Testicular cancer

Testicular Cancer

Testicular cancer is one of the more uncommon cancers accounting for just 1% of cancers that occur in men. Over 2,300 men will receive a diagnosis in the UK each year, with younger men being the main victims.

The testicles are two small oval-shaped organs which hang just below the penis in the scrotum; they’re the vital part of the reproductive system, producing sperm from puberty. Each year in the U.K alone, over 2100 men get cancer of the testicles, it’s more common in white men between the ages of 15 to 49, with cancer rates are increasing worldwide year by year.

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Most men will be familiar will checking themselves on a monthly basis for any signs of testicular cancer if you don’t already check; it’s highly recommended to start doing so.

Step 1: If it’s possible to stand in front of a mirror so you can get familiar with the ways your testicles look to observe changes over time. Check for any swelling on the scrotal area.

Step 2: With both hands, examine each testicle, if one testicle feels larger than the other, don’t worry this is normal. When examining the testicles you shouldn’t feel any pain, feel for any lumps and bumps.

Step 3: Locate the epididymis; this is the soft tube-like structure behind the testicle. Tumours are usually found on the sides of testicles but can also form on the front. Lumps on or attached to the epididymis are not cancerous, but if you are unsure, please ask a GP to examine you.

Testicular Cancer Signs & Symptoms

  • – Swelling or a lump in the testicle
  • – Painful or a dull ache in the testicles/ scrotum
  • – Heaviness in the scrotum
  • – Enlargement of a testicle or change in size (this can be a decrease)
  • – Pain or discomfort in the lower abdomen or the groin

It’s important to regularly check your testicles for any changes and if you get concerned at any time, don’t hesitate to see your doctor. Testicular cancer can affect any man that’s gone through puberty but if you fall into a ‘higher risk’ group, there’s an increased chance of developing the disease.

At risk groups

Symptoms with brain tumours and the central nervous systems can be physical and mental, depending on the part of the brain affected, if you experience one or more of common signs and symptoms plus some of the other symptoms, don’t hesitate seeing your doctor.

Undescended Testicles (Cryptorchidism):

This is the most significant risk factor for developing testicular cancer. When babies are developing in the womb their testicles grow in their abdomen and by the time the baby is born or during their first year of life, they descend into the scrotum. However, for some boys, this isn’t always the case and this puts them double the risk of developing testicular cancer at some point in their life.


White men tend to be more at risk of developing the disease compared to black men.

Previous testicular cancer:

Men who have had testicular cancer before are twelve times more likely to develop it in the other testicle. This is why it’s important to continue going for regular check-ups.

Family History:

Having a close relative such as a father, grandfather or brother will make it more likely of you developing the disease. It’s come into question that testicular cancer can be a result of mutated genes that are passed on through the family, therefore:

  • – If your father has a previous history then you are 4-6times more likely at developing it.
  • – If your brother has had testicular cancer you are 8-10times more likely at developing the cancer.
  • – If you are an identical twin, you are 75times more likely of developing it.

Previous medical history:

  • – Infertile men: 3 times more likely of developing testicular cancer
  • – Smoking: Long terms smokers are two times more prone to developing it.
  • – HIV and AIDS: studies have proven that men with HIV or AIDS have an increased risk.

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Mortality rate:

Testicular cancer is one of the most treatable cancers and is rather easy to treat.

  • – Over 96% of men diagnosed will be easily treatable if the cancer is localised.
  • – If the cancer is more advanced, 80% of the men treated will find it successful
  • – 70 men die from cancer each year out of 2,300

Treatment options:

Treatment depends on whether you have seminoma or non-seminoma:

First stage Treatment:

The first treatment option for all cases of testicular cancer no matter the stage of testicular cancer is surgery also called orchiectomy: this is to remove the affected testicle.

