At a Glance:
- Testicular cancer is not a common cancer overall, but it is the second most commonly diagnosed cancer in men aged 20-39 after skin cancer
- Testicular cancer occurs most often in men aged between 25 and 40
- Most testicular cancers are classified as seminoma or nonseminoma, which refers to the type of cells and tissue affected. Seminoma cancers are more common in men aged between 25 and 50, and non seminoma cancers are more common in men aged between 15 and 25
- Seminoma cancers typically develop more slowly than nonseminoma cancers
- At diagnosis, around 75% of testicular cancers are confined to the testicle
- In 2020, an estimated 928 men were diagnosed with testicular cancer
- Mortality from testicular cancer is low - 30 men are estimated to have died due to testicular cancer in 2020. This represents 0.1% of overall Australian male cancer deaths in 2020
- The five year survival rate for testicular cancer is 97%
- Early detection is key to successful treatment, making testicular self-examination a valuable and potentially life saving exercise
What is Testicular Cancer?
Testicular cancer is not a particularly common cancer in Australia, but that said, it is the second most commonly diagnosed cancer in men aged 20-39, after skin cancer. The two most common types of testicular cancer are called seminoma and nonseminoma. These subtypes refer to the type of abnormal cancerous tissue involved when observed by a pathologist under a microscope. Seminoma testicular cancer is more commonly seen in men between the ages of 25 and 50, whereas nonseminoma testicular cancer is more common in men aged between 15 and early 20s.
The vast majority of testicular cancers are germ cell tumours - these are the cells that are typically responsible for the sperm production. How fast these tumours grow depends on the kind of cancer. Seminoma tumours typically develop more slowly than nonseminoma tumours. In around 75% of diagnosed cases, the cancer is confined to the testicle and has not spread.
There is no clear cause of testicular cancer, but there are a few risk factors that increase your risk of developing testicular cancer. An undescended testicle while an infant increases the risk of testicular cancer, as does a direct family history (father or brother) of testicular cancer.
Some cases of testicular cancer may be asymptomatic, but other men may experience symptoms such as a change in the size or shape of a testicle, testicular pain or a feeling of heaviness of fullness in the scrotum.
Testicular cancer is highly treatable when caught early, so getting to know your testicles is an important thing for all men to do. If you discover any abnormalities in your testicles, or are experiencing testicular pain, you should schedule an appointment with a doctor to have them professionally examined
Testicular Self-Examination
While some doctors may include a testicle exam during a general health checkup, it’s advised that men inspect their own testicles on a regular basis between puberty and around the age of 50.
Performing regular testicular self-examinations helps men to familiarise themselves with the shape and feel of their testicles so any chance may be detected quickly and easily, even if there are no symptoms to indicate that something may be wrong.
During a testicular exam, a man should not just inspect the testicles themselves, but the epididymis (small tubes attached to the back of the testicle that collect and store sperm) as well as the scrotum.
No special preparation is needed for a testicular exam, so it can be performed anywhere. Many men find it easiest to check their testicles while they are having a shower, as warm water can help relax the scrotum making the process easier.
Inspecting your testicles is easy and straightforward.
Inspect one testicle at a time, rolling it softly between thumb and fingers, making sure to feel the entire testicle. Each testicle should feel smooth and fairly firm. Search for any abnormalities, such as small hard lumps, pain (your testicles should not hurt from gentle pressure), or changes in size and shape.
Becoming familiar with the shape and feel of your testicles is important as it is the key way of noticing any of these changes. Each testicle has a hard, cord-like structure at the rear. The epididymis is a normal structure so there’s no need to worry. It’s not a lump.
It’s also common for men to have one testicle larger than the other, so knowing the regular size of each testicle is vital.
If you feel anything abnormal, whether it’s a lump, a change in size or shape, or just general testicular pain, you should book an appointment to see a doctor for further testing.
What Happens If I Find a Lump?
There’s no need to panic. Testicular cancer is uncommon. There are a number of other conditions that may affect the size, shape and feel of your testicles, most of which, while potentially painful, aren’t dangerous, such as:
- Cysts – Epididymal cysts, or testicular cysts. Potentially painful but harmless buildup of fluid within the testicle or epididymis
- Epididymo-orchitis – an inflammation of the epididymis and/or testicle due to infection
- Haematocele – a blood clot in the testicle or scrotum caused by trauma
- Testicular Torsion - a testicle that has rotated in the scrotum limiting blood supply. Often causes severe pain and inflammation
- Varicocele – varicose veins (large, swollen or twisted veins) in the testicles or scrotum that may cause pain
If you’ve found something abnormal during a testicular self-exam, your doctor will most likely first order an imaging test to get a better look at the problem. A testicular ultrasound is typically the first test ordered. Sound waves are used to take a look at the interior of the testicle to identify any mass.
If the ultrasound finds a mass, blood tests looking for potential tumour markers, such as alpha-fetoprotein, beta human chorionic gonadotropin and lactate dehydrogenase may also be ordered.
While most cancers are diagnosed via a biopsy, a procedure that involves the removal of some potentially cancerous tissue for testing, this isn’t the case for the testicles. Biopsy on a potential cancer in the testicles risks spreading the cancer around the body, so if cancer is strongly suspected, the entire testicle will be removed. The mass will then be tested to confirm the diagnosis.
If the cancer diagnosis is confirmed, additional testing, such as MRI or PET scans may be required to see if the cancer has spread anywhere else in the body. 70% of all testicular cancers diagnosed in Australia are confined to the affected testicle.
Surgical removal of a testicle is known as Orchidectomy. The procedure is performed in hospital under general anaesthetic and shouldn’t impact fertility if the remaining testicle is functioning normally. In some cases, sperm production may actually increase due to the body overcompensating for the loss of a testicle, or the cancer may have had a dampening effect on the testicle before it was removed.
If the testicle has suppressed or abnormal function, or has previously been removed due to cancer, sperm storage may be recommended before the operation if having children is a consideration. Production of testosterone may also need to be monitored to see if there is any need for production to be supplemented or replaced.
The fastest and easiest way to search for and book healthcare appointments online is through MyHealth1st.