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What is testicular cancer?

Testicular cancer is the second most common cancer in young men (aged 18 to 39) excluding non-melanoma skin cancer.

The most common type is seminoma, which usually occurs in men aged between 25 and 50 years. The other main type is non-seminoma, which is more common in younger men, usually in their 20s.

In 2016, 850 new cases of testicular cancer were diagnosed in Australia. 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.

In 2018, there were 34 deaths from testicular cancer.

The five year survival rate for testicular cancer is 98%.



Testicular cancer symptoms

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

Less common symptoms include:

  • feeling of heaviness in the scrotum

  • change in the size or shape of the testicle

  • 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).



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).

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

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.

However, 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.



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.
  • Endocrinologist- specialises in diagnosing and treating disorders of the endocrine (hormonal) system.
  • 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, © 2018. Last medical review of source booklet: August 2018.  

Australian Institute of Health and Welfare (AIHW). Australian Cancer Incidence and Mortality (ACIM) books: Pancreatic cancer. Canberra: AIHW. 

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