Testicular cancer is tends to affect younger men, however it is relatively rare compared to other cancers such as lung or prostate cancer. It is the most common type of cancer to affect men between the ages of 15 and 49. Rates of testicular cancer are five times higher in white men than in black men. The reasons for this are unclear.
The most common symptom is a painless lump or swelling in the testicles. Other symptoms can include:
Men should check their testicles every month for any unusual lumps.
The different types of testicular cancer are classified by the type of cells the cancer first begins in. The most common type of testicular cancer is known as ‘germ cell testicular cancer’, which accounts for around 95% of all cases. Germ cells are a type of cell that the body uses to help create sperm.
There are two main types of germ cell testicular cancer. They are:
Blood Tests
To help confirm your diagnosis, you may need a series of blood tests to detect certain hormones in your blood, which are known as 'markers'. Testicular cancer often produces these markers, so having them in your blood may be an indication you have the condition.
Markers in your blood that will be tested for include:
Not all forms of testicular cancer produce these markers. There may still be a chance you have testicular cancer even if your blood test results come back normal.
USS
A scrotal ultrasound scan is a painless procedure that uses high-frequency sound waves to produce an image of the inside of your testicle. This is one of the main ways to determine whether or not your lump is cancerous (malignant) or non-cancerous (benign). A lump filled with fluid is known as a cyst and is usually harmless. A more solid lump may be a sign the swelling is cancerous.
Biopsy / orchidectomy
For most cases the only way to safely take a biopsy is to remove the affected testicle completely. The team will only recommend removing your testicle if they are relatively certain your lump is cancerous. The removal of a testicle is known as an orchidectomy. The main form of treatment for testicular cancer is removing the affected testicle, so if you have testicular cancer it is likely you will need an orchidectomy.
We are able to determine the stage of your cancer after an orchidectomy procedure (removal of the testicle).
There are two ways the staging of testicular cancer can be categorised. The first is known as the TNM staging system:
Testicular cancer is also staged numerically. There are four stages:
Orchidectomy (as above)
An orchidectomy is the medical name for the surgical removal of a testicle. If you have testicular cancer, it is necessary to remove the whole testicle because only removing the tumour may lead to the cancer spreading. If you have testicular cancer that is detected in its very early stages, an orchidectomy may be the only treatment you require.
The operation is performed under general anaesthetic. A small incision (cut) is made in your groin and the whole testicle is removed through this incision. If you want, you can have an artificial (prosthetic) testicle inserted into your scrotum so that the appearance of your testicles is not greatly affected. The artificial testicle is usually made from silicone (a soft type of plastic).
Testosterone replacement therapy
Those men who have undergone removal of one testicle are unlikely to require testosterone replacement therapy. However, having both testicles removed will also stop you producing testosterone. This means you could experience a number of side effects including feelings of lethargy, fatigue, a low libido (a decreased sex drive) and find it more difficult to maintain an erection. In these circumstances, you will require testosterone replacement therapy.
Testosterone replacement therapy is where you are given a synthetic version of the testosterone hormone to compensate for the fact that your testicles will no longer produce the natural version.
Testosterone can be administered in a variety of ways including skin patches, gels and via an injectable. Your surgical team will discuss these options with you and recommend the appropriate course of treatment for your GP to commence.
Chemotherapy
Chemotherapy uses anti-cancer medicines to kill the malignant (cancerous) cells in your body or stop them multiplying.
If you have advanced testicular cancer or it has spread within your body, you may require chemotherapy. It is also used to help prevent the cancer returning.
Radiotherapy
Radiotherapy uses high-energy beams of radiation to help destroy cancer cells. Sometimes, seminomas may require radiotherapy after surgery, to help prevent the cancer from returning.
If your testicular cancer has spread to your lymph nodes, you may require radiotherapy after a course of chemotherapy.
Radiotherapy and chemotherapy carries their own risks and benefits. An oncologist will be able to discuss this treatment with you in more depth. In ABUHB, a referral will be made by your clinical team to Velindre Cancer Centre, Cardiff for a consultation.
Tel: 029 2061 5888
Sperm Banking
Some cancer treatments might affect your fertility. Sperm banking is a way of storing your sperm for use in later fertility treatment. Your fertility might be affected permanently or temporarily.
Some cancer treatments cause infertility in men. These treatments include:
If it is temporary, you will become fertile again after treatment. The time this takes varies from person to person. It also depends on the type of treatment you have had. It usually takes at least a few months after the end of treatment.
Sperm banking is the name for the collection and storage of semen. Semen is the fluid that contains sperm. Sperm banking is also known as sperm cryopreservation or semen storage. The sperm is frozen and stored until you decide you want to use.
Before you start cancer treatment, your doctor will tell you whether it is likely to mean you can no longer father children and the clinical team will make an onward referral to our local team, IVF Wales.
University Hospital of Wales
Heath Park
Cardiff
CF14 4XW
Tel: 029 2074 3047