Testicular cancer represents 1% of the total cancers found in females and males in the UK each year; it tends to affect men aged between 15 and 49 years of age but is most common in the 30 - 34 age group. Many men believe that it is a form of cancer more often found in older men but as we can see it is the young to middle age that is more at risk.
The incidence of testicular cancer is one the rise and has risen by 24% since the 1990s
Finding a lump in the testicles is the moment that every man dreads but the good news is that it is eminently treatable and in England and Wales 99% of men survive for a year after diagnosis and 98% of men survive for more than 5 years
Also known as tests, testicles are part of the male reproductive system; they are held in a sack known as the scrotum. They have two main functions:
Testicular cancer is a condition that occurs when normally healthy cells begin to reproduce uncontrollably within the testicles
There are many types of cells found in the testes, each of which can develop into a different form of cancer. The reason that we need to know which form of cancer has manifested is that treatment and prognosis may differ between the types
This is the most common form of testicular cancer representing 90% of cancers of the testicle. They are called germ cell tumours because they are the cells that make sperm and there are two types, seminomas and nonseminomas which occur more or less equally. Many cases of testicular cancer contain both types and are treated as non-seminomas because they grow and spread in the same way as non-seminomas.
The fact that some seminomas can cause the rise of human chorionic gonadotropin (HCG) in the bloodstream, it can be considered a marker for some types of testicular cancer
Some testicular tumours begin in the hormone-producing and supportive areas of the testicles known as stroma - they are known as gonadal stromal tumours.
Less than 5% of adult testicular tumours are gonadal stromal tumours but up to 20% of childhood testicular tumours. There are two types of stromal tumours:
Whilst most cancers have some strong risk factors associated with them (eg. smoking and lung cancer), there are few serious risk factors associated with testicular cancer. There are however some risk factors that can be associated with a small number of cases:
Signs of a testicular tumour are:
The testicular self-examination should be routinely carried out by all men. It involves an examination of the testicles and scrotum. It is important that men know what a normal testicle feels like in their case; it is normal for one to hang lower than the other and not unusual for one to be slightly larger than the other. It is important they are of similar size and smooth to the touch
There are several non-cancerous conditions which may present like testicular cancerous but are not cancer:
Varicocele - this is best described as a collection of dilated veins found in the scrotum which may affect men in the 15 - 25 year age group. The veins can be found next to or above one or both testicles; the spermatic cord, which delivers the sperm from the testes to the urethra, has blood vessels and it is these that become dilated.
Varicoceles may be found in different sizes and whilst they are not painful they may cause a dragging sensation. They are associated with male infertility and affect approximately 15% of men in the UK
If you detect changes or a lump in your scrotum it is rare that they will be cancerous but it is important to seek advice from your healthcare professional as soon as possible. Should it be that you have developed testicular cancer it can be treated much sooner and so with much more success
Firstly the GP will carry out a full physical examination of the tests; they may use a torch to shine a light through the scrotum; tumours will present as a dense mass which will not allow light to pass through. Any fluid in the scrotum will allow light to pass through.
If your GP has any concerns he will refer you for testing. The tests that may be carried out include:
It is usual that the biopsy and histological testing is carried out after performing an orchidectomy. This is because it is usual that after ultrasound and blood tests it is already considered that the lump is cancerous and the actual process of taking a biopsy can spread cancer onto the scrotum which was initially unaffected.
Doing the biopsy is the only way to be 100% sure that the lump is cancerous; removing one testicle will not affect sex life or fertility
Other treatment for cancer may be required depending on what stage the disease has reached:
As mentioned previously, testicular cancer is every man’s nightmare and something that most men do not want to think about.
What men need to remember however is that it is always a possibility and it is important to perform regular self-examination and if any issues such as a lump or abnormality in the groin area are found that they do not ignore it and have it investigated as soon as possible.
Early treatment is the best and most effective treatment!
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