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The exact cause remains unknown, but factors that
may increase a man’s risk include undescended testes or a family history of
testicular cancer. In most cases, testicular cancer is curable.
Symptoms
The testicles (testes) are two small, oval-shaped organs located behind the penis in a skin sack called the scrotum. Sperm and sex hormones are made by the testicles.
 The symptoms of testicular cancer can include:
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A swelling or lump in the testicle, usually painless
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A feeling of heaviness in the scrotum
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Persistent ache in the lower abdomen or the affected testicle.
Most testicular lumps are not cancer but it is important to see your doctor if you have any of these symptoms. A cancerous lump may be as small as a pea or much larger. In most cases only one testicle is affected. Sometimes testicular cancer cells spread into the lymph glands and other organs in the body (most commonly the lungs). If this happens, you may have other symptoms such as a cough or shortness of breath. Even if testicular cancer spreads, it can still usually be cured.
Different types of testicular cancer
There are two main types of testicular cancer:
• Nonseminoma – men aged between 15 and 30 years are more likely to develop this type.
• Seminoma – men aged between 25 and 55 years are more likely to develop this type.
Risk of testicular cancer
Testicular cancer is one of the most curable forms of cancer when detected early and treated promptly. Males who may be at risk of testicular cancer include;
- those with uncorrected, undescended testicles as an infant or young child;
- those with a family history of testicular cancer;
- those with an identical twin with testicular cancer;
- those who have had certain viral infections (HIV or mumps);
- those who have had an injury to the scrotum. However, many doctors consider such an injury may bring attention to a tumour that was already developing.
Diagnosis
If you feel a swelling or any other type of unusual change in one of your testicles, it is important to see your doctor. Diagnosing testicular cancer involves a number of tests including:
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Physical examination of the testicles
- Ultrasound scan - this helps to distinguish between cancers and lumps due to other causes
- Blood tests - many testicular cancers produce a hormone that can be measured in the blood. Doctors call them ‘markers’.
If the ultrasound results suggest cancer then the affected testicle will need to be removed surgically. The cells from the lump will be examined under a microscope. Unfortunately, this is the only way to confirm testicular cancer. Doctors will only do this operation if they are fairly sure that it is cancer.
If your doctor suspects that the cancer has spread to other parts of the body, they will do other tests such a chest x-ray and scans – magnetic resonance imaging (MRI) scan or a computerised tomography (CT) scan.
Treatment
Surgical removal of the affected testicle (orchidectomy or orchiectomy) is usually the first treatment for testicular cancer. This can be replaced with a false one called a prosthesis. If the cancer has not spread beyond the testicle, this may be the only treatment you need.
Losing one testicle doesn’t affect your fertility, since the remaining testicle will continue to make sperm. Your ability to have an erection isn’t affected either. However, if you have both testicles removed, you will be infertile.
Further treatment for testicular cancer may include:
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Radiotherapy – the use of x-rays to target and kill cancer cells. This is most commonly used to target the lymph nodes at the back of the abdomen. Seminomas are usually treated with radiotherapy, with great success.
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Chemotherapy – the use of cancer-killing drugs as further treatment, if the disease comes back or if it has spread when first diagnosed.
- Further surgery – if the cancer has spread to the lymph nodes at the back of the abdomen, and remains after chemotherapy or radiotherapy, the lymph nodes may be surgically removed. This may cause infertility by preventing the ejaculation of sperm through the penis. However, sexual function and the ability to orgasm remain intact.
If you need further treatment or both testicles removed, you may be able to make a sperm bank donation. This will give you the option to father children in the future.
Self-examination
Cancers that are found early are the easiest to treat. Men should become familiar with the usual level of lumpiness of their testicles and see their doctor if they notice a change. Here are the necessary steps for a self-examination:
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after a warm shower or bath hold your scrotum and gently roll each testicle between your thumb and first two fingers
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examine your scrotum in the mirror noting any swelling
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be alert for any firm, hard, or fixed lumps or nodules inside or on the testicle
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locate the tube-like structure known as the epididymis; it will feel "bumpy"; this is normal
In addition to doing a self exam each month, you should ask your doctor to examine your testicles yearly. Some men need to be especially watchful. They include men and boys with a family history (father or brother) of testicular cancer, and men and boys whose testes did not descend normally when they were babies.
Where to get help
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Your General Practitioner
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Cancer Council Western Australia, Information and Support Service Tel. 131 120
Things to remember
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Testicular cancer is not common and most testicular lumps are not cancer.
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Men aged between 25 and 44 years are most at risk.
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Early diagnosis and treatment can cure almost all cases of testicular cancer.
Cancer Council of Western Australia : http://www.cancerwa.asn.au
My Doctor Australia website : http://www.mydr.com.au/
About AIDS Website: http://aids.about.com
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