Hodenkrebs: eine unterschätzte Krankheit

Testicular cancer: an overview

Overview

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Testicular cancer is the most common cancer in young men between the ages of 20 and 45. In Europe, around 25,000 new cases diagnosed each year. The incidence varies greatly between countries, with the highest rates in northern Europe (e.g. Norway, Denmark, Germany, Switzerland) and lower rates in southern and eastern Europe.

The good news is that testicular cancer is curable in most cases. Thanks to modern therapies, the 5-year survival rate is now over 95 %. Nevertheless, the disease remains a serious issue - above all because it usually affects men at a stage in their lives when family, career and future plans take centre stage. In addition, testicular cancer sometimes has a recurrence rate and therefore requires follow-up care for up to 10 years.

Important challenges are

an early and reliable diagnosis,
the avoidance of overtreatment,
long-term, minimally-invasive follow-up monitoring.

One focus of current research is therefore on non-invasive molecular biomarkers (e.g. miR-371a-3p) for the early and precise detection of testicular cancer and secure monitoring throughout treatment and follow-up. These approaches could simplify follow-up care, avoid overtreatment and further improve the quality of life of young men in Europe.

New methods of liquid biopsy like the M371-Test on the basis of the miR-371a-3p can help to detect testicular cancer early, precisely and without any invasive interventions. This helps to avoid overtreatment and maintain the quality of life of those affected.

Here or via our contact form you can learn more about the M371-Test and its uses.

types

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A broad spectrum: the types of testicular cancer

Around 95 % of all testicular tumors arise from the germ cells of the testicle, i.e. the cells that form sperm. These are called Germ cell tumours (GCTs) . They are divided into two main groups: Seminomas and Non-seminomas. There are also rarer forms that arise from the hormone-producing or supporting cells of the testicles.

Seminomas

Seminomas develop from the sperm-forming germ cells of the testicles and are the most common form of testicular cancer, accounting for around 60 % of all cases. They usually grow slowly and respond very well to surgery, chemotherapy or radiotherapy, which leads to excellent chances of recovery.

In most cases, Seminomas occur in men between the ages of 30 and 45. Only one third of seminomas can be detected by moderately elevated ß-hCG levels. As seminomas generally do not produce AFP, this marker is not suitable for the diagnosis of seminomas.

There are two subtypes of Seminomas. The classical seminoma accounts for around 95 % of all cases and mainly affects younger men. The spermatocytic seminoma is much rarer, usually occurs in men over the age of 50 and is generally less aggressive.

Thanks to the good response to therapies and the often early diagnosis, Seminoma is one of the most treatable types of cancer.

Non-seminomas

Non-seminomas are rarer than seminomas, but grow significantly faster and behave more aggressively. They usually occur earlier in life, often in men in their late teens to around their early 30s.

These tumours can consist of different cell types that differ in their behaviour and response to therapies. Often there are so-called mixed Non-seminomas that combine several cell types. Due to their rapid growth, Non-seminomas tend to metastasise more frequently and therefore require rapid and targeted treatment.

Types of non-seminomas:

Embryonal carcinoma: aggressive, spreads rapidly.
Yolk sac tumour: Most common type in children, rare in adults.
Chorionic carcinoma: very rare, but highly metastasising.
Teratoma: may contain mature (benign) or immature (malignant) cells.

Other types

In addition to germ cell tumors, there are other, much rarer forms of testicular cancer. These include the so-called stromal tumorswhich develop from the hormone-producing or supporting cells of the testicles. They account for around 5 % of cases in adults and up to 20 % in children. Most are benign, but in individual cases they can produce hormones or spread. There are two main types: Leydig cell tumorssome of which release male hormones and rarely metastasise, and Sertoli cell tumorswhich usually remain benign, but can also occasionally grow aggressively.

Another special form is the Carcinoma in situ (CIS). This is an early precursor of testicular cancer in which abnormal germ cells are present in the testicular tissue without invading the surrounding tissue. These changes usually cause no symptoms, but can develop into an invasive tumor over time.

In addition, there are Secondary testicular tumorswhich do not develop in the testicles themselves, but occur as metastases of other types of cancer. The most common of these are Lymphomas in older men, which can spread to the testicles and require special treatment.

Check Yourself

Regular self-examination of the testicles is a simple but effective method of recognising changes at an early stage. If you know your testicles well, you will notice lumps, hardening or differences in size more quickly - often long before symptoms occur.

It is best to palpate once a month, ideally after or during a warm shower when the skin is relaxed. If detected early, testicular cancer can be treated very well in most cases.

Overview

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Palpate one testicle at a time with both hands.

Roll the testicle between your thumb and fingers.

Familiarise yourself with the spermatic cord and the epididymis.

Check for lumps, hardening or other changes.

M371-Test

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The M371-Test: The future of testicular cancer diagnostics

The M371-Test based on the detection of the miR-371a-3p sets new standards in testicular cancer diagnostics. It detects tumors much more precisely than conventional markers and provides fast, reliable results from a simple blood sample. This enables earlier diagnosis and follow-up care can be personalized.

Previous diagnostics vs. M371-Test

The diagnosis of testicular cancer to date has been based on classic serum tumour markers (AFP, ß-hCG, LDH) and imaging procedures such as CT or MRI. These approaches are often unreliable or burdensome: the markers only show elevated values in some patients, and repeated imaging leads to unnecessary radiation exposure, high costs and sometimes to overdiagnosis or overtreatment. Many men are operated on even though there is no active tumor.

The M371-Test offers a precise, fast and minimally invasive alternative. It shows the tumour-specific miR-371a-3p in a simple blood sample and provides a clear indication of whether active tumor tissue is present. The result is available within a few hours and can avoid overtreatment or diagnostic irradiation by imaging.

The M371-Test is a superior tool for primary diagnostics and follow-up care

In a large multicenter study of Dieckmann et al. (2019) with 522 patients (primary diagnostics only) and 258 control subjects (37 clinics in Germany, Austria, Switzerland, Italy and Hungary), the test achieved a sensitivity of 94 % and a specificity of 96 % - significantly better than classic tumor markers.

In a comprehensive study by Belge et al. (2024) 258 patients with clinical stage I testicular cancer were followed up over a period of up to 48 months. During the observation period, 39 recurrences (15 %) occurred. The result of the M371-Test successfully recognised all recurrences, resulting in a sensitivity of 100 % results. In contrast, the serum tumor markers AFP and ß-hCG in combination achieved a sensitivity of only 45 %.

The M371-Test reduces dependence on CT or MRI examinations, lowers radiation exposure and at the same time reduces the burden on the healthcare system. It is suitable for both primary diagnostics, the monitoring of therapy success as well as for the follow-up monitoring. This enables precise, safe and patient-friendly care throughout the entire course of the disease and its treatment.

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Would you like to find out more about the M371-Test?

Further information can be found under the following link - or contact us directly if you have any questions.

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