Testicular cancer - a malignant tumor that develops in the male gonads.
Assuta Hospital has modern medical equipment to work invites the best doctors in Israel. In the development of treatment programs practiced here a comprehensive and individual approach.
Israeli doctors in the treatment of testicular cancer (testicular cancer) favored treatment methods with the least side effects, modern techniques and design used. In the field of surgery successfully performed nerve-sparing surgery with subsequent reconstruction and prosthesis.
The risk of cancer of the testicles in men with higher
- hereditary predisposition
- inverted testis
- infertility history.
The following types of malignant testicular tumors:
1.Seminoma - develop from mature cells that produce sperm;
2.Opuholi arising from violations of fetal development:
- embryonal carcinoma
- yolk sac tumor
Except for seminoma testicular cancer - a very aggressive tumor.
The reason to address the following symptoms of the disease will be a urologist Assuta Hospital:
- Seal in the egg;
- Aching pain in the lower abdomen, scrotum;
- Increasing the size of the scrotum;
After examination the doctor to the patient appoint additional examination techniques to determine the type of cancer, size of tumor and its spread.
The cost of treatment of testicular cancer in Israel in the clinic Assuta
Therapy precedes diagnosis, which includes consultation of the oncologist, PET-CT, ultrasound, general and biochemical blood tests for tumor markers test, audit biopsy AFP analysis. The preliminary cost of the diagnostic program is $ 4200.
Consider the more common treatments for testicular cancer in Israel.
Testicular Cancer Treatment in Israel
Treating Cancer in Israeldepends on the stage and type of cancer. Comprehensive treatment includes the following methods: radical orchiectomy - egg removal, radiation therapy, anti-tumor drugs.
Surgery for testicular cancer
In the process of diagnosing tumor testicle removed the majority of men. This operation is called orchiectomy. The surgeon replaces the testicle prosthesis or implant. After operation scrotum looks naturally. Sometimes a small tumor of the possible removal of a testicle - partial orchiectomy, but this kind of surgery are very rare.
The operation is performed with general anesthesia or spinal anesthesia. The groin incision and removes performs organ. Operative intervention lasts about thirty minutes.
When the patient moves away from the anesthesia after orchiectomy can eat, drink, move. Basically, the operation is performed in a day hospital, sometimes you may need to overnight hospitalization. Possible discomfort to the scrotum and the groin area within about a week, will be assigned painkillers. After 7 days, remove the sutures. Most men return to a normal life, including for work in two weeks. Need to refrain from heavy and exhausting exercise for a month.
In unilateral orchiectomy man preserves fertility and the ability to have an erection. Very rarely malignant process affects both testicles. If, however, made a bilateral orchiectomy, the man can no longer have children, there is a need in the hormone testosterone.
The lymphatic system is a network throughout the body. Cancer can spread through the lymphatic ducts. If the patient neseminomnyh testicular cancer, enlarged lymph nodes in the chest or abdominal cavity after radiation or chemotherapy, may require surgery to remove them.
Removal of lymph nodes in the abdominal cavity called the retroperitoneal lymph node dissection. It is very rare in the dissection of the thoracic cavity - papaaortalnaya.
This operation requires a general anesthesia lasts for about 3-7 hours. In just a few hours you may need to stop taking food and liquids, put on a drip. After dissection patient regains consciousness in the intensive care unit where nurses and doctors will closely monitor his condition. As a rule, it takes the night, after which the patient is transferred to the ward. It can be set drains and nasogastric tube.
The wound will cause pain and discomfort, to eliminate them prescribe analgesics. Approximately two days later, the patient is already able to start walking. Hospitalization usually takes up to ten days. complete healing process would require several weeks. Approximately half months should avoid physical exertion.
Removal of lymph nodes in the abdomen can cause infertility. Sometimes it is possible to apply to the nerve-sparing dissection, when the tumor is not located close to the nerve pathways. However, the preservation of the nerves may increase the risk of relapse.
The operation to remove the secondary tumor in the lung
Sometimes it metastatiziruet testicular cancer to the lungs. The oncologist can offer this kind of operation in the following situations:
- Detects symptoms of cancer testis after chemotherapy.
- If the disease is resistant to cytotoxic agents.
If you are unable to use other methods, the operation is performed again when the tumor reappears. The choice will depend on the state of health, the scope of the treatment of testicular cancer in Israel. This is an extensive operation which is carried out with the use of general anesthesia.
Preparation for surgery
The surgeon and the anesthetist talk with the patient and introduced into the course, as will undergo surgery. A physical therapist teaches special exercises for the legs and breathing, the implementation of which will reduce the likelihood of complications.
What to expect after surgery?
Conventionally, we can expand this section by type of surgical treatment of testicular cancer in Israel.
After removal of the testicle
After the patient recovered from anesthesia, he will be able to eat and drink. The wound will be painful, but are appointed by the painkillers, eliminating this condition.
After removal of the lymph nodes, or lung tumors
After dissection or removal of the tumor in the lungs, the patient fix several tubes:
- Intravenous drip, through which the body fluid flows.
- Drains that remove excess fluid in the wound area.
