▷ TESTICULES Cancer 🤪! Causes, Symptoms and Treatments


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Do you usually have the opinion that it's better to prevent than to cure? Are you worried about your health or are you looking for true, reliable and proven information about most common pathologies in men? Are you going through a bad experience and need someone to tell you in detail everything that nobody explains to you about the Testicular cancer? You are in the right place! Regarding men's health, there is still a lot to write, but if the motivation that has brought you here is to find real, precise and explanatory explanations about the testicular cancer, you are in the right place. You have the age or family history you have and either because you are curious or because you notice something is below that is not quite right, we encourage you to read this complete guide on this exclusive disease of man (If you are a male between 15 and 40 years old, even more).

testicular cancer causes types symptoms steppes treatments

Being aware of the peculiarities about cancer cases with a higher incidence in men can not only help prevent or detect them in their initial stages (when they are still small and easy to treat), but also to save your life. We do not mean by this that suffering from testicular cancer is the end of the world; in fact, the statistics of healing and survival (which you will find later) throw a ray of light today. In any case, you must take control of your own health. Therefore, in this guide we propose all the relevant information about the implications, causes, symptoms and stages of testicular cancer. As well as early detection techniques, the most effective healing treatments and review and monitoring methods. Do not miss the opportunity to arrive on time!

What it is and what information you should know about testicular cancer

We are sure that it is not the first time (nor will it be the last) that you hear about Testicular cancer; since, to our misfortune, and next to prostate cancer, it is one of the most frequently detected in middle-aged men. However, it is not prudent to self-suggest about it if you are not previously well defined. concept and description of this type of tumor. The time has come to put all the materials on the table to define and characterize the concept of testicular cancer.

In the first place, it is worth mentioning the organ affected by the tumor. The testicles they are part of the reproductive system of man and are responsible for produce male hormones (mainly testosterone) and sperm. They have an ovoid shape and are attached thanks to a duct called the spermatic cord, where the blood vessels and nerves reach it, and where the path responsible for carry sperm.

Consequently, however obvious or redundant it may sound, you should know that eTesticular cancer takes place in the scrotum (tissue where the testicles are located), a bag of suspended skin that is under the penis and that is of great importance in the reproductive and hormonal functions of men. The scrotum houses the cells that produce sperm, known as scientifically as germ cells. And it is precisely in them where 90% of testicular cancers begin.

Let's see how we can explain the latter in the most illustrative way possible. Our body is constituted by a set of organs, which in turn are formed by cells, such as the aforementioned germ cells. These are divided on a regular basis in order to replace old or dead ones and thus maintain the integrity and proper functioning of the various organs. Among them, the testicles in the case of men.

This division process is regulated by a series of mechanisms that indicate the cell when to start fragmenting and when to remain stable. However, put yourself in the position that for certain reasons these mechanisms are altered in a cell. What happens then? That she and her descendants undertake a uncontrolled division and excessive that will eventually lead to a tumor.

Not enough with it, if these cells, in addition to growing out of control, acquire the power to invade tissues and organs around (process known as infiltration) and move proliferating in other parts of the body (the famous metastasis), will generate a malignant tumor, which is what we commonly know as cancer. If we extrapolate the influence of these tumor cells in the tissues located in the testis, we talk about Testicular cancer.

In later sections we will talk about risk factor's and the affected groups For this pathology, but we take the opportunity to anticipate that testicular cancer is a tumor that appears mainly in young men, located in an age range between 15 and 35 years, and that, perhaps because of this incidence at an early age , usually of good prognosis. Previously we mentioned that testicular cancer is one of the most detected in men; However, despite this, the casuistry in Spain is between 1.6 and 2 cases per 100,000 inhabitants.

From our team we have always defended that information is power. And you, you just took a big step breaking with the fears and taboos that are around testicular cancer and delving into its definition and more precise characterization. You are welcome to know that it exists, if its implications or its scope are unknown. Keep reading and you will find everything you need so that nothing catches you off guard.

Risk factors in the onset of testicular cancer

Referring to the delimitation made by the World Health Organization (WHO) Regarding the concept of Risk Factors, the following definition should be highlighted: “A risk factor is any trait, characteristic or exposure of an individual that increases their likelihood of suffering a disease or injury.”Taking this perspective as a starting point, we will focus on referencing those personal elements that may contribute to the assumption of testicular cancer.

