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What is testicular cancer?

Testicular cancer is not a common cancer but it is the second most common cancer in young men (aged 20 to 39) excluding non-melanoma skin cancer.

The most common testicular cancers are germ cell tumours. There are two main types, seminoma and non-seminoma. Seminoma usually occurs in men aged between 25 and 45 years and tends to develop more slowly than non-seminoma cancers. Non-seminomasare more common in younger men, usually in their late teens or early 20s.

The projected number of new cases of testicular cancer for 2021 is 980. For Australian men, the risk of being diagnosed with testicular cancer by age 85 is 1 in 202. The rate of men diagnosed with testicular cancer has grown by more than 50% over the past 30 years, however the reason for this is not known.

The chance of surviving at least five years is 97%. 



Testicular cancer symptoms

Testicular cancer may cause no symptoms. The most common symptom is a painless swelling or a lump in a testicle or a change in size or shape.

Less common symptoms include:

  • feeling of heaviness in the scrotum

  • 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).

If found early, testicular cancer is one of the most curable cancers. This is why self-checking in so important.  

Check your balls | Symptoms of Testicular Cancer | Cancer Council

Image credit: Cancer Council Tasmania



Causes of testicular cancer

Some factors that may increase a man's risk of testicular cancer include:

  • undescended testicle (when an infant)

  • family history (having a father or brother who has had testicular cancer)

  • personal history – if you have had cancer in one testicle you are more likely to develop cancer in the other testicle

  • infertility.

There is no known link between testicular cancer and injury to the testicles, sporting strains, hot baths or wearing tight clothes.



Diagnosis of testicular cancer

If you notice any changes, you should visit your GP who will examine your testicles for any lumps or swelling. Other tests used to diagnose testicular cancer include:

Ultrasound

To confirm the presence of a mass.

Blood tests

Blood tests for the tumour markers alpha-fetoprotein, beta human chorionic gonadotrophin and lactate dehydrogenase.

Surgery

The only way to definitely diagnose testicular cancer is by surgical removal of the affected testicle. While many other types of cancers are diagnosed by biopsy (removing a small piece of tissue from the tumour), cutting into a testicle could spread the cancer to other parts of the body. Hence the whole testicle needs to be removed if cancer is strongly suspected.

After a diagnosis of testicular cancer 

After finding out you have testicular cancer, you may feel shocked, confused, anxious or upset. These are normal reactions and a diagnosis of testicular cancer affects everyone in different ways.  

It can be difficult to decide what type of treatment to have. Understanding the disease, the treatments available and possible side effects can help you weigh up your options. You may also want to talk to your doctor about how treatment for testicular cancer may affect your fertility.  



Treatment for testicular cancer

Staging

In addition to the results of the diagnostic tests above, a chest x-ray and CT scans of the chest, abdomen and pelvis are done to determine whether and how far the cancer has spread.

Stage 1 means the cancer is found only in the testicle, stage 2 means it has spread to the lymph nodes in the abdomen or pelvis, and stage 3 means the cancer has spread beyond the lymph nodes to other areas of the body such as the lungs and liver.

If the cancer is found only in the testicle (stage 1), removal of the testicle (orchidectomy) may be the only treatment needed. If the cancer has spread beyond the testicle, chemotherapy and/or radiation therapy may be used as well.

Palliative care

In some cases of testicular cancer, your medical team may talk to you about palliative care. Palliative care aims to improve your quality of life by alleviating symptoms of cancer.

As well as slowing the spread of testicular cancer, palliative treatment can relieve pain and help manage other symptoms. Treatment may include radiation therapy (radiotherapy), chemotherapy or other drug therapies.

Treatment Team

Depending on your treatment, your treatment team may consist of a number of different health professionals, such as:
  • GP (General Practitioner)- looks after your general health and works with your specialists to coordinate treatment.
  • Urologist- specialises in the treatment of diseases of the urinary system (male and female) and the male reproductive system
  • Medical oncologist- prescribes and coordinates the course of chemotherapy.
  • Radiation oncologist- prescribes and coordinates radiation therapy treatment.
  • Cancer nurses- assist with treatment and provide information and support throughout your treatment.
  • Other allied health professionals- such as social workers, pharmacists and counsellors..


Screening for testicular cancer

There is no routine screening test for testicular cancer. While it is important to get to know the regular look and feel of your testicles and let your doctor know if you notice anything unusual, there is little evidence to suggest that testicular self-examination detects cancer earlier or improves outcomes.



Preventing testicular cancer

There are no proven measures to prevent testicular cancer.



Prognosis for testicular cancer

Prognosis means the expected outcome of a disease. An individual's prognosis depends on the type and stage of cancer as well as their age and general health at the time of diagnosis. You may wish to discuss your prognosis and treatment options with your doctor, but it is not possible for any doctor to predict the exact course of your disease.

All testicular cancers can be treated and most testicular cancers are successfully treated.



Sources

  • Understanding Testicular Cancer, Cancer Council Australia, © 2020. Last medical review of source booklet: August 2020.  
  • Australian Institute of Health and Welfare (AIHW). Australian Cancer Incidence and Mortality (ACIM) books. Canberra: AIHW. 

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