Over 2000 men are diagnosed with testicular cancer every year in Britain. The majority of men affected are under the age of 45 and, for reasons which are largely unknown, the number of men diagnosed has doubled since the mid-1970s.
Despite the risk, it is estimated that 1 in 10 men still don’t know how to check their testicles for signs of cancer, and even those who do are neglecting to check them as often as they should.
As for all cancers, early detection and treatment is very important to maximise recovery rates. With this in mind, increasing consumer awareness and educating all men on the risks of the disease, how to check themselves properly, and what steps to take if they notice something unusual, is vital.
What is testicular cancer
Testicular cancer most commonly affects men between the ages of 15 and 45. The cancer develops when normal healthy cells within the testicles, which are carefully regulated by the body, begin to divide uncontrollably. The condition nearly always develops from the germ cells within the testicles – the cells which are responsible for producing sperm.
Statistically, testicular cancer is the most common cancer for men in the UK within the 25 – 49 age bracket. Currently, it’s estimated that around 60 young men will die of testicular cancer each year.”
What are the risk factors
Unfortunately, there is no hard evidence as to why certain men develop testicular cancer. We still do not know what causes the DNA to mutate and cause cancerous cells to develop however, we do know that there are certain factors that will make some men more susceptible to testicular cancer than others. These risk factors include:
- An undescended testicle – this means that one or both testicles fail to move from the abdomen into the scrotum before birth. Men who were born with this condition are more likely to develop testicular cancer than those with normally descended testicles.
- Family history – Having a father or a brother who has had testicular cancer increases the risk, however, most men with testicular cancer do not have a family history of the disease.
- HIV Infection – There is some evidence to suggest that men who are HIV positive or have AIDS are at an increased risk of testicular cancer.
- Personal history – A personal history of the condition is another risk factor. About 3-4% of men who have been cured of testicular cancer will at some point develop cancer in the other testicle.
- Age – About half of testicular cancers occur in men between the ages of 20 and 34.
- Race/Ethnicity – The risk of testicular cancer among white men is about 4 to 5 times that of black or Asian men. Worldwide, the risk of developing the condition is highest among those living in Europe or America, and lowest among men living in Africa or Asia.
- Subfertility – men who have had trouble starting a family or have a small volume testicle are at increased risk.
What are the symptoms
Testicular cancer can cause a number of different symptoms and warning signs, these include:
- A painless swelling or lump developing in one of the testicles, or a change in the shape and/or texture of the testicles. The swelling or lump can vary in size but is noticeable as a hard lump compared to the remainder of the testicle.
- A dull ache or sharp pain in the testicles or scrotum which may come and go, or a feeling of heaviness in the scrotum.
- Pain in the back or lower abdomen.
- A sudden build-up of fluid in the scrotum.
- Breast tenderness or growth – this is a rare symptom, but some testicular tumours can trigger hormones which will cause breast tenderness or growth of breast tissue.
- Shortness of breath, chest pain and bloody phlegm are symptoms of later-stage testicular cancers.
- Swelling of one or both legs caused by a blood clot (Deep Vein Thrombosis) may be the first sign of testicular cancer for some young or middle-aged men.
How to check your testicles
It’s important that all men regularly check their testicles for signs of testicular cancer – this should become part of a regular routine, for example, whenever showering or bathing. There are three basic steps for self-examination, as follows:
- Hold one testicle between the thumbs and fingers of both hands and roll it gently between your fingers
- Look and feel for any hard lumps, or smooth rounded bumps, along with any changes to the shape, size or consistency of the testicles
- Repeat the process between both testicles
It’s worth noting that “normal” testicles have blood vessels, supporting tissues, and tubes carrying sperm, these can be confused with abnormal lumps. If you have any concerns, you should see your doctor.
How is it treated
Surgery, followed in some cases by Chemotherapy, are now the main methods of treatment for testicular cancer. The recommended treatment plan will largely depend on how advanced the cancer is and the type of testicular cancer which is diagnosed. The majority of testicular cancers fall into two categories, seminoma and non-seminoma. Both types of cancer stem from germ cells – responsible for making the sperm. Seminoma cancers tend to grow slowly whilst non-seminoma cancers are more common and grow quicker than seminomas, these tumours are often made up of more than one type of cell.
The first line treatment option for all cases of testicular cancer (whatever the stage or type) is to surgically remove the affected testicle, this procedure is called a radical orchidectomy. This will then be followed up with chemotherapy depending on the severity of the cancer and where/if it has spread or some men will just require surveillance. Further surgery is sometimes required after chemotherapy to remove any affected lymph nodes in the abdomen.
Most men are still fertile after having one testicle removed however, some treatments for testicular cancer can cause infertility. For treatments that are likely to result in infertility, you should be offered sperm banking – the collection and storage of semen for potential later use, meaning you may still be able to have children in the future. Even in cases where men are found to have no sperm before the operation, techniques are now available for retrieve sperm from the affected testicle once removed. In cases where the lumps are small or the diagnosis is uncertain, partial orchidectomy can be offered.
To tie in with Movember,running throughout the month of November, Mr Asif Muneer from The Princess Grace Hospital, part ofHCA Healthcare UK, shares his expert insights on the risk factors, symptoms and treatment options available for testicular cancer.