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Symptoms Of Testicular Cancer With Swollen Lymph Node In Groin Area. Can Testicular Cancer Be There For 10 Years?

Posted on Wed, 22 May 2013

Question: sir, the symptoms of testicular cancer (swollen lymph node and groin area) is visible in naked eye ? Or how large the swollen is ? Or it can only be felt by touching it ? Or the swollen is too small to feel normally and can only be felt by thorough examination by hand ? Can testicular cancer be there for 10/11 years and the patient is unable to know that he is having it and does no treatment ?

Answered by Dr. Grzegorz Stanko (2 hours later)

Hello!

Thank you for the query.

Lymph nodes when not enlarged should bot be palpable and for sure not visible. If you can see your inguinal lymph nodes, you definitely should have a diagnostics of it. Some nodes can be enlarged and not visible or palpable. In such cases ultrasound is good to check if the lymph nodes are enlarged.
No, testicular cancer can not be present for 11 years without serious complications. If the testis cancer appears, the pain is present in one testicle, and the hard uneven mass is palpable in the scrotum.
Enlarged lymph nodes does not have to be because of testis cancer. It can also get enlarged due to inflammation in surrounding area. You never know as long as you wont take a look under the microscope.

I suggest you to have an ultrasound of this groin with enlarged lymph nodes and if lymph nodes present, one of them should be removed and send for histopathology.

Hope this will help. Feel free to ask further questions.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (6 minutes later)

thank U sir. Another question is that does carcinoma in situ present for such along period which can lead to cancer at later stage ? Among spermatocele , hydeocele, orchitis etc which is having the capacity to lead cancer or none of these can lead to cancer ?

Answered by Dr. Grzegorz Stanko (8 minutes later)

You need to imagine what carcinoma in situ is. This is presence of the malignant cells in the very first layer of the tissues. Malignant cell means that this is a cancerous cell. Such cell is usually very aggressive, because of DNA mutation and the only aim of such cells is to multiply as fast as it is possible. So even carcinoma in situ would not stay hidden for 10 years.
Neither of mentioned by you condition does not make you prone for cancer. Risk factors for testicular cancer are: testicular cancer in the family, cryptorchidism (testicle in the abdomonal cavity or inguinal canal), HIV infection, chromosomal abberrations.

Hope this will help.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (6 minutes later)

thank U so much sir. Now I feel safe. Please clear another doubt that what is the difference between carcinoma in situ and testicular cancer ? And can carcinoma in situ convert to testicular cancer at later stage ? I mean suppose I have carcinoma in situ and at later it converted to testicular cancer in the mean time it may take a long period like 10 years in total (some time may be taken for carcinoma in situ to lead cancer and some time to taken for cancer to be expressed visibly). Is it possible sir ?

Answered by Dr. Grzegorz Stanko (17 minutes later)

Carcinoma in situ is a cancer. There is no difference between testicular cancer and carcinoma in situ.
The term "carcinoma in situ" is used to describe cancer which cells are present in the very first layer of the tissue. This can be seen only with microscope. This is a part of TNM calsification of testicular cancer what helps to determine staging of the cancer. Letter T means Tumor, N - lymph Nodes, M - Metastases.
T part contains:
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor (e.g. histological scar in testis)
Tis Intratubular germ cell neoplasia (carcinoma in situ)
T1 Tumor limited to testis and epididymis without vascular/lymphatic invasion: tumour may invade tunica albuginea but not tunica vaginalis
T2 Tumor limited to testis and epididymis with vascular/lymphatic invasion, or tumor extending through tunica albuginea with involvement of tunica vaginalis
T3 Tumor invades spermatic cord with or without vascular/lymphatic invasion
T4 Tumor invades scrotum with or without vascular/lymphatic invasion

Carcnoma in situ is Tis. It is limited to the first layer of the testicular tubes.
So even if you have had carcinoma in situ, during 10 years it would kill you (sorry for this term but want to make it clear).
So it is not possible for you to have carcinoma in situ which still has not developed into regular testicular cancer.

Hope this will help.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (12 minutes later)

thank u sir. no need to say sorry for the term "kill". U R free to use this term to make me understand. My next question is is any benign cyst/ lump attached to testicle has the ability to convert into cancer in future ?

Answered by Dr. Grzegorz Stanko (1 hour later)

Most of known benign cysts or lumps in the scrotum are unable to convert into the cancer (this is what statistics say), however every person is different and extremely things can happen.
From our conversation I assume that you have a lump nearby one of the testicle which is there for 10 years. In such case, this lump is most likely spermatocele - a simple cyst of the epidydimis which contains fluid inside. If such cyst does not grow, it can be left alone as it does not increase risk of a cancer.
You may perform simple test: put the flashlight into this lump and see if it passes the light. If so, you may be sure this is the cyst. Ultrasound can confirm it.

Hope this will help.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (11 minutes later)

thank u sir, I have already did it (put a light behind the lump). It clearly allows the light to pass. But is there any chance of being cancer in future by this lump ? If I leave it ? Another thing is that sir can this symptom be due to testicular torsion ? Means can testicular torsion also have the symptom which is with me (I don't remember whether I have pain in my testicle or nor before 10 years)?
U have told to use flash light I have used torch. Is there any problem ?