  • Age: Although it could be considered as a risk factor or as an age range of incidence, age is the greatest condition when suffering from a testicular tumor. The young men between 15 and 40 years old They are the most conducive to developing this disease due to the dynamism and activity of their cells. This does not mean that, in general terms, it can appear at any age.

  • Undescended testicles: You probably don't know that the testicles form in the abdominal area during fetal development, and that they usually descend to the scrotum before birth. However, there are cases in which man has a testicle that never descended completely, is what is known as cryptorchidism, and, unfortunately, it could be another risk factor even after having relocated the testicle surgically.

  • Abnormal testicular development: There are few men who suffer from pathologies that cause the testicles to develop dysfunctionally or with poor morphology. One such case refers to Klinefelter syndrome, a genetic condition that occurs when a child is born with an extra X chromosome and that affects the growth of the testicles (causing them to be smaller) and to testosterone segregation. Abnormal testis evolution can also be an incentive that contributes to testicular cancer.

  • Family background: Family history, as is the case with a father or a brother who has been diagnosed with testicular cancer supposes, at the level of genetic traceability, a danger factor for which to keep track in professed. However, only a small number of cancers occur as a response to a genetic "transmission."

  • Personal history: The people that have already had testicular cancer They have a higher risk of having a cancer in the contralateral testicle. Around the 3% or 4% of men who have been cured of cancer in one testicle will at some time suffer from cancer in the other testicle.

  • HIV infection: Some evidence has shown that men infected with human immunodeficiency virus (HIV), especially those with the acquired immunodeficiency syndrome (AIDS), have an increased risk of suffering from testicular cancer. We emphasize that it has not been shown that other sexually transmitted infections or diseases increase the risk of testicular cancer.

  • Race and ethnicity: The racial origin of the person has been shown as a condition when it comes to suffering or not a testicular tumor. Thus, the risk between white men is about 4 to 5 times higher than that of blacks and that of Asian-African men. The reason for this difference is unknown, but different studies indicate that the greatest risk of developing this disease is that of American and European men, while the lowest risk is located in Africa or Asia.

Causes and pathology of the testicular tumor

It is common that, when facing any type of cancer, we try to look for the how and why. Not only to try to avoid the inevitable but also to self-configure a security climate thanks to the information we have available. In this sense, it is normal to ask what causes testicular cancer and how can you avoid. If you have this key, and if it is controllable, you could work for the eradication of testicular cancer.

Testicular cancer can develop from any type of cell present in the testicle, but more than 95% of all testicular cancers are germ cell. Histopathology of testicular cancer is complicated, and should be done by a experienced pathologist that specifies characteristics such as: vascular invasion (in the noseminomas), of the rete testis (in the seminomas), or the percentage of the different types of tumor if any.

So, unfortunately, as you might begin to intuit, The exact cause is unknown of most types of testicular cancer. However, what specialists are sure of is that testicular cancer occurs when healthy cells in this organ are altered and instead of reproducing in an orderly manner cause uncontrolled or even unnecessary growth. It is these cells that accumulate in the form of mass in the testicle that give rise to the tumor. The problem lies in not knowing the reason why germ cells become abnormal and end up becoming cancer.

Various investigations are currently being conducted to perform an introspection about the causes closest to the disease. However, so far, the way to categorize and carry the traceability of testicular tumors refers to the aforementioned risk factors.

Some of the inquiries made focus on DNA. Researchers have discovered how certain changes in a cell's DNA can cause the cell to become cancer. DNA is the chemical in each of our cells that makes up our genes. And genes tell our cells how they should work. They are unified in chromosomes, which are long strands of DNA in each cell.

There are certain genes that control when our cells grow, when they divide to form new ones and when they die. Those who help cells grow and divide are called oncogenes (the onco-prefix refers to the treatment of tumors). Others, which slow cell division or cause cells to die in a timely manner, are called tumor suppressor genes. In conclusion, we obtain that cancer can be caused by changes in chromosomes that activate oncogenes or deactivate tumor suppressor genes.

Symptoms, signs and conditions of testicular cancer

Before introducing ourselves fully to the variety of symptoms or signs that you might perceive as clear indicators of a testicular tumor, we would like to call for calm and reasoning. So bad is making rash decisions like making unsubstantiated guesses. In fact, most likely, many of the conditions that we will report below have their motive in a cause other than testicular cancer.

