle but have not spread into other parts of the testicles.

  • Stage I: At this stage, the cancer may have grown outside of the testicle and spread to nearby structures. Stage I is further subdivided— depending on the risk of recurrence.

 

For example, the IS stage denotes cancer confined to the testicle with elevated tumour markers after orchiectomy.

  • Stage II:The cancer cells have spread from the testicle into nearby lymph nodes in the abdomen or pelvis. Stage II may be further divided into 2A, 2B, and 2Cc, depending on the number and size of the affected lymph nodes.

  • Stage III:This is the most advanced stage, where the cancer has spread to distant lymph nodes, lungs, liver, chest, or even brain.

 

 

Testicular cancer treatment

The treatment options for testicular cancer may depend on the stage of cancer. The prevalent cancer treatments in Malaysia include:

  • Precision medicine entails the deployment of advanced diagnostic and therapeutic approaches—specifically tailored to the genetic and molecular characteristics of a male’s testicular cancer.

    This personalised treatment approach principally seeks to optimise treatment outcomes. It targets specific genetic mutations and pathways associated with testicular cancer.

    In practice, it encompasses the identification of biomarkers and genetic alterations. This is done to guide treatment decisions, predict prognosis, and facilitate the development of targeted therapies.

  • Surgery is usually the first treatment for most cases of testicular cancer. Surgery principally aims to remove the affected testicle (orchidectomy) medically—or even affected lymph nodes.

  • Radiation therapy may be utilised for stage I seminomas or when the tumour is 5 centimetres or smaller.

  • The chemotherapy treatment route involves the deployment of a combination of specialised drugs[5]— depending on the stage and type of cancer.

  • High-dose chemotherapy and stem cell transplant[6] may be considered for recurrent testicular cancer, but rarely.

 

How does testicular cancer affect you?

Unfortunately, testicular cancer may manifest various adverse effects on individuals, including physical, emotional, and financial impacts.

Side effects of testicular cancer treatment

  • Surgical removal of the affected testicle can lead to physical changes and potential psychological effects.

  • Chemotherapy may cause uncomfortable side effects such as nausea, hair loss, and fatigue.

  • Radiation therapy may trigger side effects like chronic fatigue, skin changes and even affect one’s fertility.

 

Emotional impact of testicular cancer

The discovery of testicular cancer may bring shock, confusion, and anxiety to an individual. This may lead to feelings of depression or hopelessness. Fortunately, counselling may help alleviate these feelings as the disease has a relatively high survival rate[7].

Financial impact of testicular cancer

The financial impact of testicular cancer may include:

  • Expensive costs associated with surgery, chemotherapy, and radiation therapy.

  • Inability to work due to treatment or recovery, leading to potential income loss.

  • Additional expenses for fertility preservation options[8] before starting testicular cancer treatment.

 

Insurance for testicular cancer

Critical illness insurance cover offers a lump-sum payment when one is diagnosed with a covered critical illness, including testicular cancer. These funds may be used to cover various expenses, like medical bills, living expenses, utility and other out-of-pocket costs associated with treating testicular cancer.

PRUMan is a new critical illness insurance for men from Prudential Malaysia that varies by the life-assured policyholder's gender up to age 70. This coverage is highly affordable, from only RM53 per month.

Additionally, it comes with cash rewards and a refund of premium upon maturity. Besides covering gender-specified illnesses, it supports the recovery treatments due to the covered CI or accidents.

How to prevent testicular cancer?

While no specific steps or lifestyle choice can guarantee the prevention of cancer, the following health tips might contribute to reducing the risk of this disease.

  • Consume a balanced diet and maintain a healthy weight to reduce the risk of obesity.

  • Smoking is linked to an augmented risk of testicular cancer[9]. So, avoid smoking altogether.

  • Engage in physical activity and exercise.

  • Avoid wearing tight-fitting clothes, especially underwear, as this may increase the temperature and create a breeding ground for bacteria.

  • Limit alcohol consumption

  • Do regular check-ups and self-examination.

 

Can testicular cancer be cured?

Testicular cancer is highly curable if detected early. It has a high survival rate, with a cure rate of over 90% and a five-year survival rate of over 95%. However, the cure rate largely depends on the cancer stage and the type of treatment received.

So, don’t avoid regular check-ups and self-examinations to identify signs or symptoms in the early stages.

Furthermore, critical illness coverage can provide a financial safety net in the event of a testicular cancer diagnosis. Remember, it can help male breadwinners navigate the economic challenges that may arise during the treatment and recovery. 

Conclusion

Although it is unpleasant to deal with, with proper care and clinical management, individuals who have successfully undergone treatment for testicular cancer can lead healthy lives, with a minimal risk of recurrence.

Fortunately, facilities like PRUMan may help appreciably alleviate the financial burden associated with a testicular cancer diagnosis. Thus, allowing individuals to focus on their recovery without thinking of the stresses of finances.

[1] Testicle Cancer, Available at https://www.ncbi.nlm.nih.gov/books/NBK563159/

[2] Testicular Germ Cell Cancer Study, Available at https://www.cancer.gov/ccg/research/genome-sequencing/tcga/studied-cancers/testicular-germ-cell-study

[3] Precancerous condition of the testicle, Available at https://cancer.ca/en/cancer-information/cancer-types/testicular/what-is-testicular-cancer/precancerous-conditions

[4] Tumour markers, Available at https://training.seer.cancer.gov/testicular/abstract-code-stage/extent/markers.html

[5] Chemotherapy for testicular cancer, Available at https://www.cancer.org/cancer/types/testicular-cancer/treating/chemotherapy.html

[6] Stem cell and bone marrow transplants, Available at https://www.nhs.uk/conditions/stem-cell-transplant/

[7] Testicular cancer survival rates, Available at https://www.cancer.org/cancer/types/testicular-cancer/detection-diagnosis-staging/survival-rates.html

[8] What is fertility preservation, Available at https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/fertilitypreservation 

[9] Cigarette smoking and testicular cancer, Available at https://pubmed.ncbi.nlm.nih.gov/14744732/

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