Testicular cancer FAQs

Dr Craig Knighton, Consultant Oncologist at Three Shires Hospital in Northampton, has been answering our questions on testicular cancer. Providing his expert insight into the condition, along with advice on what young men can do to help get a fast diagnosis and effective treatment.

We encourage all men to check yourselves regularly and to speak to someone if you have concerns.

What is testicular cancer?

Testicular cancer is the most common cancer affecting young men between the ages of 15 and 35. It represents a very small percentage of cancer in males and is one of the most curable with minimal treatment.

Testicular cancer, also called a germ cell tumour, can consist of one predominant type, either seminoma or non-seminoma tumours, also called teratomas. They usually present as a nodule or painful swelling in one testicle or the other and are often noted incidentally by the patient or by the partner of the patient. Some patients present with heavy sensation (also known as ”dragging”) in the genital area, or sometimes felt within the lower abdomen.

What is the prognosis of testicular cancer?

Compared to other cancers, the survival rate for testicular cancer after five years is around 95 to 98%. Very rarely will testicular cancer present with secondary spread (metastases), weight loss, back pain, bone pain, or even swelling of a leg on one side, or sometimes both.

Very occasionally, testicular tumours can present with enlargement of the male breasts (gynaecomastia), but this is rare.  This is because patients can produce a hormone called beta HCG (the same as that detected in a female pregnancy test) and this can easily be detected on blood testing.

What are the risk factors for testicular cancer?

We know that a history of undescended testicles (cryptorchidism) is a risk factor for testicular tumour in young men.

Other potential risk factors include:

• Family history
• Ethnicity
• A previous diagnosis of testicular cancer (recurrence)

What should we be doing to check for symptoms of testicular cancer?

Men are advised to examine the testicles, gently and bilaterally, every month to check for any abnormal swelling or discomfort. When examining your testicles, it is important to recognise that, although they come as a pair, rarely do they feel equally the same size.

Your testicles should have a slightly firm consistency, but there will be some give, and do not push too hard for obvious reasons. Behind the testicles there is a group of ducts called the epididymis. Often benign cysts can present in this area, leading to false concerns of a testicular tumour.

Very occasionally testicular cancer can present with blood in the semen (haematospermia), but this could also occur for more benign reasons. It is important to get this symptom checked out quickly to rule out cancer, or any other condition.

What to do if you detect a lump or a change that concerns you

Should you detect a lump, or be concerned about a strange or painful feeling within your testicle, the most important thing to do is seek attention from a specialist like an Oncologists or Urologist. They will arrange an appointment to examine you professionally and determine whether there is something sinister going on, or more likely that you can be reassured.

Certain infections of the epididymis or testicle can present with similar symptoms to those of testicular cancer.

If they find an abnormal swelling, then your specialist should refer you for a testicular ultrasound. This is the most sensitive way in determining whether a cystic lesion (full of fluid) can be differentiated between that of a solid lesion (possibly a cancer).

Should a testicular swelling be found on ultrasound, then a CT scan is normally warranted to fully stage a potential cancer. Patients can self-refer for a scan when going privately should they have any concerns.

What should a patient expect from treatment for testicular cancer?

The treatment for simple local testicular tumours involves an orchidectomy, or removal of the testicle, on the affected side. This is generally done as a very simple operation. Should a patient have any psychological concerns about appearance, please know that prosthetic replacement testicles are available and can be inserted for cosmetic reasons.

It is extremely rare that the removal of one testicle will ever present with infertility as the contralateral testicle is extremely rarely involved. This would only happen in severe cases of testicular cancer were a significant lump has been ignored for a very long time and allowed to invade the opposite side. Therefore, it is important that you are checking yourself on a regular basis, at least monthly.

When a testicular cancer is found, a stage is attributed to the cancer, and this determines what treatment you should have going forward. Often, simple orchidectomy is curative, but often now a single course of adjuvant chemotherapy is also given to improve the overall chance of survival.

Should the cancer be more locally advanced, or present with lymph nodes within the groin, then 3 to 5 courses of chemo can be given. This is however very rare, and the success rates of such treatment still remains at over 90%.

Most importantly, should you ever discover a lump on your testicle, after checking every month in the shower using soapy fingers for best detection, please flag this up at the earliest opportunity to a specialist as often we can reassure you immediately, or rarely detect a cancer an early stage, when it is very highly curative.

For further details, speak to a specialist and please feel free to make an appointment with one of the Consultants at Three Shires Hospital. Appointments can be made either via the website or by calling our bookings team. Our team will be happy to arrange an appointment as soon as possible, and at your convenience.

We see patients from Northampton, Kettering, Wellingborough, Daventry, Silverstone, Brackley, Duston, Denton and all surrounding towns and villages.