After all, there are certain symptoms to which you are probably more than accustomed for various reasons that do not have a cancerous motive, such as injuries, inflammation or testicular pain. That is, sometimes the signs may appear associated with benign diseases. However, if you consider that any of these symptoms is repeated relatively consistently or periodically or that they are not relativized in a reasonable period of time, you should consult the specialist immediately.

And from the opposite perspective we also have a point to point out. Some men with testicular cancer have no symptoms and cancer is detected during medical tests for other diseases. For example, sometimes imaging studies to determine the cause of infertility can discover a small testicular tumor.

Most testicular cancers can be found in early stages, when they are small and have not spread. In some men, testicular cancer in the early stages can cause symptoms that lead to medical attention. What will not take place, except in exceptional cases, is the suffering of general symptoms, such as fever, loss of fart or pain.

It is essential that you do not feel shame or fear when exploring. We will not deny you that in ignorance you will probably live happier, but you also live less. Get going for your health, you'll thank yourself. Once this necessary reflection has been carried out, we will come to agglutinate the different alterations of the organism to which you will have to pay attention in your daily life.

  • Swelling or lump in the testicle: Very often, the first symptom of testicular cancer consists of a mass or bulge in the testicle, or that the testicle is swollen or its size has increased.

  • Feeling of heaviness or pain in the testicle or scrotum: Despite not being especially frequent, there have been cases in which there has been a feeling of heaviness, burning and burning in the testicle or scrotum.

  • Pain in the lower abdomen or in the English: Locating the lower area of ​​the English as the closest to the testicles transversely, one of the most frequent symptoms is to feel a sharp pain in that area.

  • Irritation or breast growth: In some cases, although they are not the most abundant, germ cell tumors can cause the breasts to grow or have mild irritation. This occurs because in certain types of tumors, cells that have invaded tissues and begin to divide secrete high levels of a hormone called human chorionic gonadotropin (HCG) that stimulates breast growth.

  • Early puberty in men: Some Leydig cell tumors can produce androgens (male sex hormones). Most commonly, this does not cause any effect in men, but in the case of children, the generation of adult hormones can cause signs of puberty at an abnormally early age, such as a deeper voice and growth of facial and body hair. .

  • Back pain: In the case of not locating or starting to treat the type of cancer in time, it can happen that the testicular tumor has already spread to other parts of the body. In the case of back pain, this occurs by the spread of cancer to the lymph nodes found in the back of the belly.

Self-test for early detection of testicular cancer

While it is true that there is no proven effective way to prevent testicular cancer, it is also that finding out about symptoms, asking about family history and being aware of your body's predisposition to develop cancer can be crucial factors. when it comes to detecting the disease and trying to fight it in time.

It goes without saying that periodic reviews by specialists from a certain age and in the case of meeting any of the risk factors is of vital importance and almost mandatory. Most doctors agree that the examination of the testicles is an important part of the general physical examination that is performed during a routine medical examination.

However, some doctors recommend that all men examine their testicles monthly after puberty. The monthly self-examination of the testicles is a personal decision of each man that does not provide any guarantee but that, if done consciously and following a series of guidelines, could mark a before and after in your life.

The best time to have your testicles examined is during or after a bath or shower, when the skin of the scrotum is relaxed. Try to keep the penis apart during the test of each testicle separately. The way to perform the analysis is by holding the testicle between the thumbs and fingers with both hands and slowly rolling / sliding it between the fingers. You should look for and perceive any hard lump or nodule (uniform round mass) or any change in the size, shape or consistency of the testicles.

Do not alter if you realize that one testicle is slightly larger or hangs lower than the other. This is a typical feature of much of the male population that should not turn on alarms at first sight. In addition, you should keep in mind that, by nature, each testicle has a small coiled tube (called an epididymis) that can be perceived as a small bump in the middle or upper outer part of the testicle. It is important that you have these points so that you do not get a fright, a priori, unnecessary.

And why should testicular self-examination be performed regularly? Because the reality is that a testicle can be enlarged for many other reasons that have nothing to do with a malignant tumor and that appear and disappear periodically and intermittently. For example, fluid may accumulate around the testicle to form a hydrocele. Also, the veins in the testicle may dilate and cause enlargement or bulging around the testicle. This is known as a varicocele.

