Testicular Cancer

The causes of testicular cancer are unknown, but certain factors may increase your risk of developing it. Men between 15 and 49 years of age tend to be most affected.

Men may be at greater risk of developing testicular cancer if they have:

• had cancer in the other testicle before
• undescended testicles which means their testicles did not move down into the scrotum after birth
• a father or brother who had testicular cancer
• fertility problems
• HIV or AIDS
• a birth defect of the penis known as hypospadias

Sometimes testicular cancer has no symptoms at all.

Symptoms of testicular cancer may include:

• a painless lump or swelling of one testicle - the most common sign
• a change in the size, shape or weight of a testicle - such as swelling or heaviness in the scrotum
• pain or dull aches in the testicles or scrotum
• tender or enlarged male breast tissue
• back pain
• stomach aches

Men should see their GP if they have testicular symptoms, particularly if they feel a lump or swelling in their testicles or scrotum. The GP will examine a man’s testicles.

Scrotal ultrasound - if the GP finds a lump that might be cancer, they will refer for a scrotal ultrasound scan. This is a painless procedure that uses high-frequency sound waves to create an image of the inside of the testicle. The scrotal ultrasound will show if a lump is cancerous or not, the position and size of the abnormality in the testicle, whether the lump is in the testicle or separate within the scrotum, and whether it is solid or filled with fluid.

Blood tests – detect certain hormones in the blood that testicular cancer often produces, called tumour markers. They can help confirm a diagnosis and check how well a treatment works. A blood test may also be carried out to indicate how active the cancer is.

Removing a testicle (orchidectomy) - to examine part of the lump under a microscope. It is the only way to definitively confirm testicular cancer. It can also find out the type of testicular cancer. A biopsy sample is removed for many cancers, but in most cases, the only way to examine a testicular lump is by removing the affected testicle completely. This is only performed if a specialist is relatively certain the lump is cancerous. Orchidectomy is also the main type of treatment for testicular cancer.

Other tests to check whether testicular cancer has spread:

• X-ray – if testicular cancer spreads, it most commonly affects the lymph nodes in the abdomen and lungs and a chest x-ray can check for signs of a tumour in these areas.
• CT scan - uses x-rays and a computer to create 3D pictures of the inside of the body to check for signs of the cancer spreading.
• MRI scan - uses magnetism and radio waves to create cross-sectional pictures of the body to see if cancer has spread.

Treatment for testicular cancer depends on how far the cancer has grown or spread and the level of markers in the blood (the stage), the type of cancer (seminoma or non-seminoma), risk factors for cancer returning and a man’s general health.

Surgery includes:

• Orchidectomy or orchiectomy - to remove the testicle. This is usually the first treatment for testicular cancer.
• Lymph node and lung surgery - to remove lymph nodes in the stomach or secondary cancer in the lungs if the cancer has spread.

Surveillance – after surgery regularly checks for early signs of cancer coming back to enable early detection and treatment if required.

Chemotherapy - uses powerful drugs to kill the cancerous cells or stop them from multiplying. Commonly used for people with a higher risk of cancer coming back or if cancer has already spread.

Radiotherapy - uses high-energy waves to kill cancer cells. It is performed on men with seminoma testicular cancer that has spread to the lymph glands at the back of the abdomen and sometimes after surgery to help prevent cancer from returning.

Your doctor will also discuss sperm banking before chemotherapy and radiation treatment as these treatments can affect a man’s fertility. By collecting and freezing sperm before treatment, it may still be possible to have a baby in the future.

They may also discuss testosterone replacement therapy which may be an option if you have a lack of testosterone after surgery. Testosterone replacement therapy is where testosterone is given by injection, skin patch or gel to rub into your skin. It helps to maintain an erection and improves sex drive.

Testicular cancer starts in one or both of a man’s testicles. It is fairly rare and most often found in men aged 15 to 44 years. This cancer is highly treatable, even when cancer has spread beyond the testicle.

Here at Ramsay Health Care UK, we have a team of expert cancer specialists on hand to advise, diagnose, and treat testicular cancer.

We understand the anxiety that stomach cancer symptoms can bring and the importance of early testing to bring peace of mind and to help diagnose symptoms early for a better treatment outcome.

We offer convenient appointments to talk through the benefits and risks of all tests and treatments so that you are fully informed and understanding of all implications.