Get Checked Today
Many men are not aware of testicular cancer and ignore the warning signs until it’s too late.
It’s pretty clear early detection can be lifesaving and regular self-examinations are an essential part of early detection. Despite its prevalence in younger men, many are unaware of the early signs.
Often a small, painless lump or a subtle change in testicle size might not seem like a big deal, but these could be the first signs of testicular cancer. Since this type of cancer can grow rapidly, acting fast is crucial.
The good news is that testicular cancer has a high cure rate, exceeding 95% when detected early.
A simple, painless testicular ultrasound can quickly determine if a lump is harmless or something that needs urgent attention.
A simple and painless testicular ultrasound scan can quickly determine if a lump is harmless or something that needs urgent attention.
If you’ve noticed any unusual changes, don’t wait—book an appointment with your doctor or you can arrange a private testicular ultrasound.
Contents
What is cancer?
Cells are small building blocks that make up the body’s organs and tissues. Cells receive signals from the body, telling them where to grow and when to divide to make new cells. This is how our bodies grow and heal. Once these cells become old, damaged or no longer needed, they receive a signal from the body to stop working and die.
Sometimes these signals get confused, causing the cell to become abnormal. The abnormal cells may keep dividing into more and more abnormal cells. Eventually, this can form a lump called a tumour.
Key Points:
- Cells carry out vital functions for our body.
- When cells become old and damaged they need to be replaced.
- Signals are sent to these cells to die.
- Some cells get confused and don’t die, instead, they multiply uncontrollably.
- These cells eventually become a tumour.
Benign vs malignant tumours
Not all tumours are cancer though, with many being benign or ‘non-cancerous’.
A benign tumour may grow, but it cannot spread to anywhere else in the body. It usually only causes problems if it expands and pushes on nearby organs or tissues.
A malignant tumour is cancer and can invade and grow into other organs and tissues.
A small sample of cells from the tumour is taken and examined under a microscope to tell if the tumour is a benign or malignant cancer. A specialist examines it to check for malignant cells.
Key points:
- Not all tumours are cancer
- Malignant tumours spread into other parts of the body
- A tissue sample may be needed to be taken to tell if the tumour is benign or malignant
Primary vs secondary cancers
Sometimes cancer cells spread from where the cancer started (the primary site) to other parts of the body. They can travel around the body in the blood or through lymphatic fluid (part of the lymphatic system). When these cancer cells reach another part of the body, they may grow and form another tumour. This is called a secondary cancer or a metastasis.
The testicles
The testicles or testes, are 2 oval-shaped organs that sit inside the scrotum, a sac of skin that hangs behind the penis. Their primary job is to produce sperm, which can fertilise a female egg to make a baby.
Sperm travels from the collecting tubules inside the testicles to a tube called the epididymis. The epididymis feels like a soft swelling at the back of the testicular. This becomes a wider tube called the vas deferens which forms part of the spermatic cord. This joins a shorter tube called the ejaculatory duct which connects to a tube called the urethra. The urethra goes from the bladder to the end of the penis.
Sperm mixes with fluid from the prostate and seminal vesicles. These are glands that sit under the bladder. The sperm and fluid is forced during ejaculation along the urethra and out from the penis. The ejaculated fluid and sperm is called semen.
Key points:
- The testicles produce sperm.
- Sperm travels through tubes and ejaculates out of the penis producing semen.
Testicular cancer
Testicular cancer usually starts in one of the testicles. In the UK it is reported that around 2300 men are diagnosed with testicular cancer, and in the United States, it’s around 9700 men. The rate at which diagnoses are being made is however increasing everywhere.
Testicular cancer can affect anyone who has testicles, including men, trans women and people assigned male at birth. It is most likely to happen between the ages of 25-40.
The good news is that testicular cancer is usually curable. Like other cancers, it is not infectious, and you cannot pass it on to other people.
Key points:
- Testicular cancer can affect anyone who has testicles.
- It usually starts in only one testicle.
- It is most likely to happen between the ages of 25 – 40.
- Testicular cancer is usually curable with treatment.
Causes of testicular cancer
Currently, it is not known what causes testicular cancer, however, certain risk factors have been identified that may increase the chances of developing testicular cancer
Having one or more risk factors does not mean you will get testicular cancer though and if you do not have any risk factors, it doesn’t mean you will not get testicular cancer.
Risk Factors for Testicular Cancer
Undescended testicles / Cryptorchidism
During foetal development, the testicles are formed in the abdomen. Normally they gradually drop down into the scrotum by birth or within the first year of life.
In some boys, this does not happen. This is called having undescended testicles or Cryptorchidism. It can be just one, or both testicles that do not drop down. Surgery can be done to fix this problem and bring one or both testicles into the scrotum. This type of surgery usually is performed before 2 years of age and needs to be done by puberty.
Having undescended testicles as a child increases the risk of testicular cancer. The risk may be higher if surgery is not done. If surgery was done as a child, regular self-examinations are important so that any changes can be picked up early.
Family history
You have a slightly higher risk of getting testicular cancer if your brother or father has had testicular cancer. This may point to a genetic cause, however, research is being done looking into this.
Previous testicular cancer
If you have already had testicular cancer, there is a slightly higher chance of developing cancer in the other testicle.
Ethnicity
Testicular cancer is more common in white men than African Caribbean or Asian men, however, the reason is still unknown.
Human immunodeficiency virus (HIV)
If you are HIV-positive, you may have a slightly increased chance of developing testicular cancer.
