Testicular Cancer: The Facts
- Each year in the UK, around 2,100 men are diagnosed with testicular cancer.
- Incidence rates of testicular cancer are increasing worldwide in white men.
- It usually affects young or middle aged men.
- Treatment for testicular cancer is very effective and nearly all men are cured.
- It isn’t infectious and can’t be passed on to other people.
Testicular Cancer: Symptoms
The most common symptom of testicular cancer is a lump or swelling in part of one testicle. But most testicular lumps are NOT cancer.
A lump that is cancer can be as small as a pea or it may be much larger. It is not usually painful, but some men have a dull ache in the affected testicle, or in their lower abdomen. Your scrotum may feel heavy.
Sometimes testicular cancer cells can spread into lymph glands at the back of the abdomen. This can cause backache.
The cells can also spread to the lymph nodes in the centre of your chest, between the lungs. This could cause a cough, difficulty in breathing or swallowing, and a swelling in your chest. If testicular cancer has spread, there may be lumps in other parts of the body, such as around the collarbone, or in the neck. These lumps are lymph glands that contain cancer cells.
Testicular cancer can also spread to other organs in the body. If it has spread to the lungs you may have a cough or feel breathless. It is not very common for testicular cancer to spread to other organs apart from the lungs.
Testicular Cancer: Risks and causes
Testicular cancer is a relatively rare disease in the UK. We don't know exactly what causes it but there are several factors that can increase the risk of developing it.
Your medical history
If an undescended testicle is not corrected by the age of 11, a man’s risk of testicular cancer is increased. If you have had a rare complication of mumps called orchitis you have an increased risk.
Carcinoma in situ (CIS) means that there are abnormal cells in the testicle. This is not cancer. But if left untreated, CIS may develop into cancer. Men who have had testicular cancer also have an increased risk of developing cancer in the other testis. There is a small increase in risk in men who've had fertility problems.
Other risk factors
Having a brother or father with testicular cancer increases the risk. Researchers think that up to 1 in 5 testicular cancers (20%) could be due to inherited gene changes (faults).
Ethnic background affects risk. Testicular cancer is diagnosed in 5 times as many white men as black men in the United States. In the UK it is more common in white men than men of other ethnic groups. We don't know why this is.
Finding testicular cancer early
Cancers found early are the easiest to treat. Being aware of how your testicles look and feel helps you know if there is a change. If you notice a change that isn’t normal for you, talk it over with your doctor.
You don’t need to check your testicles every day or even every week. It is enough to do it from time to time. It is easiest to check them after a warm bath or shower, when the skin of the scrotum is relaxed. Hold your scrotum in the palms of your hands. You can then use the fingers and thumb on both hands to examine your testicles.
What to look out for
Gently feel each testicle individually. Any noticeable increase in size or weight may mean that something is wrong. You should feel a soft tube at the top and back of the testicle, which is normal. The testicle itself should be smooth with no lumps or swellings. If you do find a swelling in your testicle, make an appointment and have it checked by your doctor as soon as possible.
It is unusual to develop cancer in both testicles at the same time. So if you are wondering whether a testicle is feeling normal or not you can compare it with the other.
Testicular cancer tests
Usually you begin by seeing your GP who refers you to a hospital specialist for tests to see whether you have testicular cancer. At the hospital you will have
- A physical examination of the testicle
- An ultrasound scan of your testicles and scrotum
- Blood tests to look for hormones or proteins that may be produced by testicular cancer
Removing a testicle
If your ultrasound shows that the lump may be a cancer, your doctor may ask you to have an MRI scan. They will ask you to agree to have your testicle removed. This is called orchidectomy. A pathologist examines cells from the lump under a microscope to see if they are cancerous and if so, what type of cancer you have.
In this situation it is not possible to remove some tissue (a biopsy) without taking the whole testicle. Specialists think there is too high a risk of the cancer spreading with a biopsy. They will only remove a testicle when they are fairly sure there is a cancer there. The testicle would need to be removed anyway if cancer was found.
You will need to stay in hospital for a few days. You have the operation under general anaesthetic.The surgeon makes a small cut in the groin and removes the whole testicle. If you like, the surgeon can put a false testicle (called a prosthesis or implant) into the scrotum.
Remember that removing one testicle does not affect your ability to have an erection or father children.
Types of treatment for testicular cancer
Surgery, chemotherapy and radiotherapy are all used to treat cancer of the testicles. You may have just one treatment or a combination. The doctor plans your treatment by taking into account the type of testicular cancer, and whether it has spread beyond the testicle. Most men are completely cured, even if the cancer has spread.
Sperm banking before treatment
Some treatments for testicular cancer, such as chemotherapy or radiotherapy, can lower your ability to father a child. Before starting any treatment your doctor will offer you the chance to store sperm.
Treatment by stage
All testicular cancers are treated with surgery. Most men have the whole testicle removed (orchidectomy).
- Stage 1
If the cancer is completely contained within the testicle, you may have removal of your testicle, followed by monitoring (surveillance). If you have a non seminoma cancer (teratoma) that has a high risk of coming back you may also have chemotherapy.
- Stage 2
If a seminoma has spread into nearby lymph nodes you may have radiotherapy after removal of the testicle. If any of the lymph nodes are larger than 2cm you might have chemotherapy instead of radiotherapy.
If a non seminoma tumour (teratoma) has spread into the lymph glands, you will have chemotherapy after removal of the testicle.
- Stage 3
If the cancer has spread beyond the testicle and the nearby lymph glands, you will have chemotherapy after removal of the testicle. After chemotherapy has finished for non seminoma, if you still have areas of cancer in the lymph nodes at the back of the abdomen or in the lungs you will have surgery to remove them. If you have seminoma you will need no further treatment but your doctor will monitor you closely.
Testicular cancer that comes back
If your cancer comes back after you have been first treated, you will probably have more chemotherapy and surgery. Even cancers that come back can usually be cured.
Resources to folow
Press Release: Nearly all men survive testicular cancer
Monday 29 July 2013
Cancer Research UK Press Release
Survival for testicular cancer has risen by almost 30 per cent in the last 40 years, with nearly all men now beating the disease, according to figures published by Cancer Research UK.
These latest figures show that more than 96 per cent of men now survive testicular cancer in the UK, compared with less than 70 per cent in the 1970s. These improvements are largely thanks to the drug cisplatin,which Cancer Research UK helped to develop.
Around 2,300 cases of testicular cancer are diagnosed each year in the UK and it is the most common cancer in men aged 15-49.
Dr Harpal Kumar, Cancer Research UK’s chief executive, said: “A clear success story in cancer research has been the drug cisplatin, which our scientists helped to develop. This is helping almost all men with testicular cancer to beat the disease and is a shining example of what we can achieve through dedicated research.
“For some types of cancer, the word ‘cure’ is almost a reality – 96 per cent of men with testicular cancer are now cured. But it’s important we recognise the four per cent who aren’t surviving the disease, as well as the fact that we still need treatments to be kinder to patients in the future. It’s only by doing more research that we can bring forward the day when we are able to beat all types of cancer.”
Martin Ledwick, head information nurse at Cancer Research UK, said: “The most common symptom of testicular cancer is a lump or swelling in one of the testicles. Although most lumps in the testicle won’t turn out to be cancer, it’s important you get symptoms checked out as early as possible as this gives the best chance of cure.
“Get used to how your testicles look and feel normally and if you if you notice a lump, swelling or persistent discomfort then go and see your GP.