Cancer of the testicle (also called the testis), a rare cancer in men, is a disease in which cancer (malignant) cells are found in the tissues of one or both testicles. Sperm and male hormones (testosterone) are made in the testicles. There are two testicles located inside of the scrotum (a sack of loose skin that lies directly under the penis). Testicular cancer affects less than one percent of men overall but is the most common cancer to affect young men (20-35 years old). Testicular cancer has become somewhat infamous because it has affected a number of well-known young men and celebrities in recent years.

The exact cause of testicular cancer is unknown. There are different types of cancer (seminomas, carcinomas, teratomas, yolk sac tumours, and choriocarcinomas), classified according to the type of cell involved.

Risk factors include a history of:

  • Undescended testicle
  • Mumps (when it involves the testicles)
  • Orchitis (swelling and infection of testicles)
  • Inguinal hernia

Very often, there are no symptoms at all. Symptoms may include:

  • Testicular enlargement
  • Testicle lump
  • Blood in the semen
  • Testicular discomfort/pain (rare, but may occur occasionally)
  • Symptoms related to spread to other areas (e.g. backache, cough, urinary problems)

Tests used to confirm the diagnosis include:

  • Ultrasound (a technique that uses sound waves to produce images on a screen) will confirm the presence of the mass.
  • Alpha Fetoprotein (AFP) blood test may be raised in some forms of this cancer.
  • A biopsy, where a small sample of tissue is removed (either using a syringe needle or at surgery) and analysed, is the definitive test.

The main treatments used are:

  • Surgery is commonly performed to remove the affected testicle as well as any tissues where the cancer may have spread.
  • Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and shrink tumours.
  • Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in a vein. Chemotherapy is called a systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells outside the testicle.

Survival rates vary from 95 per cent to around 50 per cent, depending on the type of cancer (how aggressive), how far the tumour has spread, and overall health. Survival rates have improved quite significantly in recent years, due to improved awareness (leading to earlier detection) and better treatments.

Testicular cancer is quite rare but because it affects young men it is really important. All men should examine their own testicles on a regular basis and should see a doctor if they feel anything new or unusual. As ever, early detection improves the eventual outcome significantly.

Written Dr Colin Burns