Testicular Cancer & Prostate Cancer

Men, young and old, listen up! The major health risks for ALL men include both prostate cancer and testicular cancer.

The good news is that both cancers have high cure rates and can be successfully treated, as long as the cancer is detected early and has not spread to other parts of the body. Prostate and testicular cancers occur in different parts of the body, and they commonly affect men at different stages of their life.

Prostate Cancer

This cancer usually affects men 65 and older. Tumours are often slow-growing and highly treatable. However, patients sometimes experience no symptoms until the cancer has spread. Thus, early detection by your doctor is important. Prostate cancer is highly treatable if caught in the early stages. There is less than a 15% death rate with early detection and treatment.

The prostate is a gland which produces the fluid for semen. This type of cancer can be both slow growing and aggressive, and many times there are no symptoms until it has spread. Older men should have regular screenings for prostate cancer.

Common Signs & Symptoms

Symptoms for prostate cancer usually result in problems associated with urination:

  • needing to urinate more frequently, often during the night
  • needing to rush to the toilet – sometimes leaking before you get there
  • difficulty in starting to pee (hesitancy)
  • straining or taking a long time while urinating
  • weak flow when you urinate
  • feeling that your bladder has not emptied fully
  • dribbling urine after you finish

Less common symptoms include:

  • pain when urinating
  • pain when ejaculating
  • blood in your urine or semen
  • problems getting or keeping an erection – this isn’t a common symptom of a prostate problem and is more often linked to other health conditions such as diabetes or heart problems.

Symptoms that the cancer may have spread include bone and back pain, loss of appetite, pain in the testicles and unexplained weight loss.

Prostate Cancer Screening Options

One inexpensive and safe test is the PSA, or Prostate Specific Antigen blood test. It is recommended that men over the age of 50 have this test annually, especially those with a family history of prostate cancer.  A raised PSA level may suggest that you have a problem with your prostate, but not necessarily cancer. Depending on the result, further investigation by a specialist will be needed. 

The other test recommended is the DRE, or digital rectal exam, for men over the age of 40, or earlier. The examination involves inserting a gloved, lubricated finger into the rectum to check the size of the prostate and assess if there are any abnormalities. Unfortunately there is no real pain or typical symptoms with a prostate tumour, consequently this cancer can grow without any awareness.

Besides cancer, the prostate gland may cause two other common men health problems:

  • Benign enlargement of the prostate (BPH, or benign prostatic hyperplasia), one of the most common benign tumors in men and a source of symptoms for most men as they age
  • Prostatitis, painful inflammation of the prostate, the most common cause of urinary tract infections in men

Both these prostate problems are common in men after age 50, and fortunately, effective treatment and relief of symptoms is easily available.

While early prostate cancer rarely causes any typical symptoms, it is recommended that men after 50 should speak to their doctors about the need for a prostate exam. According to the National Cancer Registry, prostate cancer is the fourth most common male cancer in Malaysia, accounting for 5.7 % of cancer cases among men.

Testicular Cancer

Compared with other types of cancer, testicular cancer is rare and also highly treatable.  It can develop in one or both testicles and is rare compared with other types of cancers. The testes, located in the scrotum, produce sex hormones and generate sperm for reproduction. Testicular cancer can be easily detected using a safe and effective testicular ultrasound if symptoms present themselves. 

Who Is At Risk For Testicular Cancer? 

In Malaysia, testicular cancer is the 9th and 10th most frequent cancer in males aged 0-14 years old and 14-49 years old. 

Although this is a relatively rare cancer, young men should be aware of the risk factors.

Some common risks include:

  • A family history of testicular cancer
  • A previous diagnosis
  • Infertility
  • History of undescended testicles which occur at birth affecting about 3-4% of male babies.
  • Certain genetic disorders such as Down Syndrome
  • Men with HIV

Testicular cancer is highly treatable and one of the most curable forms of cancer. It is especially important to detect testicular cancer in the earliest stages where the cure rate is almost 100%. That is why self-exams, starting in the adolescent years, are key in early detection of testicular cancer.

Two main types of testicular cancer are:

Seminomas – two sub-types of seminomas:

  • Classical seminomas are more likely to occur in men between the ages of 30 and 50.
  • Spermatocytic seminomas are less common and are found more frequently in men 55 years and older.

Non- seminomas – Four main subtypes of non-seminomas:

  • Embryonal carcinomas – This type tends to grow and spread quickly.
  • Yolk sac carcinomas – This is the most common form of germ cell tumor in infants and boys.
  • Choriocarcinomas –This type is very rare, tends to grow fast and often spreads quickly to other parts of the body.
  • Teratomas – Under a microscope, these tumours look like the 3 layers of tissue in a growing embryo.

Young men should perform monthly self-exams as a screening tool. While in the shower and using the thumb and forefinger, look for any changes in shape, any lumps or nodules, unusual firmness, or tenderness.  

Common Signs & Symptoms

Common signs and symptoms of testicular cancer include:

  • Painless lump or swelling of the testicle
  • A change in how the testicle feels
  • A dull ache in the groin or lower abdomen
  • A build-up of fluid in the scrotum
  • Pain or discomfort in the testicle or scrotum
  • A scrotum that feels heavy or swollen
  • Bigger or more tender breasts

Testicular Cancer Screening Options

Tests for diagnosing testicular cancer include:

  • X-rays – to determine whether the cancer cells have spread to the lungs.
  • Ultrasound – To help doctors determine whether a lump in the testes is solid, or filled with fluid.
  • Biopsy – Performed after removing the affected testicle because of the danger of cancer spreading into lymph nodes.
  • Computerised tomography (CT) scan – To check if the cancer has spread to other areas of the body.
  • Magnetic resonance imaging (MRI) – To determine if cancer cells have spread to the brain or spinal cord.
  • Positron emission tomography (PET) scan– To help find small metastases or determine if enlarged lymph nodes contain cancer cells.

Men who have had testicular cancer may have a higher risk to develop prostate cancer later in life. Although both cancers are highly treatable, detection remains the key to survival. Being aware of any changes can make it easier to spot cancer in the early stages. With prompt treatment, there is an excellent outlook for cure.

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