Around 2,200 men in the UK are diagnosed with testicular cancer and it mostly affects men between 15 and 49 years old.
Men in their early 30s are the most likely to get it. It represents about 1% of all cancers in men. It is one of the most treatable types of cancer, and the outlook is one of the best for cancers. In England and Wales 99% of men with testicular cancer survive for a year or more after diagnosis, while 98% of men survive for 5 years or more following the diagnosis.
There are 2 main types of testicular cancer. The first type is seminomas. Pure seminomas make up about 40-45% of all testicular cancers. Most other testicular cancers are a mixture of teratomas, embryonal carcinomas, choriocarcinoma and yolk sac tumours, these are called non-seminomas as they don’t have any seminoma cells. Some tumours may have both seminoma and non-seminoma cells, however, these are all treated in the same way as non-seminomas.
The most common symptom of testicular cancer is a lump or swelling in part of one of the testicles. It is usually as small as a pea but may be much larger. The difference between the two testicles should be noticeable. However, most testicular lumps are not cancer. Your scrotum may feel heavy and you may have discomfort or pain in a testicle or the scrotum. Testicular cancer is not usually painful. But the first symptom for some men is a sharp pain in the testicle or scrotum.
There is no definitive idea of what causes testicular cancer, but there are a number of risk factors. The most significant risk factor for testicular cancer is undescended testicles, especially in men where the condition isn’t corrected and who haven’t had surgery by age 11-13. Men with undescended testicles are about three times more likely to develop testicular cancer.
A family history of testicular cancer or an undescended testicle increases your risk of also developing it. If your father had testicular cancer, you’re four times more likely to develop it than someone with no family history of the condition. If you’ve already had testicular cancer already your risk of developing cancer in the other testicle is also increased.
If you find a lump on your testicle you should visit a GP for a physical examination. This often involves a GP holding a small light or torch against your scrotum, so they can see whether light passes through it.
Testicular lumps tend to be solid, which means light can’t pass through them. If you are referred to a specialist, you will most likely have an ultrasound on your scrotum, this is a painless procedure that will allow the specialist to determine the position and size of the lump and whether it is cancerous. This will usually be accompanied by a blood test and an MRI scan.
Unlike many cancers a biopsy is not possible as the only way to examine a testicular lump is to remove the affected testicle completely, but an ultrasound and blood test is usually sufficient to make a firm diagnosis.
Your treatment will depend on whether you have seminoma or non-seminoma testicular cancer and what stage the cancer is at. Men with testicular cancer will have surgery to remove the testicle, this is called called an orchidectomy. Some men may also have chemotherapy and radiotherapy after their surgery.