Seminom

Seminom

The seminoma is a germ cell tumor of the testicles. It is formed from the cells of the so-called spermatogonia. The prognosis of a seminoma is usually good because all stages can be treated well.

What is a seminoma?

Seminoma is the most common form of testicular cancer. It belongs to the germ cell tumors, which develop through the degeneration of precursor cells of the germ cells (sperms). Testicular germ cell tumor is the dominant form of testicular cancer. However, in the case of germ cell tumors, a distinction must be made between seminomas and non-seminomas. For autoimmune thyroid disease in dictionary, please visit dictionaryforall.com.

The seminomas form on the basis of degenerated primordial germ cells. These are stem cells that have already undergone the first cell divisions in the direction of germ cells. These cells can be converted back into pluripotent stem cells. Pluripotent stem cells are original cells that can still differentiate into all cells in the body. The primordial germ cells are also referred to as spermatogonia.

Throughout life, the male organism forms spermatogonia in the testicles, which are continuously transformed into sperm. In contrast to real germ cells (sperm), spermatogonia still have diploid sets of chromosomes, which are subject to meiosis (halving of the chromosome set during cell division) as part of germ cell development.

Seminomas account for approximately 53 percent of all germ cell tumors. The remaining 47 percent of germ cell tumors are non-seminoma. These develop from the same but already further differentiated progenitor cells of the germ cells.

Causes

The causes of the development of seminoma and the other forms of testicular cancer are not yet exactly known. It has been shown that a maldescensus testis ( undescended testicles ) that has gone through is a risk factor for the development of testicular cancer. When the testicles are undescended, the testicles are exposed to a body temperature of around 36 to 37 degrees Celsius.

Outside the body in the scrotum, the temperature is only 33 degrees Celsius. This cooling effect protects the testicles. Higher temperatures lead to their damage. Hypospadias (malformation of the urethral opening) also carries an increased risk of developing testicular cancer. Hereditary factors were also identified. Testicular cancer cases tend to run more frequently in certain families.

A hormonal influence of female sex hormones can also lead to testicular cancer. These risk factors apply to both seminomas and non-seminomas. The risk is also increased in the case of infertility due to underdeveloped testicles or a lack of viable sperm.

Symptoms, Ailments & Signs

Seminomas and the other forms of testicular cancer produce similar symptoms. Symptoms also depend on the cancer stage. In the beginning, the symptoms relate specifically to the testicles. In later stages, there are still multiple symptoms throughout the body, which depend on the location of the metastases.

First, a gradual hardening of a testicle develops, which can also be felt from the outside. The affected testicle also swells. This is caused either by the tumor itself or by water retention. The testicles also become heavier due to the increase in size and mass. In parallel with the heaviness of the testicle, there is a painful pulling up to the groin area.

Furthermore, the testicles hurt in some cases. Since female sex hormones are also increasingly produced in the context of testicular cancer, breast formation ( gynaecomastia ) can occur in men. In later stages, metastases can also develop in other organs. Here, degenerated cells of the testicular tissue migrate via the lymph to distant parts of the body. Among other things, the lymph nodes swell.

The lungs, bones, brain and liver are particularly affected by the metastases. Depending on the organ affected, persistent coughing, respiratory problems with shortness of breath, nausea, chest pain or bone pain occur. All symptoms can occur in both seminomas and non-seminomas.

Diagnosis & course of disease

For treatment, it is important to know whether it is a seminoma or non-seminoma. First, the doctor performs a physical examination. The testicles are palpated for hardening and swelling. Blood tests are used to detect tumor markers. The tumor can be visualized with an ultrasound scan.

A biopsy of the testicle reveals which tumor it is. If metastases are suspected, x-rays, computed tomography, and MRI can be used to detect secondary growths.

Complications

A seminoma can cause various complications. Similar to other forms of testicular cancer, the germ cell tumor also leads to a gradual hardening of the testicles – either through water retention or through the tumor itself. This is usually associated with painful pulling up to the groin area. Breast formation can also occur in men.

As the cancer progresses, it can spread to other organs and cause chronic pain. If the lymph nodes swell, this can also cause pain and a feeling of pressure. When the lungs are affected, coughing, shortness of breath, and other respiratory problems occur. Bone pain occurs when the bones are affected.