Carcinoma in situ (CIS)
Carcinoma in situ (CIS) is when there are abnormal cells in the testicle. If it is not treated, it increases the risk of testicular cancer developing.
CIS is sometimes found after having a biopsy of the testicle, for example, to investigate other problems such as infertility.
If the treatment involves removing the affected testicle, it should not affect your ability to get an erection or make someone pregnant, as long as the other testicle is healthy.
Factors that do not increase the risk of testicular cancer
There is no evidence to suggest that injury to a testicle increases your risk of getting testicular cancer. but an injury to a testicle or groin area may bring possible symptoms of testicular cancer to your doctor’s attention.
Having a vasectomy also does not increase the risk of getting testicular cancer.
Key points:
- Some men have a higher chance of developing testicular cancer.
- Factors such as undescended testicles, ethnicity, HIV or previous cancers can increase the risk.
- Injury to the testicles or having a vasectomy does not increase the risk of developing testicular cancer.
Symptoms of testicular cancer
Common symptoms of testicular cancer are:
- swelling in the testicle – this usually is painless but may become painful as the swelling gets bigger
- a dull ache, pain or feeling of heaviness in the scrotum.
If the cancer has spread to the lymph nodes or other parts of the body, it may cause:
- pain in the back or lower abdomen
- weight loss
- a cough
- breathlessness
- feeling of being unwell
- a lump in the neck
Very rarely the hormones the cancer produces can cause the nipples or male breasts to feel swollen or tender.
How to check for testicular cancer
It is important to self-check your testicles regularly from puberty onwards. It’s usually possible to cure testicular cancer but easier to treat when diagnosed early.
Testicular self-examination
Checking for testicular cancer or testicular self-examination should be performed regularly as part of a healthy lifestyle routine. Doing a check regularly means you will get to know what feels normal for you.
A normal testicle should feel firm, but not hard.
You should feel for:
- lumps or swelling
- anything unusual
- differences between your testicles
- It is normal for the testicles to be slightly different in size.
- It is also normal for one to hang lower than the other.
The tubes behind your testicles (epididymis) are behind the top of each testicle. It feels like a soft, coiled tube. It is common to get harmless cysts or benign lumps in the epididymis. The treatment for these can vary.
How to check your testicles
It can be easier to check your testicles during a warm bath or shower when the scrotal skin is relaxed.
STEP 1
Cup one testicle at a time using both hands.
STEP 2
Examine by rolling the testicle between the thumb and fingers using slight pressure.
STEP 3
Familiarise yourself with the spermatic cord & epididymis – tube-like structures that connect on the back of each testicle.
STEP 4
Feel for any lumps, changes in size or irregularities – it is normal for one testicle to be slightly larger than the other.
When to see a doctor
Many other conditions can cause lumps or swellings in the scrotum, and most are not cancer. You must get your doctor to check anything unusual as soon as possible. You can also go to your local sexual health clinic. You can find the nearest one on the NHS website.
How is testicular cancer diagnosed?
Typically you will begin by seeing your doctor who will examine you. If they think your symptoms may be linked to testicular cancer they will refer you for an ultrasound scan or to see a specialist at the hospital.
Ultrasound scan to diagnose testicular cancer
An ultrasound scan is the quickest and most accurate test for diagnosing testicular cancer.
An ultrasound scan uses sound waves to produce real-time images of the inside of your testicles. This is done by putting some gel onto the scrotum and passing a probe over the area. It is a simple and painless test. The ultrasound scan can tell whether the lump is a harmless fluid-filled lump like a cyst or likely to be a cancer.
Blood tests
Some testicular cancers make certain chemicals called tumour markers that are released into the bloodstream. You may have a blood test to see if you have raised levels of these chemicals, however even if these are normal, you may still have testicular cancer.
After the ultrasound scan
If the ultrasound scan shows the lump is very likely to be testicular cancer, the whole testicle needs to be closely examined. The only way to get a definitive diagnosis is to have surgery to remove the whole of the affected testicle. This is because just taking a small piece of tissue may miss the cancer cells.
This type of operation is called an orchidectomy. In rare circumstances such as someone who only has one testicle, the surgeon will only remove part of the testicle.
As well as confirming a diagnosis, removing the testicle removes the cancer. It is the main treatment for testicular cancer that has not spread. This may be the only treatment you need if the cancer has not spread outside the testicle or if there is a low risk of the cancer coming back.
Your doctor or nurse will explain why you need it and can guide you through any concerns you may have. It is natural to be worried about having this operation and how it may affect your body image, sex life or fertility.
If your other testicle is healthy, removing one testicle will not affect your fertility or ability to get an erection.
Testicular Implant or prosthesis
Once the affected testicle is removed the surgeons can put an artificial testicle into your scrotum or if you are not sure this can be done later.
Fertility and storing sperm
As long as the other testicle is healthy, removing one testicle will not usually affect your fertility. You will be asked if you would like to store sperm in a sperm bank before your operation. This is because you may need to have further treatment after your surgery such as chemotherapy which could affect your fertility.
Storing some of your sperm allows you to use it in the future to help start a pregnancy. This could be an option even if you are not in a relationship at that moment in time.
For this, you will have to provide a sample of sperm. If your sperm count is low, or there is no sperm present it may be because the other testicle is small or making less sperm.
If you are offered further treatment and have not stored any sperm, you can store sperm after the surgery.
Further Reading and support
