Testicular Cancer in Paris & Neuilly

Dr Adam Vardi - Urologist

Tumor pathology of testicular tissue

Testicular cancer specialist in Paris

Testicular cancer is a tumor pathology that develops at the expense of testicular tissue. Although rare in the general population (approximately 1 % of cancers in men), it is the most frequent malignant tumor in young men aged 15 to 35.

Thanks to surgical advances and complementary oncological treatments, testicular cancer is today one of the best-treated cancers, with a cure rate exceeding 95 % for localized forms. Dr. Adam Vardi provides rapid management, essential to therapeutic success.

Risk factors and the importance of self-examination

Urological Surgery in Paris & Neuilly

The precise etiology of testicular cancer remains partially unknown, but several risk factors have been clearly identified:

Cryptorchidism: a history of an undescended testicle in childhood multiplies the risk of developing a tumor in adulthood by 5 to 10.
Family or personal history: having a first-degree relative affected or having previously had cancer of the contralateral testicle.
Testicular atrophy: certain alterations in the size or consistency of the gland.

Self-examination: a simple preventive gesture

Dr. Adam Vardi - Urological Oncology in Paris

The diagnosis is most often suspected by the patient upon discovery of a hard, irregular, and painless mass in a testicle. An overall increase in scrotal volume or a sensation of scrotal heaviness is also warning signs that should lead to a urological consultation without delay.

Management of testicular cancer in Paris and Neuilly

Urological Oncology Specialist in Paris

The diagnostic work-up: a medical urgency

Faced with a suspect of scrotal mass, the urologist initiates a standardized work-up aimed at confirming the nature of the lesion and its extent.

Scrotal ultrasound — The first-line imaging examination. It confirms that the tumor is intra-testicular and clarifies its characteristics (size, vascularization).
Serum tumor markers — Three specific markers are measured: alpha-fetoprotein (AFP), total hCG and LDH. Their elevation is a strong indicator of the presence of a germ cell tumor, although their normality does not exclude the diagnosis. They also serve as a baseline for follow-up after treatment.
Thoraco-abdomino-pelvic CT scan — Once the diagnosis is suspected, this scan provides the staging work-up, looking for any retroperitoneal lymph nodes or distant secondary localizations.

Therapeutic strategy: inguinal orchidectomy

The first phase of treatment is surgical. It consists of total orchidectomy by the inguinal route. The procedure involves removing the affected testicle and its spermatic cord through a short incision in the groin. This approach is essential to avoid the dissemination of tumor cells towards the lymphatic drainage of the thigh.

Histological analysis: The testicle is analyzed in the laboratory to determine the type of tumor (seminoma or non-seminomatous germ cell tumor). This analysis guides further treatment.
Testicular prosthesis: For aesthetic and psychological reasons, Dr Vardi systematically offers the placement of a silicone prosthesis in the scrotum during the same operative session.

Fertility preservation and follow-up

Testicular cancer often affects young men who have not yet completed their parental project. Although a single testicle is sufficient to maintain normal fertility and testosterone levels, treatment (notably complementary chemotherapy or radiotherapy) may impair sperm production. Sperm conservation (CECOS) is therefore systematically offered and arranged before the procedure or before any complementary treatment, to safeguard the patient’s reproductive future.

Complementary treatments and surveillance

Depending on the histological type and stage of the cancer, orchidectomy may be the only treatment necessary (active surveillance strategy), or be supplemented by:

hemotherapy: highly effective, often administered in short cycles.
Radiotherapy: used for certain seminomas.
Lymph node dissection: a surgical procedure to remove suspect nodes in the abdomen.

Post-treatment surveillance is rigorous and extends over several years. It is based on regular clinical examinations, CT scans, and tumor marker assays. This vigilance enables early detection of any recurrence, which would then remain entirely treatable.

Conclusion

Testicular cancer, although fearsome in the collective imagination, is today a condition that modern urology manages with remarkable success. The key to success lies in the rapidity of diagnosis and the expertise of initial surgical management. Dr Vardi seeks to offer a coordinated care pathway, integrating the oncological, functional, and aesthetic dimensions to enable the patient to return to a normal and serene life.