Testicular cancer is a rare but treatable cancer that affects the testicles, which are the male reproductive organs. In Singapore, there are various treatment options available for testicular cancer.
The specific treatment plan will depend on the stage of the cancer, the type of cancer, and other individual factors
Surgery is the primary treatment for testicular cancer. The type of surgery recommended depends on the stage of the cancer and whether it has spread beyond the testicle. In most cases, a radical orchiectomy is performed, which involves the removal of the entire affected testicle through a small incision in the groin.
During the surgery, the surgeon will remove the testicle, the spermatic cord, and the surrounding lymph nodes. A prosthetic testicle can be inserted in the scrotum to restore the normal appearance of the testicles.
After surgery, the removed testicle will be sent to a pathologist for examination to determine the type and stage of cancer. If the cancer has spread to the lymph nodes, the surgeon may also remove it during the surgery.
Radiation therapy uses high-energy radiation to destroy cancer cells. It may be recommended for testicular cancer that has spread to nearby lymph nodes or other parts of the body. Radiation therapy is usually given after surgery to reduce the risk of cancer recurrence.
There are two types of radiation therapy for testicular cancer: external beam radiation therapy and internal radiation therapy.
(A) External beam radiation therapy: This type of radiation therapy involves a machine that delivers high-energy radiation to the affected area from outside the body. The patient lies on a table while the machine moves around the body to deliver radiation to the cancerous area. The treatment is usually given daily over a period of several weeks.
(B) Internal radiation therapy (brachytherapy): This type of radiation therapy involves placing a small radioactive device directly into the body near the cancerous area. The device is removed after a short period of time, usually a few minutes. Internal radiation therapy is not commonly used for testicular cancer but may be recommended in certain cases.
Chemotherapy is a treatment that uses drugs to kill cancer cells. It may be recommended for testicular cancer that has spread beyond the testicle or if there is a high risk of the cancer spreading. Chemotherapy may also be given after surgery to kill any remaining cancer cells in the body.
There are several chemotherapy drugs that may be used to treat testicular cancer, including:
Chemotherapy is usually given in cycles over a period of several weeks. The length and frequency of the treatment depend on the type and stage of the cancer. Chemotherapy may be given intravenously (through a vein) or orally (in pill form).
Targeted therapy is a newer type of cancer treatment that uses drugs to target specific molecules or proteins that are involved in the growth and spread of cancer cells. Targeted therapy is not commonly used for testicular cancer but may be recommended in certain cases.
There are two main types of targeted therapy for testicular cancer:
(A) Monoclonal antibody therapy: This type of targeted therapy uses drugs called monoclonal antibodies to target specific proteins on the surface of cancer cells. The monoclonal antibodies attach to the cancer cells and either kill them directly or help the body’s immune system to attack them.
(B) Tyrosine kinase inhibitors: This type of targeted therapy blocks specific molecules inside cancer cells that are involved in their growth and spread. By blocking these molecules, tyrosine kinase inhibitors can slow or stop the growth of cancer cells.
Targeted therapy may be used alone or in combination with other treatments, such as chemotherapy or radiation therapy.
Immunotherapy is a type of cancer treatment that works by boosting the body’s immune system to fight cancer cells. Immunotherapy is not commonly used for testicular cancer, but it may be recommended in certain cases.
One type of immunotherapy used for testicular cancer is called checkpoint inhibitors. Checkpoint inhibitors are drugs that block certain proteins on the surface of cancer cells or immune cells. By blocking these proteins, checkpoint inhibitors can help the body’s immune system to recognize and attack cancer cells.
Immunotherapy may be used alone or in combination with other treatments, such as chemotherapy or radiation therapy.
Like any surgical procedure, testicular cancer surgery can cause side effects. The type and severity of side effects depend on the extent of the surgery and the individual’s overall health.
Some common side effects of testicular cancer surgery include:
Radiation therapy is a common treatment for testicular cancer, especially for seminoma. Radiation therapy can cause side effects, which vary depending on the dose and duration of the treatment and the individual’s overall health.
Some common side effects of radiation therapy for testicular cancer include:
Chemotherapy is a common treatment for testicular cancer, especially for non-seminoma. Chemotherapy drugs work by killing fast-growing cancer cells, but they can also affect healthy cells in the body, causing side effects.
