Bay Biosciences provides high quality, clinical grade, biopsy tumor tissue bio-specimens, cryogenically preserved sera (serum), plasma and peripheral blood mononuclear cells (PBMC) biofluid samples from patients diagnosed with testicular cancer.
The sera (serum), plasma and PBMC biofluid specimens are processed from patient’s peripheral whole-blood using customized collection and processing protocols. The testicular cancer biopsy tumor tissue samples and biofluids are collected from unique patients diagnosed with testicular cancer and are provided to a valued pharmaceutical customer for research, diagnostics, discovery and drug development.
Detailed clinical data, testicular cancer patients history, symptoms, complete blood count (CBC), serology, chemotherapy information, biopsy tumor tissue, elevated biomarker levels, genetic and metabolic information, histopathological findings, annotations associated with testicular cancer specimens is provided to a valued customer for research, development and drug discovery.
The testicular cancer sera (serum), plasma and peripheral blood mononuclear cells (PBMC) biofluid are processed from patients peripheral whole-blood using customized collection and processing protocols.
Testicular Cancer Overview
Most types of testicular cancer develops in the sperm-producing cells known as germ cells and are referred to as germ cell tumors. Germ cell tumors can start in several parts of the body:
- The testicles, which is the most common location
- The back of the abdomen near the spine, called the retroperitoneum
- The central portion of the chest between the lungs, called the mediastinum
- The lower spine
- Very rarely, a small gland in the brain called the pineal gland
Testicular cancer is almost always curable if found early, and it is usually curable even when found at a later stage.
Types of Testicular Cancer
Following are the two main categories of germ cell tumors that start in the testicles:
- Seminoma: A tumor is only called a seminoma if it is 100% seminoma. This means that the cancer does not include any of the types of tumor listed below.
- Non-seminoma. A non-seminoma contains at least one of the following types of tumor:
- Choriocarcinoma
- Embryonal carcinoma
- Yolk sac tumor
- Teratoma
Each of these can occur alone or in any combination. Most non-seminomas are a mix of at least two different subtypes of germ cell tumor. Non-seminomas may also be partly seminoma at any percentage level less than 100%. For example, a tumor that is 99% seminoma and one percent yolk sac tumor is still diagnosed and treated as a non-seminoma. Generally, non-seminomas tend to grow and spread more quickly than seminomas, but prompt diagnosis and treatment are important for both types of tumors.
Other, less common types of testicular tumors include:
- Leydig cell tumor
- Sertoli cell tumor
- Carcinoma of the rete testis, which is a part of the testicles
- Testicular lymphoma
Testicular cancer is uncommon in those who have not yet reached puberty. Childhood testicular cancer that occurs before puberty is treated differently from cancer that develops after puberty in teenagers and adults. Other types of cancer, such as lymphoma and leukemia, occasionally spread to the testicles. To find out more about cancer that started in another part of the body and spread to the testicles.
Signs and Symptoms of Testicular Cancer
Following are the common signs and symptoms of testicular cancer may include:
- A painless lump or swelling on either testicle. If found early, a testicular tumor may be about the size of a pea or a marble, but it can grow much larger.
- Pain, discomfort, or numbness in a testicle or the scrotum, with or without swelling.
- Change in the way a testicle feels or a feeling of heaviness in the scrotum. For example, one testicle may become firmer than the other testicle. Or testicular cancer may cause the testicle to grow bigger or to become smaller.
- Dull ache in the lower abdomen or groin
- Sudden buildup of fluid in the scrotum
- Breast tenderness or growth. Although rare, some testicular tumors make hormones that cause breast tenderness or growth of breast tissue, a condition called gynecomastia.
- Lower back pain, shortness of breath, chest pain, and bloody sputum or phlegm can be symptoms of later-stage testicular cancer.
- Swelling of one or both legs or shortness of breath from a blood clot can be symptoms of testicular cancer. A blood clot in a large vein is called deep venous thrombosis or DVT. A blood clot in an artery in the lung is called a pulmonary embolism and causes shortness of breath. For some young or middle-aged people, developing a blood clot may be the first sign of testicular cancer.
Many symptoms and signs of testicular cancer are similar to those caused by noncancerous conditions. These are discussed below:
- Change in size or a lump in a testicle
- A cyst called a spermatocele that develops in the epididymis. The epididymis is a small organ attached to the testicle that is made up of coiled tubes that carry sperm away from the testicle.
- An enlargement of the blood vessels from the testicle called a varicocele.
- A buildup of fluid in the membrane around the testicle called a hydrocele.
- An opening in the abdominal muscle called a hernia.
- Pain
If cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may be called palliative care or supportive care. It is often started soon after diagnosis and continued throughout treatment. Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.
Risk Factors of Testicular Cancer
The following factors can raise a patient’s risk of developing testicular cancer. However, it is important to note that the cause of testicular cancer is unknown.
- Age: More than half of the patients who are diagnosed with testicular cancer are between age 20 and 45. However, people of any age can develop this disease, including those in their teens and in their 60s, so it is important that anyone with signs and symptoms of testicular cancer visit the doctor.