Seminomas Overview and treatment:

Also known as ‘pure seminoma’ or ‘classical seminoma’, this is a germ-cell tumour of the testicle and is a slow-growing form of the disease. Seminoma is very sensitive to radiotherapy which makes it easy to treat with most men being treated successfully, especially if found early. Seminoma is more commonly found in older men in their 30s to 40s and is not as common as non-seminomas.

Seminomas: Stage one;

  • – Firstly, the testicle is removed and you may have a single dose of chemotherapy (this is to avoid the cancer returning)
  • – Sometimes your doctor will recommend a short course of radiotherapy

Non-Seminomas: Overview and treatments:

Unlike seminomas, non-seminomas isn’t ‘pure’ and often has a mixture of cells, it tends to grow more quickly than seminomas and is more commonly found in younger men. Non-seminomas tumours can also contain seminoma cells ‘pure cells’ since both will receive different treatment, if a non-seminomas contains ‘pure cells’, the treatment will be the same as other non-seminomas tumours.

Very rarely other types of cancers can develop in the testicles with the most common being Lymphoma, this usually occurs in men over 50.

Non Seminomas: Stage one:

  • – Surveillance is usually recommended (observing the development of the cancer)
  • – A short course of chemotherapy using a combination of different medication

Stage two & three:

  • – 3 or 4 cycles of chemotherapy using a combination of different medication
  • – Further surgery to remove lymph nodes if they’re affected

Treatment side-effects

Surgery/ orchiectomy:

  • – If you have both testicles removed, you will be infertile. (You may be able to bank sperm- see below)

Testosterone replacement therapy

If you have both testicles removed, you will stop producing testosterone; this will give you side-effects of:

  • – Loss or no sex drive
  • – Unable to maintain or achieve an erection

Testosterone replacement therapy compensates for the testosterone your body isn’t producing; this synthetic version is usually a skin patch or injections, (Injections are every 2-3 months).

Side-effects from testosterone therapy are:

  • – Oil skin which can cause acne
  • – Needing to urinate more often
  • – Having problems passing urine
  • – Enlargement or swelling of breasts

Radiotherapy side-effects

Side-effects for radiotherapy are often only temporary and should improve on completion of your treatment.

Radiotherapy can cause other side-effects if damage occurs to healthy tissue, such as:

  • – If you have one testicle removed, you may still be infertile due to radiation damage
  • – Damage to blood vessels, organs near the treatment area


Chemotherapy is done by using strong medication that can shrink a tumour or prevent cancer from returning. The medications used in chemotherapy attack cells that are dividing quickly, which is why they work well against cancer cells. Chemotherapy can be done as a stand-alone treatment or in conjunction with radiotherapy or surgery.

Chemotherapy Side-effects

Chemotherapy may stop the cancer if it has spread and is also used to prevent it from spreading. It’s more commonly used for non-seminomas tumours. Chemotherapy medicines are either injected or given orally, the main problem with chemotherapy is that it can attack your body’s healthy cells, which is why you get side-effects. These side-effects are usually only temporary and will improve once the course of chemotherapy has come to an end.

  • – It’s recommended that you should not try for a baby once chemotherapy has completed for up to a year as chemotherapy damages sperm, this will make it more likely that your baby will have serious birth defects.
  • – After having a course of chemo, you should use a condom for 48hours to protect your partner from any harmful effects of chemotherapy medications in your sperm.

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Once treatment has come to an end and you’ve received the all-clear, you will become more at risk of getting cancer again in the future. Around 25-30% of people get reoccurring cancer within the first two years after treatment has finished.

Tests and examinations are usually done over a period of time to monitor the return of any cancer.

Sperm Banks

If you are having both testicles removed or you’re worried about the risk of infertility; you may want to consider sperm banking.

Sperm-banking is where a sample of your sperm will be stored and frozen so you can use it at a later date if required. Some NHS cancer treatment centres offer this procedure for free but not all have this facility. If you’d like to get your sperm stored but don’t have the facility you can choose to go private, prices vary privately from £200-£400 upfront cost then a further £125 per year to store it.

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