Testicular cancer

Testicular malignancies are rare, accounting for about 1% of all cancers. The importance of this type of cancer is given by the fact that it is the most common tumour in young men aged between 15 and 35 years and has an exceptionally good recovery rate even in metastatic cases. In 2019 there were 570 new cases in Hungary. Its development is based on genetic variations and the developmental abnormalities such as hidden testicles, undescended testicles, increase the risk, as does the presence of testicular tumours occurring in the family. In early stages, painless swelling of the testicle is the most common symptom, and many people consult a urologist at this point. In more extensive cases, symptoms can be varied, such as pain in the lower back, involvement of the abdominal lymph nodes, coughing, difficulty breathing, bloody sputum if the disease has spread to the lungs. Rarely, bone pain and neurological symptoms, such as epilepsy, may also occur.

Examinations

First, a urologist colleague will diagnose the disease by performing a physical examination and testicular ultrasound. Blood tests for tumour markers may help, significant elevations in AFP (alpha-fetoprotein), HCG (human choriogonadotropin) and LDH (lactate dehydrogenase) levels can further confirm the diagnosis. A chest, abdomen and pelvis CT scan is also recommended to rule out distant metastases.

Its treatment is primarily surgical. If one testicle is affected, the affected testicle, the epididymis and the spermatic duct are removed through a (groin) inguinal incision (this is the so-called high castration). In the case of simultaneous tumours of both testicles, hormone replacement is required due to bilateral castration; since the testicle produces the testosterone hormone and no sperm is produced, the operation causes infertility. This can be avoided by a pre-operative sperm preservation.

95% of testicular tumours are of germ cell origin, of which half are classified as seminoma and half as non-seminoma. Based on their biological behaviour, non-seminomas are more aggressive and therefore develop at a younger age, predominating in the twenties, and metastasize to a greater extent already at the time of making the diagnosis.

Psychological support is recommended

Metastatic disease can be cured with chemotherapy, with a recovery rate of over 90%. In general, after 3 cycles of BEP (bleomycin, etoposide and cisplatin) chemotherapy, the tumour cells are destroyed. During the treatment, the most common side effects are a decrease in white blood cell count, hair loss and nausea, of which hair loss is the least preventable. After recovery, follow-up visits are recommended, which consist of a medical examination, imaging tests and tumour marker testing at intervals in accordance with international oncology guidelines.

In the group of testicular cancer patients, it is of high importance to preserve the quality of life, given that patients undergo treatments at the age of 20-30 years and live for many decades after recovery. The main factors affecting the quality of life are: changed body image due to castration, sexual life and fertility, long-term side effects caused by chemotherapy, psychological stress before the controls.

Psychological support is definitely recommended, as it significantly helps to cope with the disease, the illness awareness and to accept the changed life situation.

In terms of fertility preservation, sperm conservation is recommended even before the start of chemotherapy treatment, as it freezes and stores sperm for later artificial insemination, if infertility eventually occurs as a result of the treatment.

For people who undergo chemotherapy, special emphasis should be placed on exercise and maintaining a normal body weight, as the risk of obesity, metabolic syndrome and cardiovascular diseases increases after the treatment. Regular exercise can significantly reduce this risk, as well as the risk of recurrence.

az egyik első olyan új betegtámogató rendelés, amely a külföldi példák nyomán elérhető Magyarországon,
amely az állami ellátásban korlátozottan érhető el,
amelynek célja az onkológiai betegek életminőségének javítása a lehetőségekhez képest legmagasabb szintre,
valamint célja az esetleges visszaesés vagy a betegség tovább terjedésének megelőzése.

Onko-rehabilitációs szakorvosaink:

Dr. Martin Tamás

Klinikai onkológus

Intézetünk klinika onkológusa pesti járóbeteg rendelőnk Onkorehabilitációs Központjában tumoros betegek komplex rehabilitációját, utógondozását, valamint rákprevenciót végez. A többi között felméri a betegség kiújulási áttétképződési esélyeit és javaslatot tesz ezek kiszűrésére, megelőzésére.

Dr. Szőnyi Márta

Klinikai onkológus

Onkológiai esetek (például emlőrák, vastagbélrák, prosztatarákos betegek) úgynevezett prerehabilitációját, komplex rehabilitációját, utógondozását, a tumorellenes kezelésé hosszútávú mellékhatásainak megelőzését valamint rákprevenciót végez.