Testicular cancer Dr Rob Hicks Testicular cancer affects a man's testes. If it's detected early enough, it's almost always curable.

In this article

Causes Examine them

Prevention Symptoms

Diagnosis and treatment

The testes are a man's sperm production factories. On average, about 300 million sperm are produced by the testes every day. They also produce the male sex hormone testosterone that's responsible for a man's physical characteristics.

Testicular cancer is the most common cancer affecting young men between the ages of 19 and 44. If it's detected early enough it's almost always curable - with the majority of men who have treatment making a full recovery. So why are men still dying from it every year?

It's not known why testicular cancer occurs or why one man is more likely to get it than another. It may be hereditary. If you have a close male relative with testicular cancer then you could be ten times more likely to develop it.

Men who had an undescended or partly descended testicle are five times more likely to develop testicular cancer.

After a warm bath or shower look out for:

• Testicle swelling
• A pea-sized hard lump on the testicle
• A dull ache
• A sharp pain felt around the testicle or in the scrotum

If something doesn't feel right get it checked out - don't ignore it.

Some research suggests regular exercise may prevent testicular cancer from developing. If a boy with an undescended testicle has it corrected before the age of ten then his risk drops back down to the average risk a man has of developing testicular cancer, which is about one in 450.

But until more is understood about why testicular cancer develops the emphasis is on being more aware and examining your testicles regularly. Then if cancer does develop it can be detected and treated early on.

Ideally, examine your testicles every month. Get used to what your testicles feel like normally. If you're not sure what they're supposed to feel like then ask your doctor to show you.

Self-examination is best done after a bath or shower when the scrotum is relaxed. It's no good examining them when you have an erection because the scrotal sac is too tight, preventing you from feeling the testes properly.

Holding your scrotum in the palms of the hands, use your fingers and thumbs to examine the shape, size, consistency and smoothness of the testes. It's not unusual for one testicle to be larger than the other or for one to hang lower than the other.

Don't die of embarrassment

The reasons men give for not examining their testicles include embarrassment, fear of finding something wrong and uncertainty about how to examine themselves or what to look for.

Others remember sporting days, when any testicular contact was associated with excruciating pain and wrongly believe that self-examination will be painful.

Some men leave it to their partners to take responsibility. Often it's a woman who discovers the problem and encourages her partner to see the GP.

If something doesn't feel right then get it checked out by your doctor, don't ignore it.

• A painless lump or swelling in either testicle
• Enlargement of the testicle
• A feeling of heaviness in the scrotum
• A dull ache in the scrotum or the groin
• Pain or discomfort in the testicle or scrotum
• A sudden collection of fluid in the scrotum

If you notice any of these, or if you're worried and just want some reassurance that everything is all right, then ask your GP to check you. Don't ignore any changes or worries.

To diagnose testicular cancer your GP will examine your testicles and feel for any lumps or swellings. Your GP may need to refer you to the hospital for treatment and will arrange for an ultrasound scan that will show any changes in the structure of the testicles.

If you're referred to a specialist, they may arrange for you to have an orchidectomy (removal of the testicle). The testicle is then sent to the laboratory for tissue testing. If the tumour is low grade, a 'watchful waiting' policy may be adopted. If the tumour is more advanced, then chemotherapy, or occasionally radiotherapy, may be used.

A prosthetic testicle replaces the one removed to ensure the scrotum appears normal. Having a testicle removed shouldn't affect a man's sex life or his chances of becoming a father.

This article was last medically reviewed by Dr Rob Hicks in November 2006.
First published in April 2001.