What is testicular cancer ?

Testicular cancer is not a common cancer but it is the second most common cancer in young men (aged 20 to 39) excluding non-melanoma skin cancer.

The most common testicular cancers are germ cell tumours. There are two main types, seminoma and non-seminoma. Seminoma usually occurs in men aged between 25 and 45 years and tends to develop more slowly than non-seminoma cancers. Non-seminomasare more common in younger men, usually in their late teens or early 20s.

It is estimated that more than 1,000 people were diagnosed with testicular cancer in 2023. The average age at diagnosis is 36 years old.

Testicular cancer signs and symptoms

• painless swelling or a lump in a testicle or a change in size or shape.
• feeling of heaviness in the scrotum.
• feeling of unevenness.
• back pain.
• enlargement or tenderness of the breast tissue (due to hormones created by cancer cells).

If found early, testicular cancer is one of the most curable cancers. This is why self-checking in so important.

Causes of testicular cancer ?

Some factors that may increase risk of testicular cancer include:

• undescended testicle (when an infant).
• family history (having a father or brother who has had testicular cancer).
• personal history – if you have had cancer in one testicle you are more likely to develop cancer in the other testicle.
• infertility.
• Intersex variations - risk is higher in people with some intersex variations, such as partial androgen insensitivity syndrome.

Risk factors

Factors that may increase your risk of testicular cancer include:

• Having an undescended testicle, which is called cryptorchidism. The testes form in the belly during fetal development. They typically descend into the scrotum before birth. If you have a testicle that never descended, your risk of testicular cancer is higher. The risk is increased even if you've had surgery to move the testicle to the scrotum.
• Having a family history of testicular cancer. If testicular cancer runs in your family, you might have an increased risk.

Diagnosis:

• Physical examination by a urologist.
• Ultrasound to visualize and confirm abnormalities.
• Blood tests to measure tumor markers like AFP, hCG, and LDH.

Treatment Options:

• Orchiectomy (surgical removal of the affected testicle).
• Radiation therapy for seminomas.
• Chemotherapy for non-seminomas or advanced cases.
• Surveillance for certain early-stage, low-risk tumors.