What is testicular cancer?
Testicular cancer is a condition where abnormal cells develop in the testicle. These cells then grow, divide and multiply, creating a growth or tumour. It will usually appear as a painless lump on your testicle. Many lumps are found to be fluid-filled cysts (growths), rather than cancer. Testicular cancer has a cure rate of over 95%, and is uncommon.
If you’re between 20 and 40, you’re in the age group with the highest risk of developing testicular cancer.
What are the symptoms of testicular cancer?
Testicular cancer symptoms usually start with a hard lump in either testicle. The lump is usually painless, but in about one in 10 cases it’s painful or tender. Other symptoms include constant backache, coughing or breathlessness, and enlarged or tender nipples, which could mean that the cancer has spread. If you have these symptoms, it’s definitely a good idea to see a doctor straight away. However, there are many other reasons why you might have these symptoms.
What can cause testicular cancer?
If you have a family history of testicular cancer, or you’ve had previous testicular cancers yourself, it’s more likely that you might develop it.
If you’ve been diagnosed with fertility problems, and/or a history of undescended testes, you have a much higher chance of developing testicular cancer. The risk might be lower if you had surgery to fix your undescended testes when you were still a baby. If you had only one undescended testicle, the risk of cancer is usually only in that testicle.
If you have Down syndrome, you could be at higher genetic risk of getting testicular cancer, gastrointestinal cancer, and leukaemia.
Can I prevent testicular cancer?
Because we mostly don’t know what causes testicular cancer, there are no particular ways to prevent it.
There isn’t evidence that injury or sporting strains, lifestyle (for example, smoking or diet), or sexual activity are linked with testicular cancer.
However, an injury to the groin area can sometimes prompt you to check or notice a problem with your testicles that needs to be looked at by a doctor.
What can I do?
To make sure your testicles are healthy, it’s important to do regular testicular self-examinations (TSE). A TSE is a quick and simple process. You might find it easier after a warm bath or shower, when the skin of your scrotum is relaxed.
Stand in front of a mirror. To start with, check for any swelling on the skin of your scrotum. Hold your scrotum in your hands and feel the size and weight of each testicle. Don’t worry if one testicle is a little bigger or hangs lower than the other, that’s normal.
Feel each ball and roll it between your thumb and finger, one at a time, checking for any lumps or swelling. The testicles should feel firm, and the surface should feel smooth. You should be able to feel your epididymis, a soft tube toward the back of each testicle that carries sperm to the ejaculatory ducts. Check for any swelling in this area. You shouldn’t feel any pain when checking your testicles.
Once you get to know your testicles, keep an eye out for any changes. If you detect a change, it doesn’t mean it’s anything serious, but it’s still best to see a doctor as soon as possible.
What treatments are available for testicular cancer?
Testicular cancer treatment will depend on the type and stage of cancer. Your doctor will assess the chance of the cancer moving from the testicles, before deciding on the best treatment for you.
The first stage of treatment is surgery, which involves the removal of the affected testicle. The removed testicle is then sent to a pathology laboratory to confirm the stage and type of cancer.
After surgery, your doctor will check you regularly to see if the cancer has moved elsewhere in your body, including to the other testicle.
Chemotherapy or radiotherapy might be needed after surgery to kill off any cancer cells that might have spread to other parts of your body. The level or amount of chemotherapy and radiotherapy you’ll have will depend on the stage and type of cancer.
Will testicular cancer make me infertile?
Often, testicular cancer and its treatment won’t affect your sexual performance, but the stress and anxiety of cancer can affect sexual function. Sometimes, people going through testicular cancer treatment have concerns about changes in body image, which can cause sexual problems and anxiety.
If you’re diagnosed with testicular cancer, you’re more likely to have lower fertility, or complete infertility, even before any treatment starts. Your level of fertility can then be further affected by cancer treatments such as radiotherapy and chemotherapy.
That’s why, if you have suspected cancer, it’s a good idea to consider sperm storage before you have any treatment. You can freeze your sperm to use later in life if you want to have children.
Your remaining testicle will continue to make sperm and testosterone (the male sex hormone). In most cases, hormone levels remain normal and testosterone therapy is not needed.
Your doctor’s appointment
Questions to ask your doctor
Will I be able to father children if I have my testicle removed?
Should I consider sperm banking before treatment for testicular cancer?
If I have a testicle removed, will I still produce enough testosterone?
Am I at risk of getting testicular cancer in the other testicle?
Testicular self examination