Testicular Cancer
What is it?
Testicular cancer, although rare, is the commonest cancer in young men. Between the ages of 15 and 50 about one in 500 will develop the problem. As with any cancer, the cause is unknown, although there are some risk factors such as a family history of testicular cancer, a sedentary (inactive) lifestyle and men who have a testicle that failed to descend.
What are the symptoms?
If testicular cancer is caught at an early stage, it has a 99% cure rate. It is therefore vital that men regularly examine their testicles for any change in shape, texture or the presence or lumps. You should look out for the following symptoms:
If you do find a swelling, it is important that you go to your GP as soon as possible. Most cases of testicular cancer can be cured if it is caught at an early stage. If you are too embarrassed to go to your doctor, you can go to your local sexual health clinic.
How is it diagnosed?
Your GP will usually examine your testicles in the first instance and take your medical details. You will then be referred to a hospital specialist for further investigations, advice and treatment.
The specialist will give you a full physical examination. You are likely to have a special ultrasound test of the scrotum and the testes. Ultrasound uses sound waves to build up a picture of your testes and scrotum. This test can often tell whether the lump or swelling is due to cancer or another cause. However, the only way to know for sure that the swelling is cancer is for a surgeon to examine the testicle during an operation.
Blood tests
Some testicular cancers release chemicals into the bloodstream which can be used to check whether the cancer has spread and to measure the effect of your treatment on the cancer. These are done before and after your operation.
Surgery
If the ultrasound indicates a cancer and during surgery it is clear to the surgeon this is testicular cancer, the testicle will be removed there and then (this operation is known as orchidectomy). Occasionally, a small piece of tissue may be removed and immediately examined under a microscope by a pathologist (this is known as a biopsy). If the biopsy shows that the lump is cancerous, the testis is removed. The surgeon will not be able to do this unless you have provided written consent before the operation. The removal of one testicle does not affect your ability to have an erection or to father children. It is possible for an artificial testicle (known as an implant or prosthesis) to be inserted into your scrotum to restore a normal appearance.
Following the operation, if the biopsy has confirmed that you have cancer, further tests will be conducted to check whether the cancer has spread. These tests may include:
Imaging tests
These investigations could include a computerised tomography (CT) scan or magnetic resonance imaging (MRI) of your chest, abdomen and pelvis. A CT scan takes x-rays of your body from different angles to make a detailed cross-sectional image. Sometimes a dye is injected to make the images more detailed. MRI uses magnetic fields instead of x-rays to produce similar images. Sometimes a bone scan may also be performed, to check whether the cancer has spread to your bones.
What is the treatment?
If the cancer has not spread beyond your testicles, removal of the testicle may be the only treatment you need.
Radiotherapy
Radiotherapy is the use of x-rays (and other rays) to destroy cancer cells, while avoiding harming normal cells. With certain types of testicular cancer, radiotherapy will be given to prevent the cancer from returning or to kill cancer cells that have spread beyond the testicles, for example, the glands at the back of the abdomen.
Chemotherapy
Chemotherapy is the use of special anti-cancer (cytotoxic) medicines to destroy cancer cells. These medicines enter the bloodstream either by injection or by mouth and stop the growth and division of cancer cells that have spread to any part of the body. Chemotherapy is usually given to people where the cancer has spread to other parts of the body, such as the lymph glands in the abdomen or the chest. The prognosis however still remains good. There are many side effects of chemotherapy and these vary depending on the exact medicine that is taken. Treatment for testicular cancer is very successful, and the cancer does not usually come back after standard chemotherapy treatment.
Further information
Your local GP surgery is the best place for you to find information on testicular cancer, especially if you have specific concerns about your symptoms or treatment. Charities can also be useful sources of information and support.
Orchid Cancer Appeal www.orchid-cancer.org.uk
Cancer BACUP www.cancerbacup.org.uk
Cancer Research UK www.cancerresearchuk.org
Men's Health Forum www.malehealth.co.uk
