Testicular cancer is a comparatively rare cancer in men, but the number of people who develop it has doubled in the UK since the 1970s. The reasons for that are not entirely clear, but what’s more problematic is the sense of embarrassment or reluctance when it comes to talking about it, which can lead to later diagnosis and make it harder to treat. Caught quickly, testicular cancer is one of the most treatable cancers in men - almost 98% survive for five years or more after diagnosis in England and Wales.
Types of testicular cancer
Types of testicular cancer are defined by the cells that the cancer begins in. The most common type is germ cell testicular cancer, which accounts for approximately 95% of cases. Beyond that, there are two main subtypes: seminomas and non-seminomas. There are also some fewer common types of testicular cancer including Leydig cell tumours and sertoli cell tumours.
Spotting the signs and symptoms
One or several of the following can be a sign of testicular cancer, and if you notice any changes like these then it’s a good idea to speak to your GP. However, it’s important to remember that these symptoms can also be caused by other things as well, such as cysts or swollen blood vessels, and are not necessarily a sign of cancer.
- A painless swelling or lump in one of the testicles
- An increase in testicle firmness
- A difference in appearance between one testicle and the other
- A dull ache or sharp pain in your testicles or scrotum
- A heavy feeling in your scrotum
Who is at risk of getting testicular cancer?
Testicular cancer is relatively rare and accounts for 1% of all cancer in men. That said, that still means that around 2,300 men are diagnosed with testicular cancer each year in the UK. It tends to mostly affect men between 15 and 49 years of age, and for reasons unknown white men seem to have a higher risk of developing it than those from other ethnicities.
Other risk factors include:
- Having undescended testicles
- A family history
- If you have had testicular cancer before
Treatments for testicular cancer
Depending on the stage of cancer that you have, as well as the type, treatment for testicular cancer is likely to be one or a combination of surgery, chemotherapy and radiotherapy.
Generally, stage one cancer is treated surgically – with the removal of the affected testicle – followed by a single dose of chemotherapy to help prevent recurrence. Sometimes a short course of radiotherapy will also be advised. More often than not the chances of a recurrence are low, but doctors will usually monitor things over the next few years to make sure.
If the cancer has spread then it may mean needing further treatment, and that’s something your doctor will be able to advise on.
Side effects of cancer treatments
The procedure to remove a testicle is called an orchidectomy. It’s the only way to remove a tumour that hasn’t spread and hopefully stop it from spreading. If you have a single testicle removed it should not affect either your sex life or your ability to have children.
Occasionally however, cancer can return in the other testicle. This will of course affect fertility, but sometimes it’s possible to only remove part of the testicle – your doctor will be able to advise if you are interested in sperm banking. An orchidectomy is a procedure under general anaesthetic, and you can speak about having a prosthetic testicle inserted so appearance is not greatly changed.
Chemotherapy can have a number of short-term side effects, which we have talked about in greater detail in our article How chemotherapy affects the skin and what you can do about it. It can also cause infertility in itself, although the chances are less than 50%. Further surgeries can also have side effects. For example, some patients report changes in their ability to ejaculate following treatments such as retroperitoneal lymph node dissection.
Most men with one remaining testicle have enough testosterone to not feel very different. However, if any problems occur, such as tiredness, weight gain, loss of libido, reduced beard growth or erectile dysfunction, hormone replacements may be prescribed.
As with all types of cancer, everyone’s experience is different, but there are parallels in each individual’s journey as well. If you have any concerns, never be afraid to speak to your doctor or a specialist to ask advice. The chances are it’s nothing to worry about, but if it is, then there are lots of people and support who want to help support you on the road ahead.