- Cryptorchidism: Cryptorchidism is an undescended testicle, meaning that one or both testicles do not move down into the scrotum before birth. This condition increases the risk of developing testicular cancer. This risk may be lowered if surgery is used to fix the condition before puberty. Some doctors recommend surgery for cryptorchidism between ages 6 months and 15 months to reduce the risk of infertility. Infertility is the inability to produce children. Because cryptorchidism is often fixed at a young age, many people may not know if they had the condition.
- Family history: A person who has a close relative, particularly a sibling, who has had testicular cancer has an increased risk of developing testicular cancer.
- Personal history: Patients who have had cancer in one testicle have an increased risk of developing cancer in the other testicle. It is estimated that out of every 100 people with testicular cancer, two will develop cancer in the other testicle.
- Race: Although people of any race can develop testicular cancer, white people are more likely than those of other races to be diagnosed with testicular cancer. Testicular cancer is rare in Black people. However, Black people with testicular cancer are more likely to die of the cancer than white people, particularly if the cancer has spread to the lymph nodes or other parts of the body when it is diagnosed.
- Human immunodeficiency virus (HIV). Patients with HIV or acquired immune deficiency syndrome (AIDS) caused by HIV have a higher risk of developing seminoma.
Diagnosis of Testicular Cancer
Following tests are performed to diagnose, testicular cancer and to find out if the cancer has spread to another part of the body from where it originated, this is called metastasis. Imaging tests can show if the cancer has spread inside of the body.
- Type of cancer suspected
- Signs and symptoms
- Age and general health
- The results of earlier medical tests
Patients develop a testicular lump or something else that could be testicular cancer, it is important to see a urologist for more tests. A urologist is a doctor who specializes in treating testicular cancer and other conditions of the urinary tract. Physical examination and ultrasound tests are show an abnormality that appears to be a tumor, then blood tests are done. In addition, the testicle may need to be surgically removed to look for signs of cancer.
Physical examination: The doctor will feel the testicles for any sign of swelling, tenderness, or hardening. The doctor will also feel the abdomen, neck, upper chest, armpits, and groin for evidence of enlarged lymph nodes, which may indicate that a cancer has spread. The breasts and nipples will also be examined to look for growth, and the legs will be examined for swelling. Leg swelling can be from blood clots in veins in the legs, pelvis, or abdomen.
Ultrasound: An ultrasound uses sound waves to create a picture of the internal organs. The sound waves produced by the ultrasound bounce off tissue in the scrotum. The echoes of the sound waves produce a series of images called a sonogram. These images of the testicle help the doctor find any tumors or other abnormalities. If there is a tumor large enough to be seen on an ultrasound, then the sonogram will show the size, location, and solidness of the tumor. A solid tumor inside the testicle is very likely to be cancerous.
Blood tests/tumor markers: The levels of serum tumor markers are measured before surgery to remove a testicle. Tumor markers are substances made by a cancer that are found at abnormally high levels in the blood of some people with cancer. For testicular cancer, serum tumor marker levels are used to find out the cancer’s stage and to confirm whether a tumor is a pure seminoma. Different types of cancer make different tumor markers. The following tumor markers are used to help stage and plan treatment for testicular cancer:
- The alpha-fetoprotein (AFP) level is often elevated in patients with non-seminoma. AFP is not made by seminomas, so an increased level of AFP is a sign that the tumor is not a pure seminoma.
- Beta human chorionic gonadotropin (beta-hCG) is often, but not always, elevated in people with seminoma or non-seminoma. However, beta-hCG levels above 1,000 IU/L generally indicate that the cancer is a non-seminoma and not a seminoma.
Elevated levels of these tumor markers may indicate testicular cancer or another type of cancer. However, it is possible to have testicular cancer and have normal tumor marker levels. It is also possible to have elevated levels of these markers without having cancer.
Other tumor markers that may be used for testicular cancer include:
- Lactate dehydrogenase (LDH), which is only used to determine how much chemotherapy to give for metastatic non-seminoma. This is because many other cancers and non-cancerous conditions can increase LDH levels. LDH is not used to find testicular cancer.
- Placental alkaline phosphatase (PLAP) is another tumor marker doctors may test for, although it is not commonly measured.
Orchiectomy/surgical pathology tests: If testicular cancer is suspected, a surgeon will perform a radical inguinal orchiectomy. During this surgery, the entire testicle is removed through an incision in the groin. Then, a pathologist will examine very thin slices of tissue from the testicle under a microscope to diagnose the type of cancer. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. For testicular cancer, the pathologist determines if the tissue from the testicle contains cancer cells. And, if it does, the pathologist determines what type of cancer cells they are. Most testicular cancers are germ cell tumors, which are divided into two categories: seminoma and non-seminoma. If a person has only one testicle to begin with or the diagnosis is uncertain, the surgeon may remove only a small sample of tissue from the testicle. The testicle may still need to be removed if there are cancer cells. If the tissue sample does not show cancer, it may be possible to repair the damage from the tissue removal and replace the testicle in the scrotum during the same surgery. However, this procedure is very rare.
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