Here’s what every man should know about testicular cancer

By Petrus Malherbe
30 April 2016

Testicular is a highly treatable disease if it is caught early – but it's crucial men know what to look out for.

Testicular cancer is a highly treatable disease if it's caught early – but it's crucial men know what to look out for.

This type of cancer affects about eight out of every 100 000 men.

Dr Kenny du Toit, a urological consultant at Tygerberg Hospital in Cape Town, breaks down the facts and the bare necessities every man should know.

Who are most at risk for testicular cancer?

  • Young men aged between 20 and 40.
  • Men with a family history such as a father or brother who was diagnosed with the disease.
  • Men with undescended testes at birth including those who required surgery as an infant.
  • Men with atrophic (small) testes.

From what age should a man regularly examine himself for signs of testicular cancer?

Self-examination from the age of 18 is probably acceptable; yet, many health authorities feel men don't examine themselves often enough. Dr Du Toit recommends men in the susceptible age range should examine themselves at least once a week. “It only takes a few seconds to check that the testicles are a normal size and consistency,” he says.

What does self-examination entail?

A warm environment is best for your testicles, for example in a hot bath or shower. “Take the testes between the thumb and index finger of both hands. Gently roll it up and down while gradually moving from the top to the bottom pole of the testicle,” Dr Du Toit explains. Don’t be shy: check both testicles for lumps or swelling.

What is normal?

  • Testicles should be smooth, firm and comfortable to the touch
  • It’s completely normal if one testicle is a little larger or hangs lower than the other

What isn’t?

  • A firm lump or swelling that wasn’t there before
  • A dull aching pain in the nether region
  • A heavy or swollen testicle

Not all lumps and bumps you feel on your testicle are cancer, but if you suspect something might be wrong, rather have it checked out. Early detection is key.

What should I do if I feel something out of the ordinary?

“A firm lump in the testes or a dull ache in an enlarged testicle should be seen to without delay,” Dr Du Toit says. “If you have a dull ache that doesn’t settle after a day or two, go to your doctor.” Dr Du Toit also explains that the sudden onset of pain in the testicles isn't a sign of testicular cancer, but of testicular torsion. “Torsion is an emergency requiring immediate evaluation and treatment,” he warns.

What if I’m uncomfortable going to the doctor for an examination?

If you have a lump, bump or pain, you must muster up the courage to get it checked out, Dr Du Toit says. “It’s cancer we're talking about, something that even the shyest introvert must take seriously and get checked out. Early diagnosis often results in cure. Cancer never goes away, no matter how much you hope it will.”

Treatment of testicular cancer

The good news is testicular cancer is highly treatable if diagnosed early. The bad news is that the testes can almost never be spared. “A radical orchiectomy (surgical removal of the affected testicle) is performed and the testes and spermatic cord are removed in an attempt to cure a patient in early stages of the disease,” Dr Du Toit explains. Only the affected testicle is removed, never both.

Life after testicular cancer

The removal of one testicle will rarely have a significant effect on hormone production and sexual function. “However, some men may need a single course of chemotherapy that can affect fertility negatively,” Dr Du Toit adds. Therefore it's suggested that men with testicular cancer speak to their oncologist about banking their sperm for possible future fertility treatment before commencing chemotherapy. But rest assured “the majority of men will be able to father a child naturally a few years following the surgery and chemotherapy”.

Is there any correlation between testicular cancer and prostate cancer?

“The development of testicular and prostate cancer has a complex link to hormones in the body,” Dr Du Toit says. But luckily studies have shown only a small increased risk of prostate cancer in men with testicular cancer.

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