testicular Cancer
Introduction
Testicles are the part of the male reproductive system. Cancerous conditions may invade testicle to cause testicular cancer. Surgery is the first line of treatment.
A common type of surgery is called radical inguinal orchiectomy. For the surgery the patient has to undergo general health check-up and routine blood tests. Testicular cancer may sometimes spread to other major organs like the brain, liver, lungs etc. If this has happened, the patient may not benefit much with surgery alone. Patient should be counselled before undertaking the surgery and explained the risks and benefits of the operation.
Procedure and considerations
Inguinal orchiectomy can be performed under general anesthesia or regional anesthesia. In general anesthesia, patient is rendered unconscious. Regional anesthesia includes spinal and epidural anesthsia. In this an anesthetic agent is injected into the spine and the patient feels no pain waist downwards. The groin is cleaned and shaved. An incision is made over the lower abdomen. The testicle is examined and removed. All blood vessels connecting the testicle are clipped. The surgeon takes special precaution so that tumour cells are not dislodged into the blood stream.
Iranian researchers designed highly effective nano-micelles to carry anticancer drugs into the tumor tissues.
Some patients might opt for a cosmetic recreation of the removed testicle to restore normal appearance.
Depending on the type and stage of cancer the draining lymph nodes are also removed. This step should be preceded by proper pre operative evaluation. In some cases surgeon may remove the lymph nodes by laparoscopic surgery. The lymph nodes are sent to the pathologist for microscopic examination and detection of spread of the cancer.
As a possible complication of the lymph node resection nerves that control ejaculation may be damaged. There will be backflow of semen called retrograde ejaculation. However all patients do not develop erectile dysfunction after this surgery. If both the testicles are removed the sperms will not be produced leading to sterility.
After surgery a small tube is placed for drainage of excess fluids and the incision is sutured or stapled. The wound is dressed. Usually hospital stay is short. Patient is advised not to lift heavy weights before complete healing that may take 6 or more weeks. Regular follow up for assessment of the cancer recurrence is essential. In some patients with advanced cancers, surgery is followed up with chemotherapy or anticancer drug therapy and/or radiation therapy. This kills the remaining cancer cells to a greater extent.
Testicular cancer usually occurs early in life. If the patient is wishes to have children, he should discuss the option with his surgeon. The team of physicians treating him may consider appropriate surgery or may consider sperm banking. For sperm banking, sperms are frozen and stored under adequate conditions for future use.
Some patients might opt for a cosmetic recreation of the removed testicle to restore normal appearance. Testicular prosthesis may be considered in these cases.