Answered by Dr. Grzegorz Stanko (48 minutes later)

Torch is fine. If it clearly allows the light to pass, and does not get bigger since 10 years, this is for 99% a benign cyst. It should be left alone in such case and no further problem is expected. No cancer possible.

Testicular torsion gives very strong pain (unbearable) in one testis and lower abdomen. Fever, nausea and vomiting can be also present. This condition is urgent and when left alone usually causes testicle necrosis. So it is rather not possible that your pain is caused by testicle torsion. If you have notice such pain, it would force you to visit ER.

Our body is constructed in its own way and every person is different. So one thing which is not present in other person, can be a normal thing for you. If this cyst is with you for 10 years, and since than nothing has changed, you need to accept that as this is just a part of your body.

Hope this will help.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (34 minutes later)

thank U sir. Sir, can it so happen that spermatocele or hydrocele or epididymal cyst which is not increasing in size now , may increase in size in future ? And can it cause any harm to life in future ?

Answered by Dr. Grzegorz Stanko (42 minutes later)

Yes, it can happen that such cyst will start growing. However most likely it will remain as it is. In case of growing only by pressing surrounding tissues it can cause pain and in such case simple surgical removal will cure it.
Such cyst does not cause any fertility problems, no risk of cancer etc. It may start causing pain, that's it. So you should keep palpating it from time to time.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (20 hours later)

sir, can it so happen that the said lump(as it discussed before) can grow without pain in future ? If so is it necessary to remove it or not ??

Answered by Dr. Grzegorz Stanko (1 hour later)

Yes, it can get larger without any signs. If it will start compressing other things in the scrotum like testis or epidydimis, it should be removed. Definitely, if it will start growing, you should assume that something in the scrotum has changed and verify it with an ultrasound. But most of this lumps when were inactive for 10 years, wont start growing ever.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (4 minutes later)

thank u sir. How shall I know that it is compressing other things in the scrotum like testis or epidydimis ? What are the symptoms ? and what do U exactly mean by compressing ? Can it cause any harm to my life by compressing other organs ? Please reply sir.

Answered by Dr. Grzegorz Stanko (6 minutes later)

No, it wont cause any hard for surrounding tissues. It is filled with fluid which is soft and wont cause any serious damage. But if you will notice that the skin on the scrotum is getting tense due to some mass inside it which seems to not have more space inside, you should than react.
Some earlier symptoms like pain or discomfort (before significantly visible enlargement) can appear, but you have asked me about growing without the pain. Usually it gives pain due to venous circulation problem or due to pulling muscle or testis.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (4 minutes later)

thank U sir, U mean if it grows tp such extent that it will not any more space to grow(the scrotum will be tensed) then it should be removed ? and it may also happen with/without pain? and It can only be removed but it can't cause any cancer ? Am I correct sir? if not then please explain me just like U made me understand previously. Thank U sir.

Answered by Dr. Grzegorz Stanko (16 minutes later)

You should have it removed if:
- you will notice any pain, discomfort caused by it
- you will find out during self palpation that this has gotten larger
- or if you wont have any pain or changes during the palpation (it will become larger without causing any pain) and you will notice that something is happening in the moment when scrotum skin will get tensed (this is very extreme example and most likely you will notice it earlier)

So in simple words: any changes with this lump (no matter when noticed), you go to the urologist and consider removal
Nothing is happening - nothing needs to be done.

It can not cause a cancer. Please stop thinking about the cancer. You are a very young person. Cancer is not a very common disease. Testicular cancer risk is about 1%. What means that only 1 % of all people will be testicular cancer sick.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (8 minutes later)

thank U sir, sir suppose I don't remove it in spite of all/any of these symptoms U have defined . (suppose I unable to notice the above symptoms U have said). Will there be any serious problem ?

Answered by Dr. Grzegorz Stanko (12 minutes later)

No, no problems from not noticing its enlargement. Sooner or later you will notice it.
The only problem it can cause is large scrotum. Nothing more.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (4 minutes later)

thank U sir. before some time U have told that it is having very less chance to grow (because it has not grown since last 10 years) but just now U have said that it will definitely grow. I could not understand sir. What are its chances of growing ? And is growing means XXXXXXX ?

Answered by Dr. Grzegorz Stanko (7 minutes later)

No, not meant that. Just said that If it will grow (what is very unlikely) you will notice it sooner or later.
But most likely it wont grow. The chance of it is very low. But if such rare situation will occur, you need to check it as it can start causing pain and surgery might be necessary.
So please stop worrying about it. It is really a small (tiny) reason to be worried. It is with you for 10 years. You should accept it and do not focus on it.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (12 hours later)

sir, the size of the said lump is about 1.5-2 cm in width (length may be a little more because it is like a small testicle or elliptical shape I mentioned the width only and I unable to hold it by its length because it slips from my hand and a cord(perhaps epididymis cord) is obstructing me). Is the size very large or should cause the matter to be worried and remove immediately ? Now what ever I have decided that because it is with me since 10/11 years (may be 12 years) and it has not created any problem then I will leave it as usual just as a part of my body and only remove it or do ultrasound to diagnosis if it creates any problem like constant pain etc. Am I in correct path sir ?

