Medical Matters: Testicular Cancer

written by Scally McDaid Roarty July 13, 2018

This week on the health column Medical Matters, Dr Ciaran Roarty of Scally/McDaid Medical Practise explains the symptoms and treatments of  Testicular Cancer. 

Testicular Cancer: As the name suggests this is a form of cancer that develops in the testicle. It occurs in under 35s about half the time and rarely before puberty. Almost all develop from the cells that make sperm (and are therefore called germ cell cancers). Often it develops for no apparent reason though some risk factors have been identified. These include:

  • Family history of testicular cancer.
  • Where you are from – white males from Northern Europe have an increased risk.
  • Having HIV/AIDS.
  • Undescended testicles and infertility
  • Other rarer genetic disorders such as Kleinfelter’s syndrome

What are the symptoms?

Mostly the first thing noticed is a painless lump on one of the testicles, though occasionally some discomfort is noticed. We should remember that most lumps on the testicle are not due to cancer, but should be checked by a doctor nonetheless. Untreated, the cancer may lead to back pain or shortness of breath.

How is it diagnosed?

After a history (where the doctor asks about your symptoms) and examination, the doctor will refer you to a specialist if he/she suspects cancer.  

You may have a simple scan performed which gives a lot of information as well as blood tests. If cancer is confirmed surgery is required to remove the affected testicle.  This will not affect either your desire or ability to have sex.

If radiotherapy or chemotherapy is required it may affect your fertility, though a lot of men find this returns to normal about a year after their treatment. You will also have tests to see if the cancer has spread anywhere else.  This will also help doctors decide how to treat you and what the likely outlook is for you.

Treatment of testicular cancer.

Treatment options as mentioned above include surgery, chemotherapy and radiotherapy.

The type of cancer and whether or not it has spread along with your general health will determine which of the above are indicated. Surgery is normally advised in all cases and if the cancer is in the early stages, removing the affected testicle may be all that is required. If it has spread, further, surgery may be necessary to remove lymph nodes after chemotherapy or radiotherapy.

Chemotherapy is using medicines to kill cancerous cells. Radiotherapy is the use of high energy beams of radiation to kill cancerous cells.

After treatment, specialists will keep a close eye on you with regular tests to ensure the cancer has not returned. We know that people who have been successfully treated for testicular cancer have a higher chance of cardiovascular disease ( heart attacks, strokes angina  etc) so it will be important to take care of other risk factors for these diseases such as not smoking, maintaining a healthy diet and weight and controlling our cholesterol .

Whats the prognosis after testicular cancer has been treated?

Thankfully testicular cancer is one form of cancer which can be really successfully treated. Over 95% of cases are curable. Most testicular cancers are diagnosed at an early stage, and even if it has spread to other parts of the body, it still responds very well to chemotherapy.  

How can we pick it up early?

It’s important for a man/teenage boy to know how his own testicles feel. That way any change is readily noticeable.

The best time to examine them is after a bath or shower when you are relaxed and can easily examine the testicles and nearby structures.  It is quite normal for one testicle to be slightly bigger and for one to hang slightly lower. They feel like smooth soft balls with a soft swelling attached at the top and to the back – this is the epididymis which stores sperm. From this, the vas deferens or tube passes up into the groin. These are all normal structures.  

Change in size, weight or abnormal lumps or swellings should prompt a visit to the doctor and remember most abnormalities are not actually cancer. Cancer tends to start off as a small hard painless lump.

The above information is intended as advice only and should you have any concerns contact your own Doctor.

Dr Ciarán Roarty MB, BCh BAO MICGP DRCOG Grad. Cert. Obst. Ultrasound  is a full-time GP at Scally McDaid Medical Practice , Scally Place, Letterkenny,  Tel 0749164111




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