- A catheter to drain urine.
- Oximeter (for pulse), and a cuff for measuring blood pressure on the arm.
- It can be mounted pump (pump) with painkillers, coupled with a dropper. Applicable, including manual control with the button to get an extra dose of analgesic, if necessary.
As a patient to recover, these devices will be removed.
You need time to recover. If the recovery is slower than expected patient should talk to your doctor.
Possible side effects orchiectomy
When you remove one testicle long-term adverse effects are observed. The second egg up for the absence of producing more testosterone and sperm. It is possible to install a false egg on the spot removed during surgery to look like in a conventional manner afterwards.
When held bilateral orchiectomy, the patient becomes unfruitful. It is possible to keep the sperm before the operation, to be able to become a father. Also, the body will no longer produce testosterone, respectively, will require replacement therapy to maintain sex drive and the ability to have an erection.
Side effects removal of lymph nodes
If conducted retroperitoneal lymph node dissection, the man becomes sterile. This is associated with damage to the nerves that control the release of sperm. After removal of the lymph nodes sperm moving backwards into the bladder. This condition is called retrograde ejaculation. Man is able to have an erection and have an orgasm, but it will be dry without the release of sperm.
Sometimes it is possible to conduct nerve-sparing dissection. The nerves that control ejaculation, remain intact in order to reduce the risk of retrograde ejaculation.
Monitoring of testicular cancer
After unilateral orchiectomy at an early stage of the disease (1), many men do not need further treatment, because the risk of recurrence - low. Depending on the type of testicular cancer, and other factors, the probability of the return of the disease may be of the order of 13%, in some cases - more than 50%. The doctor tells the patient about the possible risk to his particular situation, it may recommend monitoring.
Monitoring aims to identify signs of relapse to the disease found and treated at an early stage. Treatment eliminates testicular cancer most men, even if the disease returns.
Appointed by regular meetings with the doctor, usually once or twice a month for neseminomnyh testicular cancer, every few months - for seminoma. During the meeting, the doctor examines the patient, check the other testicle, asks about health.
It's time to tell the doctor about the existing problems and the appearance of new symptoms.
If the tumor produces tumor proteins (markers), will be assigned to blood tests to check their levels. Also, the patient will undergo regular chest X-rays and CT scans sometimes.
Over time, the risk of recurrence is reduced, the meeting will occur less frequently. Control is usually carried out at least 5 years.
If testicular cancer returns
When the level of markers is increased and the scan confirms the return of the disease, chemotherapy may be recommended. However, there is still a high probability of complete cure.
Some people find it very hard to realize that you need to monitor that the cancer may return. However, with early detection of treatment of testicular cancer is very likely to lead to getting rid of the disease. You must talk to your doctor, he calmed down and explain how often will check and tell you about possible treatment at relapse.
What measures can be taken on their own?
The patient can take certain actions to preserve and maintain health:
- Eat right.
- Learn relaxation and relaxation.
- Quit smoking.
- Capture new symptoms and report them to your doctor.
Diet high in fresh fruits, vegetables and fish, low - animal fat - the best option for the health, including the heart.
There is currently no evidence linking stress with cancer. But monitoring can be a stressful situation for some people, and relaxation will feel better and cope with it. A person can try to find a new hobby or learn relaxation techniques.
Smoking cessation and changes related to the way of life, help to feel control over the situation.
Radiation therapy of testicular cancer
Radiotherapy treats oncology using high-energy rays.
Radiotherapy is recommended for the treatment of testicular cancer in Israel that has spread to the lymph nodes in the abdomen. This method is usually very effective for seminoma testicular cancer, almost all patients recover completely.
Treatment is preceded by careful planning teletherapy as the radiation dose calculated and determined treatment site. Is scanned by CT, MRI or PET. On the skin can cause tiny tattoos to indicate the size of therapy areas.
This treatment of testicular cancer in Israel (3-4 weeks) are divided into short sessions (fractions), which are held on weekdays and rest on the weekend. Therapy session takes from one to several minutes.
Possible side effects
1.Luchevaya therapy causes fatigue, which will accompany all treatment and continued for some time after its completion.
2.U some men in the field of skin treatment becomes red and painful, a bit like a mild sunburn. This is a standard symptom, especially if therapy lasts for 2 weeks.
3. When radiotherapy in the abdomen in men can experience nausea and diarrhea, they are quite small. Sometimes completely absent.
- Nausea can be prevented or treated using the drug. They will be assigned antiemetic tablets that are taken every day before the procedure. If the patient does not feel the taste of food, it may be recommended to high-calorie drinks. In the event of serious problems with the diet will help dietician.
- Diarrhea can be treated with medication, slowing the bowels. Will benefit from a diet low in fiber. It is necessary to exclude whole grain cereals, bread, whole wheat, bran, dried fruit, cabbage. It should reduce the consumption of fresh fruit, fruit juice and vegetables. Will be useful for bananas. For a healthy diet the patient can return after treatment. During diarrhea, it is important to drink plenty of fluids.
