Youth Cancer

Testicular Cancer

Testicular cancer only affects males. Testicular cancer is not infectious and cannot be passed on to other people.
  • The testicles are two small oval-shaped organs suspended below the penis in a pouch of skin called the scrotum.
  • They are part of the male reproductive system. From the start of puberty, the testicles produce sperm.
  • They also produce the hormone testosterone. This hormone maintains sex drive (libido) in men and is the main cause of the development of male characteristics such as a deep voice, beard growth, muscle development, the ability to have an erection.

Types of testicular cancer

There are two main types of testicular cancer – seminomas and teratomas. These may be called germ cell tumours.
  • Seminomas most common in men between 25 and 55 years of age.
  • Teratomas usually affect younger men – from 15 to about 35 years.
Other rare types of testicular tumour are Leydig and Sertoli cell tumours.

What causes testicular cancer?

It is not known exactly what causes of testicular cancer.

But there are factors that increase the risk of getting testicular cancer, including:
  • Failed Testicular Descent: Testicular cancer is more common in men who have a testicle that has failed to descend (normally the testicles descend in the first year of a baby’s life).
  • Family History: Men with a brother or father who has had testicular cancer are slightly more at risk of developing it (although the risk is still small).
  • Ethnic groups: Testicular cancer is more common in white men than African-Caribbean or Asian men.


What are the symptoms?

The most common symptoms are:
  • Swelling in part of one or both testicles.
  • Feeling of heaviness in the scrotum.
  • Lumps in the body of the testicle.
  • Rarely, tender nipples may be caused by hormonal changes within the body.

TIP: If you have any of these symptoms you should have them checked by your doctor - but remember, they are common to many illnesses other than testicular cancer.

Self Examination of Testicles

Cancers found early are the most easily treated. The best way to check for testicular cancer is self examination once a month.

The best time to do this is after a warm bath or shower, when the scrotal skin is relaxed.

How is it diagnosed?

After visiting a GP a referral will probably be made to a hospital for some tests.

These may include:
  • X-rays
  • Ultrasound
  • Blood test
The doctors will ask for the patients medical history, which could help them in the treatment of testicular cancer.

If the results of the test show testicular cancer, another referral will be made to a doctor who specialises in the treatment of reproductive organs.

Staging

The stage of a cancer describes its size and whether it has spread beyond the area of the body where it started. A staging system commonly used is called the TNM system, is described here:
  • T: refers to the tumour size.
  • N: refers to whether lymph nodes are affected.
  • M: refers to whether cancer has spread to other parts of the body (metastases).


How is it treated?

A team of doctors and other staff at the hospital will plan treatment. It will depend on the size of the tumour and where it is.

Treatment may be coordinated by an oncologist (a doctor who specialises in treating cancer with chemotherapy) and a radiologist (a doctor who specialises in treating cancer with radiation).

Treatment may involve:
  • Chemotherapy
  • Radiotherapy
  • Surgery

Chemotherapy for testicular cancer

  • Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate in the bloodstream and can reach cancer cells anywhere in the body. Sometimes high dosages are needed.
  • High-dose chemotherapy for testicular cancer: Involves giving very high doses of chemotherapy to try to destroy all the testicular  cancer cells. Cells in the blood called peripheral blood stem cells are collected and stored before treatment begins, then returned to the blood afterwards (stem cell support).
  • Often chemo starts again after surgery to kill any remaining cancer cells and stop them from spreading. This is called adjunct chemotherapy.
TIP: Contraception- It is not advisable to father a child while having any of the chemotherapy drugs used to treat testicular cancer, as they may harm the developing foetus. Condoms should be used during sex to protect your partner from any of the drug that may be present in semen, and also as contraception.

Surgery for testicular cancer

  • The aim of surgery is to remove the tumour. Sometimes surgical removal of the testicle (orchidectomy) is often the first treatment for seminoma or teratoma. It also allows the doctor to make an exact diagnosis.

Radiotherapy for testicular cancer

  • Radiotherapy may be given to men with seminoma either to prevent the cancer coming back after surgery or to treat any cancer cells that have spread to the lymph nodes at the back of the abdomen.
  • Normally given in the hospital, as a series of short daily sessions.
  • Usually given from Monday to Friday as an outpatient (no pyjamas needed).
  • Each treatment takes 10–15 minutes.

TIP: External radiotherapy does not make the patient radioactive or glow and it is perfectly safe for them to be with other people, including children, after their treatment.