In any case, keep in mind that self-analysis is a comfortable, simple and useful way to be aware of any alteration in your genitals, but in no case should it replace a periodic medical check or at the slightest symptom that something is not going as should. At the end of the day, it is understood that there will be no one who is more familiar with your intimacy than yourself and that, if you follow a habitual ritual in which you check the size, shape and level of knotness, you could detect your own pathology.

Tests and analysis to diagnose a testicular cyst

What is clear here is that neither we nor probably you have the title of oncology framed in the room. Therefore, for many self-examination tips that we can give you, where they will give you a final verdict that calms your anxiety is in a specialized medical center where they have the methods, technical equipment and qualified personnel for this purpose.

Naturally, all this has a utility. A utility that is based on the knowledge and information that you probably didn't have before. Think that misinformation creates uncertainty, fears, anguish … In this way, you will still have to visit the specialist, yes, but you will enter the consultation with another mood.

That said, there are several technical tests that facilitate the analysis and diagnosis of your situation. Some may sound more to you, others probably seem unthinkable. In any case, before undergoing any in-depth examination, the doctor will palpate your testicles to detect swelling or tenderness, as well as to check the size and location of any bump.

In addition, your specialist will carefully examine your belly, look for lymph nodes and look at other parts of the body for any signs that the cancer has spread. Often, the test results are normal, regardless of morphological changes in the testicles. If a mass or other sign of testicular cancer is found, tests are necessary to find out the cause.

  • Ultrasound of the testicles: Ultrasound is usually the first study done if the doctor thinks you might be susceptible to testicular cancer. This method uses sound waves to produce images of the inside of the body. It can be used to find out if a change in the testicles is a benign condition or a solid tumor that could be a cancer (in which case we would normally be talking about a more solid lump or mass) .In this case, the doctor might recommend other tests or even surgery to remove the testicle.

  • Blood tests for tumor markers: There are blood tests or tests that can help diagnose testicular tumors by measuring the levels of tumor markers. These are, in their simplest definition, proteins that are generated due to many types of testicular cancer. We are talking, for more information, about Alphafetoprotein (AFP) and Human Chorionic Gonadotropin (HCG). Once identified, increases or decreases in their levels are measured to identify the type of cancer we face (which may be a non-seminoma tumor or pure seminoma).

  • Surgery with biopsy equivalence: As a rule, most types of cancer are diagnosed by removing and analyzing a small tumor fragment to observe under a microscope and try to detect if you have cancer cells. This is known as a biopsy. However, in the case of testicular tumors this technique is usually omitted since there is a risk of spreading cancer. Consequently, if the doctor has not obtained an accurate idea based on ultrasound or blood test, radical inguinal orchiectomy surgery would be recommended to remove the tumor as soon as possible.

  • Imaging studies: The diagnosis by means of images uses sound waves, X-rays, magnetic fields or radioactive substances to obtain images of the interior of your body. These types of studies fundamentally pursue three objectives: to know if the cancer has spread and to what extent, to help determine the effectiveness of the treatment, and to detect possible signs of tumor return after treatment.

  • CT scan: Those known as CT or CT scans consist of a technological tool that is mainly used to determine the stage and extent of cancer, focusing on the analysis of the areas where it could have spread: lymph nodes, lungs, liver …

  • Magnetic resonance imaging: Since there are areas of the organism that cannot be studied by CT scans such as the brain or spinal cord, it is necessary to study by means of magnetic resonance imaging.

  • Positron emission tomography: Despite being a technique that requires special machines only present in certain centers, positron emission tomography (PET) can help find small groups of cancer cells in the body. This study is sometimes useful to determine if lymph nodes that are still enlarged after chemotherapy contain cancer or are simply scar tissue.

  • Bone scintigraphy: Given the case that the doctor considers that the cancer has been able to spread to the bones, a bone scan could be performed, a study that detects the most intrinsic conditions in the body.

Classification of the type of testicular tumor

It should be noted that any of the aforementioned medical tests or exams will be valid according to what context, situation or variables to diagnose a testicular cancer or tumor. In the event that the prognosis was positive, a series of treatment guidelines or guidelines would be applied. Not before determining the type of cancer that is treated by analyzing the testicle removed. Germ cell growth abnormally can then lead to two different families of tumors.

Seminoma

Seminomas account for approximately 50 percent of germinating tumors and are characterized by not being mixed in any case with any other type of tumor. It is that type of cancer pathology that is most present in age groups, that is, in the elderly. These, in general, are less aggressive than non-seminoma. There are two subtypes:

  • Classic half-moon: The most common in the age range between 30 and 50 years.

