Testicular cancer, unlike most cancers, is more common in younger men and in fact is the second most common cancer in men aged between 18 to 39, with non-melanoma skin cancer being the most common.

There are 2 main types, called seminoma and teratoma with seminoma being the most common in younger men, usually in their 20’s.

There were 850 new cases of testicular cancer in Australia in 2016 and rate of diagnosis has increased by more than 50% in the last 30 years.

The good news is that testicular cancer is very treatable with the five-year survival rate being 98%. Sadly, it can claim lives and in 2018 34 men died from testicular cancer.

Symptoms

There may be none, but the most common symptom is a painless swelling or lump in a testicle.

Other symptoms may 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
• back pain
• enlargement or tenderness of the breast tissue (due to hormones created by cancer cells)

Diagnosis

A doctor will examine the testicle to determine if the lump is in the main part (the testis) or the collecting system around it, called the epididymis, which is less worrying. Epididymal cysts are common here and almost always benign. If a lump is found within the body of the testis, or there is any doubt, your doctor will arrange an ultrasound examination and probably some blood tests.

The blood tests measure some hormones which are normally at very low levels and if raised are suggestive that something is wrong.

Your doctor will refer to a specialist, a urologist or urological surgeon, at this stage

The only definitive way to diagnose testicular cancer is to surgically remove the affected testis. Many other cancers can be diagnosed by biopsy – removing a small sample of the tissue for analysis first. However, cutting into a testicular carries the risk of spreading it to other parts of the body and so in suspicious cases the whole testicle must be removed by the surgeon (orchidectomy).

Treatment

Treatment will depend on how far the cancer has spread but, in addition to orchidectomy, chemotherapy is often considered to treat any cells that may have spread elsewhere but are too small to detect. The good news is that testicular cancer is very chemo-sensitive, which means even in later stages the chance of putting it into remission is higher than other cancers.

Screening and prevention

Screening means conducting a test on people without symptoms to detect disease in an early and treatable stage and although we have some good screening programs for breast, cervical and bowel cancer, currently there is no way to screen Men for testicular cancer.

We also do not know of ways to prevent it occurring, but it is important for you report any new symptom as early as possible.

Testicular self-exam

The best time for you to examine your testicles is during or after a bath or shower, when the skin of the scrotum is relaxed

• Hold your penis out of the way and examine each testicle separately
• Hold your testicle between your thumbs and fingers with both hands and roll it gentle between your fingers
• Look and feel for any hard lumps or nodules (smooth rounded masses) or any changes in size, shape or consistency of your testicles

Below is a guide published on the Movember Foundation website:

References

https://www.cancer.org.au/cancer-information/types-of-cancer/testicular-cancer

https://au.movember.com/about/testicular-cancer