Answered by Dr. Grzegorz Stanko (9 hours later)

Yes, you are correct. This is quite small lump. Everything what has been said in our previous conversations is no changing because of the size of it.
So like I have said before, no reason to worry. Just take a look on it from time to time. Nothing has to be done with it right now. Only in case of size change etc.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (10 minutes later)

sir, I went for an ultrasound today . But they said that it can't be done today(due to their problem). Sir, does scrotal ultrasound need any special machine/doctor or it can be done with the same machine/ doctor ? If I don't do ultrasound can this lump be a threaten to my life with cancer ? How far the light test is reliable ? Is there any chance that although light is passing through it still it is cancerous or it can be cancer in future ? Sir does the removal of this lump by surgery may cause infertility ? thank U .

Answered by Dr. Grzegorz Stanko (40 minutes later)

Testis ultrasound is just a regular one. No special skills necessary and no any special ultrasound. Just a regular one.
We have discussed it so many times. This lump is totally harmless. Forget about the cancer. Test light is very characteristic for cysts and allows to spot the difference between the cyst and the cancer. If it passes the light, it contains fluid. If it contains fluid, it can not contain anything else. So this test is quite reliable. No cancer from that lump in the future.

Surgery of this lump is just a small incision. No risk for your fertility. So please stop worrying about it.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (3 hours later)

thank U sir, Sir, will it create any problem or pain if I do physical exercise or outdoor sports ? I am asking U because I am going to learn martial art(judo/karate/Taekwondo ) very soon. Can I learn it ? I will only learn it if there is no chance of any problem from the lump like any harm to my life and if U permit me to do so. Waiting for your reply sir.

Answered by Dr. Grzegorz Stanko (1 hour later)

Hello!

Physical activity is more than recommended. You should treat yourself as a healthy person as this testis cyst is not a problem at all. And as healthy person any physical activity including martial arts is a very good idea.
It does not make any difference for martial arts if you have a small cyst or not. So go ahead.
Moreover, physical activity will let you keep your body healthy, improves blood circulation and has any cancer protective effect.
So no harm for your life, nothing will happen with the cyst. And it will let you forget about it.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (34 hours later)

sir, today i did the ultrasound test of the scrotum. I have uploaded the report. Sir i am a little tensed after seeing the report (although I have not much idea about medical science). Another small cyst is also there in right testicle detected (which was never known to me) and also a large cyst is detected in the left testicle. Sir is it XXXXXXX or cancer ? Please see the report I have uploaded and please tell me is there anything serious or will there be any effect on my fertility ? Please help me sir. Thank U. sir they have also given me another material(just like X-ray photo, after ultrasound). Is this report enough or that X-ray photo like material should also be needed for diagnosis ? (I don't know what is it) Thank U . If I have both cyst on both of my testicle is there any serous problem ? What are the complication I will face ? Please help me sir. Thank U in advance sir.

Answered by Dr. Grzegorz Stanko (6 hours later)

Hello!
The report is enough, no need to attach photos.

Your ultrasound result is a very good one. First of all, no evidence of cancer which has been ruled out in that way.
And the cyst were confirmed. That is also a very good news as you dont need any surgery. The cyst is really a small one and should be left alone.
There is another cyst in right epidydymis. But it is so small that can be barely visible in the ultrasound (2x2 mm is really a tiny thing). It completely DOES NOT bring a risk of cancer.
So your ultrasound has just confirmed all what has been said before in this conversation. No need to worry, no need to be afraid of cancer, no risk of cancer, no risk for fertility. No complications from this cysts.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (2 days later)

sir, sorry to again knock your door. Sir I have already discussed much with U about the lump attached to my testicle and my ultrasound report. U have advised me that there is no need of surgery and also no cancer is there and also it will not be cancer in future. Sir, my question is will I leave this lump as it is or what should I do with this lump ? Thank U again.

Answered by Dr. Grzegorz Stanko (2 hours later)

Hello!

You should leave this lump as it is. No surgery is necessary. Cancer has been ruled out. If you want to be sure, repeat the ultrasound in a year or so, to see if it does not get larger. But for now, no need to do anything with it.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (18 minutes later)

sir, U have told me to repeat the ultrasound every year. Is it necessary or U R saying it only for my satisfaction ? can an epididymal cyst be cancer in future so that I have to repeat ultrasound ? Please reply me sir. Thank U.

Answered by Dr. Grzegorz Stanko (18 minutes later)

Ultrasound is more for your tranquility. We have discussed so many times that it can not be cancerous. We have also discussed that in case of getting larger, it might need surgery. In that matter ultrasound can be helpful.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (18 minutes later)

Its Ok sir. from today I will totally forget about that lump and leave it as it is. And no need of ultrasound again from year to year. Am I right sir ?

Answered by Dr. Grzegorz Stanko (1 hour later)

Exactly. It is really not a big deal this lump. So just forget about it and you will be fine.

Regards.

Note: For further inquiries on surgery procedure and its risks or complications book an appointment now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar