Testicular cancer: symptoms, diagnosis and treatment

Testicular cancer is the commonest cancer in young men, it is highly curable and is easier to treat the earlier it is diagnosed. Find out more about the symptoms and the diagnosis and treatment options available at Cromwell Hospital. 

What is testicular cancer?

Testicular cancer occurs when tissue found in the testicle becomes malignant (cancerous). The cancer develops in the cells that make sperm known as germ cells. This is the commonest cancer in young men.

There are two main types of testicular cancer - seminomas and non-seminomas. Seminomas usually affect those aged 15 to 55 and non-seminomas usually affect those ages 15 to 35.

Who is at risk of getting testicular cancer?

In the UK, around 2,300 men are diagnosed with testicular cancer each year. There are some factors that can put people at greater risk, which are;

  • undescended testicles (cryptorchidism).
  • men who are having difficulty conceiving or have a low sperm count.
  • abnormal cells in the testicle (germ cell neoplasia in situ (GCNIS). If untreated, GCNIS develops into cancer within 5 years in about 50 out of 100 (about 50%) of the men who have it, it is sometimes found when a biopsy is done for infertility investigations.
  • family history, brothers or sons of men who have had testicular cancer.
  • previous testicular cancer, those who have had testicular cancer before may have a higher risk of developing it in the other testicle.
  • abnormality of the penis and urethra called hypospadias.
  • those with HIV or AIDS have an increased risk of testicular cancer, though most cases of testicular cancer are not linked to being HIV positive.
  • ethnicity, as white men are at a higher risk of developing testicular cancer than other ethnic groups.
  • height - those who are taller than average are at a greater risk.

Signs and symptoms of testicular cancer

Testicular cancer is highly curable and is easier to treat the earlier it is diagnosed, so it is important to check testicles regularly from puberty onwards. Symptoms to look for are:

  • a lump or swelling in a testicle.
  • dull ache or pain in the testicle or scrotum
  • heavy scrotum
  • a testicle that gets bigger

Symptoms can be similar to other conditions such as infections, so it’s important to see a doctor if any of these symptoms are present.

How is testicular cancer diagnosed?

A General Practitioner (GP) will ask questions about symptoms and general health, as well as provide an examination of the testicles, lymph nodes and perform blood tests. If cancer is suspected, a GP will make an onward referral to a urologist with a specialist interest who will perform diagnostic testing. This may include:

  • blood tests to check for higher-than-normal levels of specific proteins.
  • ultrasound scan of both testicles and scrotum. This is painless and simple to perform. MRI scan can be performed if the ultrasound scan is equivocal.
  • if diagnostic tests show that it is highly likely a patient has testicular cancer, the affected testicle will be safely removed under a general anaesthetic. In some early cases the bulk of the testis can be spared to minimise loss to fertility and hormonal production.
  • a CT scan will usually take place to check the cancer hasn’t spread to lymph nodes or other parts of the body.

Testicular cancer treatment 

Surgery is the first treatment for testicular cancer and often part of the diagnosis process. After surgery patients might have one of the following or a combination:

Advice for those worried about testicular cancer

Always contact your GP if have any concerns. There is no way to prevent testicular cancer but early detection is important. By performing testicular self-examination once a month you will know what’s normal for you and if you notice a change, contact your doctor right away.

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