Some common side effects of chemotherapy for testicular cancer include:
Targeted therapy is a newer type of cancer treatment that targets specific molecules that are involved in cancer growth. Targeted therapy drugs are designed to block the signals that cancer cells use to grow and divide.
Some common side effects of targeted therapy for testicular cancer include:
Immunotherapy is a type of cancer treatment that helps the body’s immune system to identify and attack cancer cells. Immunotherapy drugs work by blocking certain proteins that help cancer cells hide from the immune system or by boosting the immune system to recognize and attack cancer cells.
Some common side effects of immunotherapy for testicular cancer include:
It is important to remember that testicular cancer can be treated successfully if caught early. If you have any concerns about your testicular health or notice any changes, do not hesitate to see a healthcare professional for evaluation.
If you suspect that you or your loved one have testicular cancer, it is advisable to get the support you need. Early detection and diagnosis of testicular cancer is key to treating the disease.
Regardless of what stage your testicular cancer may be at, you should schedule an appointment to see an oncologist specialising in testicular cancer as soon as possible. With the speed of developments in testicular cancer diagnosis and treatment, novel emerging treatment options could be explored by your medical oncologist.
Our cancer specialists at OncoCare specialise in treating late stage and advanced stages of testicular cancer, as well as earlier stages of the disease.
Senior Consultant, Medical Oncologist
MBBS (Delhi) – American Board Certified (Int Med) – American Board Certified (Hematology) – American Board Certified (Med Oncology)
Before joining OncoCare Cancer Centre at Mount Elizabeth Hospital, Singapore, Dr Akhil Chopra was a Senior Consultant in Medical Oncology at Johns Hopkins Singapore, Tan Tock Seng Hospital and Adjunct Associate Professor at Lee Kong Chian School of Medicine.
Dr Chopra has experience treating multiple cancer types including breast cancer, lung cancer, cancers of stomach, colon, rectum, liver, prostate, kidney, testicular and bladder, gynaecological cancers such as ovarian and uterine/cervical cancers; as well as Sarcomas and chronic leukaemia’s/multiple myeloma. Besides his clinical and research work, he has been involved in teaching medical students from the Lee Kong Chian School of Medicine as well as medical residents and students from Johns Hopkins University, Baltimore in USA.
Cancer Specialities: breast cancer, lung cancer, cancers of stomach, colon, rectum, liver, prostate, kidney, testicular and bladder, gynaecological cancers such as ovarian and uterine/cervical cancers
Senior Consultant, Medical Oncologist
MBBS (Singapore) – M.Med (Singapore) – MRCP (United Kingdom) – FAMS (Medical Oncology)
Dr Tay Miah Hiang, Senior Consultant Medical Oncologist at OncoCare Cancer Centre, was previously consultant at the National Cancer Centre Singapore’s Department of Medical Oncology, and Chairperson of Patient Education & Patient Survivorship programmes. Dr Tay also served on the board of Singapore Children’s Cancer Foundation from 2006 till 2015, and was Chairperson of this foundation from 2011 to 2013, and now serving as advisor. He is an elected member of Singapore Medical Council (SMC) since 2017 till date.
Dr Tay is passionate in contributing to Continuous Medical Education in the region, giving lectures in cancer management to cancer specialists, general practitioners, medical students and patients. He has won numerous awards for his service excellence and humanity contribution to disaster inflicted regions as such as post-Afghanistan war and Sri Lanka after Tsunami.
He has been actively involved in clinical and translational research for many years, in genitourinary (testicular, kidney, bladder, prostate), lung and other cancers. His research work is well published in hormone-refractory prostate cancer involved chemotherapy agents such as docetaxel and carboplatin. Acknowledged as a senior cancer specialist and an authority in prostate cancer in Singapore, he had also published on the use of ketoconazole and as part of a multi-centre clinical trial, the use of abiraterone acetate in metastatic castration-resistant prostate cancer progressing after chemotherapy.
As a pioneer in kidney cancer oncology, he had used sunitinib (Sutent), refametinib in kidney cancer patients when the drugs were coming into clinical practice in Singapore. Recognised as an authority in prostate cancer in Singapore, he had helped developed guidelines for the treatment of prostate cancer in Singapore in 2013 and the management of kidney cancer in Asia at the Asian Oncology Summit 2012.
His significant research work has been published in both local and international journals including Urology, Cancer, and Annals of Oncology. He also wrote chapters in several internationally recognised cancer specialty books such as Comprehensive Textbook of Genitourinary Oncology (3rd Edition), American Cancer Society’s Complete Guide to Prostate Cancer 2006, and Textbook on Urologic Oncology 2004.
