What is testicular cancer?
Testicular cancer is the second most common cancer in young men (aged 18 to 39).
The most common type is seminoma, which usually occurs in men aged between 25 and 50 years. The other main type is non-seminoma, which is more common in younger men, usually in their 20s.
For men, the risk of being diagnosed with testicular cancer by age 85 is 1 in 201. The rate of men diagnosed with testicular cancer has grown by more than 50% over the past 30 years, however the reason for this is not known.
Testicular cancer symptoms
Testicular cancer may cause no symptoms. The most common symptom is a painless swelling or a lump in a testicle.
Less common symptoms include:
- feeling of heaviness in the scrotum
- change in the size or shape of the testicle
- feeling of unevenness
- pain or ache in the lower abdomen, the testicle or scrotum
- enlargement or tenderness of the breast tissue (due to hormones created by cancer cells)
Causes of testicular cancer
The causes of testicular cancer are unknown, however factors that may increase a man’s risk are:
- undescended testicle (when an infant)
- family history (having a father or brother who has had testicular cancer).
There is no known link between testicular cancer and injury to the testicles, sporting strains, hot baths or wearing tight clothes.
Screening for testicular cancer
There is no routine screening test for testicular cancer. There is also little evidence to suggest that testicular self-examination detects cancer earlier or improves outcomes.
Diagnosis for testicular cancer
Tests used to diagnose testicular cancer include:
- ultrasound (to confirm the presence of a mass) and
- blood tests for the tumour markers alpha-fetoprotein, beta human chorionic gonadotrophin and lactate dehydrogenase.
However, the only way to definitely diagnose testicular cancer is by surgical removal of the affected testicle. While many other types of cancers are diagnosed by biopsy (removing a small piece of tissue from the tumour), cutting into a testicle could spread the cancer to other parts of the body. Hence the whole testicle needs to be removed if cancer is strongly suspected.
Treatment for testicular cancer
Staging
In addition to the results of the diagnostic tests above, a chest x-ray and CT scans of the chest, abdomen and pelvis are done to determine whether and how far the cancer has spread.
Stage 1 means the cancer is found only in the testicle, stage 2 means it has spread to the lymph nodes in the abdomen or pelvis, and stage 3 means the cancer has spread beyond the lymph nodes to other areas of the body such as the lungs and liver.
If the cancer is found only in the testicle (stage 1), removal of the testicle (orchidectomy) may be the only treatment needed. If the cancer has spread beyond the testicle, chemotherapy and/or radiotherapy may be used as well.
Treatment team
Depending on your treatment, your treatment team may include a number of the following specialists:
- urologist who specialises in the treatment of diseases of the urinary system and male reproductive system
- medical oncologist who prescribes chemotherapy treatment
- radiation oncologist who prescribes radiation therapy
- cancer nurses
- endocrinologist who specialises in diagnoses and treatment of disorders of the endocrine system. For men who have had both testicles removed, this will include testosterone replacement
- other health professionals such as dietitians, social workers and physiotherapists.
Prognosis for testicular cancer
An individual's prognosis depends on the type and stage of cancer as well as their age and general health at the time of diagnosis. All testicular cancers can be treated. The five year survival rate for men diagnosed with testicular cancer is close to 98%.
Most testicular cancers are successfully treated.
Preventing testicular cancer
There are no proven measures to prevent testicular cancer.