  • Atypical seminoma: It is the least frequent subtype and can be developed from 50 years of age, the average age of manifestation being 65 years.

Not seminoma

Nonseminoma tumors are those that manifest at earlier ages. Because of their aggressiveness, they also have to grow and spread very quickly. Among its variations within the specific group we find the following subtypes:

  • Embryonic carcinoma: This is the most frequent non-seminoma tumor type, as well as one of the most aggressive. In these unfortunate cases, cancer tends to radiate to other organs and develop very quickly.

  • Choriocarcinoma: This type is very rare and only manifests in adults.

  • Endodermal Sinus Tumor: is the well-known childhood embryonic carcinoma tumor or orchidoblastoma. It mainly affects children and young people, having great chances of healing when detected in early childhood. However, they are much more complicated in adult individuals.

  • Teratoma: we talk about germ cell tumors with areas that, seen under the microscope, resemble the three layers of a developing embryo: the endoderm (the deepest layer), the mesoderm (the intermediate layer) and the ectoderm (the layer Exterior).

Stages, phases and stages of evolution of testicular cancer

Once testicular cancer has been diagnosed, doctors will try to identify if it has spread; and, being so, how much. This process is known as staging or stage classification. The stage (stage) of a cancer describes how much cancer is in the body, and helps determine how severe the cancer is, as well as the best way to treat it.

The staging of the stage involves numerical levels. As a general rule, the lower the number, the lower the spread of cancer. That is, a high number such as Stage 3, taking into account that there are up to 4 stages, means that the cancer is quite advanced. Also, some stages are further divided to provide more details, using capital letters (A, B, etc.), and within it, a smaller letter means a less advanced stage.

The most frequently used classification method for testicular cancer is the TNM system of the American Joint Committe on Cancer. This is based on four information keys: the size and extent of the main tumor, the spread to the adjacent lymph nodes or lymph nodes, the spread or metastasis in the body, or the serum blood levels in the tumor markers.

  • Stage 0: The tumor is only in the seminiferous tubules (the small ducts within each testicle). It has not grown to other parts of the testicle, it has not spread to adjacent lymph nodes, nor to distant parts of the body. In addition, all levels of tumor markers are within normal ranges.

  • Stage 1: In the first stage, the tumor has grown beyond the seminiferous tubules and could have spread outside the testicle and into adjacent structures. However, the cancer has not spread to the lymph nodes or to distant parts of the body. At this level, the results of the tumor marker are not available, or the tests have not been performed. This stage contains the subdivisions in order of severity: IA, IB, IS.

  • Stage 2: The situation in the second stage is that the tumor may or may not have grown outside the testicle. Or the extent of it cannot be determined for some reason. The cancer has spread to one or more of the adjacent lymph nodes, but has not spread to any distant part of the body. On the other hand, the results of the tumor marker are not available, or the tests have not been performed. This stage contains the subdivisions in order of severity: IIA, IIB, IIC

  • Stage 3: Arrived at Stage number three, the initial scenario is the same as in the previous one. The tumor may have grown outside the testicle, or not. And its extent may not be determined for some reason. The cancer may or may not have spread to adjacent lymph nodes. However, it will have already spread to distant parts of the body. At the same time, the results of tumor markers are not available, or the tests have not been performed. This stage contains the subdivisions in order of severity: IIIA, IIIB, IIIC.

Methods of medical treatment of testicular tumor

There are different types of treatment available for patients with testicular cancer. Algunos tratamientos son estándar (tratamiento que se usa en la actualidad) y otros se están probando en ensayos clínicos (estudios de investigación realizados con el fin de mejorar la eficacia de los tratamientos actuales). En cualquier caso, se utilizan cinco tipos de tratamiento estándar:

  • Cirugía: Como ya adelantábamos anteriormente, la cirugía para extirpar el testículo una vez se ha detectado el cáncer se (denominada orquiectomía inguinal) y algunos de los ganglios linfáticos, a veces se realiza en el mismo momento del diagnóstico y la estadificación. (Consulte las secciones de este sumario Información general y Estadios). Después de que el médico extirpa todo el cáncer visible en el momento de la cirugía, es posible que algunos pacientes reciban quimioterapia o radioterapia para destruir cualquier célula cancerosa que quede.

