Testicular cancer Q&A

Three of our leading urological specialists answer common questions on testicular cancer including signs and symptoms, diagnosis and effective treatments.

Mr Gurminder Mann
Testicular cancer is a tumour of the testicles and may also be called Germ Cell Tumours (GCTs). Germ cells produce sperm and cancers can arise from these specific cells which are found in the testicles. The lifetime risk is around 1 in 200 for men in the UK.


Professor Christopher Eden
A malignant condition of the testis. The three types are seminoma, non-seminoma (teratoma, embryonal carcinoma, choriocarcinoma and yolk sac tumours) and mixed tumours.


Mr Sachin Agrawal
Testicular cancer is a common cancer of young and middle age men affecting over 2200 men a year. It is an exceptionally treatable cancer even if it has spread, with cure rates above 90% at 5 years for the majority of patients.

Mr Gurminder Mann
The symptoms can vary but very often a lump, or a swelling, is found in the testicle. The lump feels part of the testicle and may give an aching sensation, some heaviness or, indeed, no symptoms at all.

If the cancer has spread, the symptoms may include back or lower abdominal pain, changes in breathing or a persistent cough or a lump elsewhere such as the neck.

Professor Christopher Eden
Usually, a painless lump in the testis. Less commonly it presents with leg swelling due to lymph node spread, problems with breathing if it has spread to the lungs or breast swelling if it is hormone-producing. 


Mr Sachin Agrawal
Testis cancer normally presents as a painless hard or irregular lump in the testicle. Often these changes are not cancer but all lumps need to be checked out.

Professor Christopher Eden
No one knows but factors pre-disposing to it include testicular maldescent, infertility, a positive family history and testiculat microlithiasis (microscopic calcification).


Mr Sachin Agrawal
Most cases of testis cancer do not have an underlying cause. Although testis cancer in more common in men of North European descent, and is increasing in Asians and Black North Americans.

Mr Gurminder Mann
Men most at risk are in the younger group unlike many other cancers, with the most cases occurring in the early 30s. Risk factors include having a previously undescended testicle (one that hasn't dropped down while still an unborn baby). A family history may be a factor with a slightly increased risk if a father or brother has had testicular cancer. White men are more at risk than Asian or Black men.


Professor Christopher Eden
Younger men (aged 15-35) but there is a secondary peak for seminoma for men in their seventies.


Mr Sachin Agrawal
Men with a family history of testis cancer, history of an undescended testicle, small volume testicle or those with a history of difficulty conceiving a child are thought to be at increased risk.

Rarely testis cancer is associated with HIV, mumps and a previous testicular cancer on the other side.

Mr Gurminder Mann
Testicular cancer may be suspected when the testicle is examined by a doctor and is confirmed by performing an ultrasound scan. This is a very quick and painless test. Once confirmed, it is vital that surgery is performed quickly to remove the testicle so that the diagnosis can be confirmed and the specific type of cancer is discovered. Blood tests are carried out before surgery as some testicular cancers can release certain markers into the blood stream.

Removal of a testicle is naturally worrying for men, but if the other testicle is normal it should not affect your sex drive or your ability to have children in the future.

After removal of the testicle a CT scan is carried out to check for signs of cancer elsewhere in the body.

Professor Christopher Eden
Initially it’s diagnosed by ultrasound and then surgery, which provides the ultimate biopsy. Less commonly, it is diagnosed by blood tests or, rarer still, a pregnancy test if it’s a choriocarcinoma.


Mr Sachin Agrawal
Clinical examination is the mainstay of diagnosis along with blood tests and a testicular ultrasound. A CT (Computer tomography) scan is often done to assess for areas of spread.

Mr Gurminder Mann
Additional treatment may be required but this depends on many factors. These treatments may include chemotherapy or radiotherapy. 

Testicular cancer is very treatable and overall survival is as high as 98% after 5 years. Every man should regularly check their testicles from puberty onwards and become familiar with their own layout. Anything new, or different, should be brought to the attention of a doctor immediately. Men should go and see their GP without delay - men should also remember that in most cases new lumps are NOT cancer but the only way to be sure is to GET IT CHECKED. As already stated above, testicular cancer is nearly always curable if it is found early.


Professor Christopher Eden
Surgery to remove the testis and then monitoring, radiotherapy, chemotherapy and/or retroperitoneal lymph node dissection. The treatment depends on the tumour type and the stage at diagnosis.


Mr Sachin Agrawal
For the majority surgical removal of the testis called a radical orchidectomy is the first step. This is done through a small cut in the groin.

Your surgeon will also discuss options of sperm banking to preserve fertility and those of an artificial testicle.

Occasionally a biopsy of the remaining testis is also performed.

Some patients need further treatment in the form of chemotherapy for high-risk disease or surgery to remove areas of spread from the abdomen called a RPLND (retro-peritoneal lymph node dissection).

Mr Gurminder Mann
I wanted to become a consultant urologist as I have always enjoyed doing practical things with my hands and urology offered a real range of surgical options as well as treating patients with medication too where appropriate.


Professor Christopher Eden
I’ve always wanted to be a surgeon. It’s a job that attracts people that like variety, problem-solving, thinking on their feet and those who are practical.


Mr Sachin Agrawal
The urological patient group and the ability to make a visible difference is what made me want to be a consultant urologist. Urology blends both surgical and medical knowledge with technical challenges both involving open and minimally invasive surgery. 

Mr Gurminder Mann
Greatest accomplishments are establishing laparoscopic surgery in Nottingham and providing that service to our patients. The vast majority of my accomplishments have all been possible due to great teamwork with colleagues and staff everywhere that I have worked.


Professor Christopher Eden
The day I got my Surgical Fellowship. I still remember it well, even though it was quite a while ago now.


Mr Sachin Agrawal
As a new consultant, my career highlight to date has been helping shape change in the local department with the introduction of new pathways and colleagues to build and be part of a team, which was recently called a ‘urological family’.

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