4.Vremennoe may cause damage to sperm radiotherapy lymph nodes in the peritoneal cavity. Because radiation can be directed to the inguinal region, there is a small risk that the remaining testicle will receive some dose of radiation, as is near. Doctors recommend that men abstain from conceiving a child up to a year after radiotherapy. Side effects can only be stored for several months after radiotherapy, as sperm in a healthy testicle played repeatedly. After this time, according to studies, the risk of abnormalities in the child in connection with the treatment available.
Other side effects depend on the part of the body, which is subjected to treatment.
Chemotherapy in the treatment of testicular cancer in Israel
To destroy cancer cells Chemotherapy uses cytotoxic drugs.
Indications for this method with testicular cancer:
- Prevent the risk of relapse after orchiectomy.
- Treat cancer, which gave secondary foci or recurred after surgery.
- Relapse after chemotherapy.
Testicular cancer cells are able to hit the lymph nodes that are located near the main artery in the abdomen - aorta. These are called para-aortic lymph nodes. Neoplastic process can spread to the lungs, more rarely in other organs - liver, or brain. If the doctor there are such suspicions may be recommended chemotherapy.
How is treatment with cytotoxic drugs?
The course usually includes some medication. They enter the body by injection or by dropper. Outpatient for a few days with medication, followed by a rest for a couple of weeks before treatment resumes. The number of such cycles is determined by the degree of spread of testicular cancer, the body's response to treatment.
Chemotherapy after surgery testicular cancer
Cytostatic therapy can be carried out in order to reduce the likelihood of cancer recurrence after unilateral orchiectomy. For the treatment of seminoma of the early stages is usually assigned one therapy cycle via carboplatin.
When seminoma at an early stage after surgery performed with 2 cycles using BEP or PEB circuit. BEP contains bleomycin, etoposide and cisplatin. The cycle lasts about three weeks. The patient may stay in the hospital the first few days, in some cases, the treatment of testicular cancer is performed in an outpatient setting. On the second and third weeks of weekly injections.
Chemotherapy for metastatic or recurrent testicular cancer
In the presence of secondary foci or relapse is usually carried out 3-4 BEP cycle. Performing blood tests, the doctor determines the level of the markers on the basis of which assesses the effectiveness of the treatment of testicular cancer made in Israel. If markers are elevated, you may need a larger number of cycles of chemotherapy.
If BEP scheme is not effective, the doctor uses different combinations of cytostatics:
- VIP or PEI - cisplatin, etoposide, ifosfamide.
- VeIP (vinblastine, ifosfamide, cisplatin).
- The TIP (paclitaxel (Taxol), ifosfamide, cisplatin).
- POMB / ACE (cisplatin, vincristine, methotrexate, bleomycin, actinomycin, cyclophosphamide and etoposide).
- High-dose chemotherapy with cisplatin and etoposide in clinical trials.
High-dose chemotherapy testicular cancer
The patient may be recommended for high-dose chemotherapy with carboplatin and etoposide. Employs high doses of cytotoxic drugs, resulting in damage to bone marrow cells. To correct this condition can be carried out transplants of their own stem cells after chemotherapy.
Common side effects of chemotherapy with testicular cancer
Chemotherapy increases the risk of infection, because it reduces the number of white blood cells. If the temperature rises or there are signs of infection, you should immediately consult a doctor. Appointed by antibiotic therapy.
Possible unwanted effects of chemotherapy using BEP scheme
Men with seminoma testicular cancer at an early stage is usually administered one dose of carboplatin. Most often cited fatigue and malaise.
Neseminomnyh patients with testicular cancer or metastatic recommended a combination of BEP, include bleomycin, etoposide, cisplatin. Such treatment of testicular cancer can cause
- hair loss;
- reducing the level of blood cells;
- flu-like symptoms;
- changes in the skin and nails;
- ulcers in the oral cavity;
- taste changes;
- tingling in the fingers and toes.
Many of these side effects can be reduced with medication that prescribed by a doctor. Therefore, he must be aware of the symptoms arise. Paracetamol, for example, reduce the flu-like symptoms, mouthwash - stomatitis and pain.
After the treatment the state of testicular cancer will improve. hair growth resumes after 3 - 6 months.
Possible permanent adverse effects of chemotherapy
In most patients, there are no permanent side effects. But sometimes there are consequences that do not pass completely. A doctor interacts with patients closely monitoring for side effects. It can be:
- Damage to sperm and infertility. You should use a reliable method of contraception during chemotherapy and for several months thereafter. Chemotherapy drugs can damage sperm. A man may be barren for some time after the treatment of testicular cancer. In most patients, fertility is restored.
- Irregularities in the lungs. Bleomycin sometimes causes pneumonia, usually in a mild form, rarely becomes chronic. If there is shortness of breath or coughing, you should immediately notify the specialist. It may be necessary to change the dose or change the medication.
- Changes in hearing. Cisplatin can affect hearing. Some men develop tinnitus. Sometimes hearing changes become permanent, the patient can not hear high frequency sounds.
- Numbness or tingling in the fingers and toes. It happens that cisplatin provokes these symptoms, as the impact on the nerves. The condition is improving slowly, it is difficult to say how long it will take. But sometimes such injuries become permanent.