  • Radioterapia: Se trata de un tratamiento del cáncer para el que se usan rayos X de alta potencia u otros tipos de radiación para destruir células cancerosas o impedir su multiplicación. Hay dos tipos de radioterapia: la externa, para la cual se usa una máquina que envía la radiación hacia el cáncer desde el exterior del cuerpo; y la interna, la cual implica una sustancia radiactiva sellada en agujas, semillas, alambres etc. que se sitúan directamente sobre el tumor.

  • Quimioterapia: Consiste en un tipo de tratamiento que utiliza las vías de los medicamentos (muy agresivos y potentes) para matar las células cancerosas. Estos medicamentos se desplazas por el cuerpo para ir deshaciéndose de las células canceras que puedan haber migrado desde el tumor original. En el caso de que se diagnostiquen ganglios linfáticos la quimioterapia es el método más recomendado y eficaz. No obstante, el halo que enturbia la palabra “quimioterapia” recae sobre sus efectos secundarios: fatiga, náuseas, caída del cabello y aumento del riesgo de infecciones.

  • Dosis muy altas de Quimioterapia con trasplante de células madre: Como decíamos anteriormente, los medicamentos de la quimioterapia se utilizan para matar a las células cancerosas. Pero, en dicho proceso, el tratamiento también va destruyendo células sanas, entre ellas las células formadoras de sangre. El trasplante de células madre (extraídas de la sangre o la médula ósea y posteriormente congeladas) se utiliza para reemplazar y convertir en células sanguíneas del cuerpo las células destruidas.

  • Vigilancia: A pesar de la simpleza del concepto, la vigilancia hace referencia a una observación minuciosa del paciente sin administrar ningún tratamiento, a no ser que se detecten cambios que lo hagan oportuno. Se usa para distinguir signos tempranos de que el cáncer ha vuelto a reincidir. Durante la vigilancia los pacientes deben someterse a pruebas y examinaciones de forma constante y habitual.

Cabe destacar que el tratamiento del tumor de testículos será distinto en función del estadio del cáncer en que se encuentre el paciente. Por ejemplo, en el Estadio 1, casi todos los varones se curan mediante la extirpación del testículo. Por su parte, en el Estadio 2 los pacientes suelen curarse aun requiriendo una terapia específica en el caso de que el cáncer afecte a los ganglios del retroperitoneal, la zona ubicada detrás del abdomen. Por último, en el Estadio 4 se aplicarán 3 ciclos de quimioterapia para los pronósticos favorables y hasta cinco en el resto.

Cada año, 49.000 nuevos casos de cáncer de testículo se diagnostican en todo el mundo, de los cuales, 823 corresponden a España. A pesar de que, tal y como nos hace llegar la Asociación Española contra el Cáncer (AECC), el cáncer testicular sólo representa alrededor del 0,5-1% de los tumores del sexo masculino, el número de pacientes diagnosticados se ha incrementado en los últimos 50 años (especialmente en países desarrollados, donde se registra el 60% de los casos).

Más de la mitad de los casos se diagnostican en varones de entre los 20 y lo 35 años y, aunque no se conocen bien los motivos que pueden producir un cáncer de testículo, su aumento en las últimas décadas hace pensar que pueda deberse a causas medioambientales. Coyunturalmente, además, está produciendo un descenso de la fertilidad masculina. No obstante, quedémonos con el dato positivo, ya que el 96% de los pacientes que sufren un cáncer de testículo sobreviven con una excelente calidad de vida ¿A que esperas para hacerte tu revisión?

¿Sabías que cada año hay 49.000 😱 Casos de Cáncer de Testículo? ¡Hay 7⚠️Factores de Riesgo⚠️! Aprende a Detectarlo🔎🥚
y conoce las Causas, Fases y Tratamientos 👨🏻‍⚕️

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¿Qué te ha parecido nuestra guía de detección y prevención del cáncer de testículo? ¿Sabías que eran tantos hombres los que padecen esta enfermedad? ¿Sabías las bajas tasas de mortalidad que tiene? ¿Sigues algún para cuidar tu salud como hombre que te gustaría compartir con nosotros? ¿Crees que nos hemos dejado alguna cosa? Have you had any doubt or question? Entonces te pedimos que dejes un comentario. No matter whether it is a question or a simple thank you, but we will be very happy to read it and answer it.


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