Metastases in the brain can cause neurological deficits and, in the worst case, lead to a stroke. In the further course, a seminoma leads to an increasing decrease in well-being – it comes to depressive moods and usually also to chronic pain. Chemotherapy can lead to inflammation of the mucous membranes, hair loss and changes in the blood count. Heart damage, nerve disorders, allergies and kidney or bladder disorders occur less frequently as a result of aggressive therapy. The prescribed medicines can also cause a number of side effects.

When should you go to the doctor?

Since seminoma is a tumor, it should always be treated by a doctor. This disease cannot heal on its own. The tumor can spread to neighboring regions of the body. This may also reduce the life expectancy of the person affected. For this reason, a doctor should be consulted at the first signs and symptoms of this disease in order to prevent further complications.

A doctor should be consulted for seminoma if the person affected suffers from severe water retention. These occur all over the body, with the testicles being particularly affected by these deposits. They increase significantly in size and weight, and these symptoms are usually visible to the naked eye. Furthermore, severely swollen lymph nodes can indicate the seminoma, most patients also suffer from pain in the bones or permanent nausea. The seminoma can be detected by a urologist. Further treatment depends on the severity of the tumor, although complete healing cannot be guaranteed.

Treatment & Therapy

Therapy for testicular cancer depends to a large extent on whether it is seminoma or non-seminoma. If metastases have not yet developed, simple surgical removal of the affected testicle is often sufficient in the early stages of the disease. After that, we wait and observe the development over a longer period of time.

Since the second testicle can also be affected in five percent of cases, it is of course examined by palpation and, if necessary, by an additional biopsy. A seminoma can also be treated well in other stages because it is sensitive to radiation. So his prognosis is good. If the seminoma reappears some time after the operation, the tumor can be successfully treated with radiation or chemotherapy.

In the early stages, radiation is not used after the operation because it can also cause cancer. In addition, a recurrence of a seminoma is always easy to treat, so waiting is sufficient for the time being. Carboplatin, among other things, is used for chemotherapy of seminoma.

Prevention

There are no recommendations for preventing seminoma because the causes are largely unknown. If there is a family history of testicular cancer, the testicles should be examined regularly.

Aftercare

After a successful operation, chemotherapy or radiotherapy of seminoma, close follow-up examinations and observations for the early detection of any recurrences and late effects are necessary within the first two years, especially since doctors expect 300-600 recurrences in 4000 patients treated. In this way, a relapse can be detected more quickly and the chances of recovery can be increased many times over.

Recurrences discovered too late can severely worsen the prognosis and require intensified therapy. During the follow-up checks, physical examinations and laboratory checks take place at predefined intervals, which can also include lung X-rays, tumor markers, ultrasound of the lower and upper abdomen and CT scans of the pelvis and abdomen. These are carried out by specialist staff based on the stage, therapy and histology.

The doctor examining you will look for symptoms such as back or flank pain, swelling, headaches and seizures, which could indicate a possible recurrence. Patients treated with cytostatic therapy in early stages generally have a much lower risk of recurrence; nonetheless, they too are closely followed up.

According to statistics, if a recurrence occurs, this usually happens in the first two years after the seminoma treatment has been completed; later relapses are extremely rare, but still possible and generally easily curable. Operations, radiotherapy and chemotherapy and their side effects can also leave behind psychological damage, which should be discussed with a psychologist as part of the aftercare.

You can do that yourself

After the successful treatment, it is important for the seminoma patients to get used to everyday life again. This includes regular follow-up examinations by the doctor. The relatively frequent appointments ensure that the disease does not recur.

Mental health care is also important for most men. This helps them regain more self-confidence after cancer treatment. The large burden and loss of the organ negatively affects self-esteem. In many cities there are psychosocial counseling centers that are often networked with the clinics. The treating doctor can provide his patients with the appropriate contact addresses. The psychological support often begins with the doctor himself, who looks after the patient in the first phase after the operation. Other medical professionals are also familiar with the topic and know how to fix the typical problems.

For self-help in everyday life, supply and insurance issues also play a role. In some cases, there are already competent people to talk to in the hospitals who can help those affected. A self-help group is ideal for mutual support on the one hand and for getting back into everyday life on the other.

Seminom