Dr Tay is lauded for his experience in treating prostate, kidney, testicular and the bladder, gynaecological cancers such as ovarian cancer and uterine/cervical cancers, gastrointestinal & hepatobiliary cancers, lung cancer, brain tumour. He does not see patients with lymphoma, leukemia and breast cancer.
Testicular cancer is a type of cancer that begins in the testicles, which are the male reproductive glands located in the scrotum. Testicular cancer occurs when abnormal cells in the testicles grow and divide uncontrollably, forming a mass or tumour.
The most common type of testicular cancer is germ cell tumourus, which account for about 95% of all testicular cancers. Germ cell tumours are divided into two subtypes:
Other, less common types of testicular cancer include:
According to the World Health Organization (WHO), testicular cancer is a relatively rare cancer, accounting for less than 1% of all male cancers. However, it is the most common cancer in young men aged 15-44 years.
In Singapore, testicular cancer is also relatively rare, accounting for about 1-2% of all male cancers. According to the Singapore Cancer Registry’s Annual Registry Report 2020, there were 100 cases of testicular cancer diagnosed in Singapore between 2014 and 2018. The incidence rate was 1.1 cases per 100,000 men, and the median age at diagnosis was 35 years.
It’s important to note that while testicular cancer is relatively rare, early detection and treatment can greatly improve the chances of a successful outcome. Regular self-examination and seeing a doctor in Singapore promptly if you experience any symptoms are important steps in detecting testicular cancer early.
It’s important to note that not all lumps or swelling in the testicles are cancerous, and there can be other causes of these symptoms. However, if you experience any of these symptoms, it’s important to see a doctor for an evaluation.
There is currently no standard screening test for testicular cancer, as routine screening is not recommended for the general population. However, men should perform regular self-examinations of their testicles to help detect any changes or abnormalities.
Here’s how to perform a testicular self-examination:
If you notice any changes or abnormalities, such as a lump or swelling, it’s important to see a doctor for further evaluation. They may perform a physical examination, imaging tests, or a biopsy to determine if there is a cancerous growth.
It’s important to note that while routine screening for testicular cancer is not recommended, men who are at higher risk, such as those with a family history of the disease or a personal history of testicular cancer, may benefit from more frequent self-examinations or screening tests.
Testicular cancer is typically diagnosed through a combination of physical examination, imaging tests, and biopsy.
The exact causes of testicular cancer are not well understood, but research suggests that several factors may increase the risk of developing the disease. Here are some known risk factors for testicular cancer:
Age: Testicular cancer is most common in young and middle-aged men, with the highest incidence occurring between the ages of 15 and 44.
Family history: Men with a family history of testicular cancer are at higher risk of developing the disease. Having a brother or father who has had testicular cancer increases the risk by about 4 to 6 times.
Personal history: Men who have had testicular cancer in one testicle have an increased risk of developing cancer in the other testicle.
Abnormal testicular development: Men born with abnormalities of the testicles, such as undescended testicles, are at increased risk of developing testicular cancer.
Race/ethnicity: Testicular cancer is more common in Caucasian men than in men of other races and ethnicities.
HIV infection: Men with HIV have an increased risk of developing testicular cancer.
It’s important to note that having one or more of these risk factors does not mean that a man will develop testicular cancer. Conversely, some men who develop testicular cancer have no known risk factors.
There are several types of testicular cancer, but the two main types are:
There are several subtypes of non-seminomas, including embryonal carcinoma, yolk sac tumour, choriocarcinoma, and teratoma. In some cases, these subtypes may be mixed together, and the tumour is then referred to as a mixed germ cell tumour.
Less common types of testicular cancer include:
It’s important to note that the treatment and prognosis for testicular cancer may vary depending on the type and stage of the cancer.
Testicular cancer is typically staged based on the extent of the disease, which includes the size of the tumour, whether the cancer has spread to nearby lymph nodes or other parts of the body, and whether there are any tumour markers (substances in the blood that can indicate the presence of cancer).
The stages of testicular cancer are:
Doctors use several diagnostic tests, including blood tests, imaging tests (such as CT scans and PET scans), and sometimes surgical exploration, to determine the stage of the cancer. Knowing the stage of the cancer helps doctors develop a treatment plan that is tailored to the patient’s individual needs.