Testicular cancer is the most type common cancer in men 15-49 years old and has a high survival rate provided it’s caught early. So, it is important that men know the symptoms of testicular cancer and that they visit their GP as soon as they see or feel any changes.

So what exactly is testicular cancer?  

The testicles are the two male organs that hang behind the penis, contained in the protective pouch of skin known as the scrotum. The testicles produce sperm and testosterone. Testicular cancer occurs when cells in the testicles grow and divide in an abnormal and uncontrollable way, causing lumps or tumours to form. In some cases, the cancer can spread beyond the testicle to other parts of the body and cause serious harm.

However, men are notoriously loathed to discuss their health, especially anything to do with their sexual organs, and will often put off seeing their GP due to embarrassment.

Breaking down this stigma is vital.  At The Urology Foundation (TUF) we are working with England and Lions rugby star, Alex Corbisiero, who was capped 20 times for his country and is now a NBC commentator. 

Alex has never been afraid of seizing the ball and has spoken eloquently about his testicular cancer diagnosis last November and his subsequent treatments. You can see his recent interview with Sky Sports here.

Alex is keen to use his experiences to raise awareness about testicular cancer.  His upfront and positive approach is making a real contribution to breaking down the silence around the disease and to getting the message out that:

a) Men need to routinely check their balls for signs of testicular cancer; and

b) If they feel any change not to delay in seeing their GP.  As one urologist so succinctly put it on Twitter recently #dontsitonit   

Alex is now an Ambassador for The Urology Foundation’s “TUF Nuts Tuesday Campaign.”

Knowing what feels normal and being able to spot any changes or anomalies in your testicles is important.  TUF launched the “TUF Nuts Tuesday” campaign to encourage (and remind) men to check their balls when in the shower on the first Tuesday of every month and show them how to do so.

Signs & symptoms to look for:

• A painless lump or swelling in one of the testicles. It can be the size of a pea or it may be much larger.
• A feeling of heaviness in the scrotum
• A dull ache or discomfort in the testicle or scrotum

It's important to be aware of what feels normal for you. Get to know your body and see your GP if you notice any changes.

If the cancer has spread to the lymph nodes or other parts of the body, you may experience some less common symptoms such as:

• Backache or a dull ache in the lower tummy.
• Lumps in lymph glands in other parts of the body, such as around the collarbone or in the neck.
• A cough or feeling breathless.
• Tender or swollen breasts.

What causes testicular cancer?

It is unclear what causes cells to become cancerous. However, several factors are thought to put one at greater risk of the disease:

• Undescended testicle – this is when the testicle has not come down from the abdomen into the scrotum within the first year after birth
• Age - young to middle-aged men are most at risk
• Ethnic background – a study of men in the UK indicated Caucasian men are at a greater risk of testicular cancer
• Infertility
• Other medical conditions – including HIV/AIDS<
• Family History – it is thought that a family member with a history of testicular cancer may increase your risk of developing the disease
• Height – taller men are more likely to develop testicular cancer

Seeing the GP

The first thing a GP will do is to ask you about what you have found and any other symptoms you are worried about. They will also check to see if there is any family history of testicular cancer. They will then conduct an examination. If they suspect testicular cancer they will refer you to a hospital specialist known as a urologist. There would then be one or more of the following tests:

• Ultrasound scan – sound waves are used to create a computer image of your testicles.
• Blood tests – testicular cancers sometimes release particular hormones into the blood. High levels of these hormones may lead to a diagnosis.
• Surgery – to confirm a diagnosis of testicular cancer or see how far the cancer has spread, your testicle will be surgically removed (known as an orchidectomy) to be examined in the lab. This type of surgery is only performed if your consultant  / urologist is fairly certain that the testicle is cancerous (removing a single testicle will not affect your sex life or your ability to have children)
• Other scans such as an MRI scan or chest x-ray can be taken to examine the extent of the cancer

Treating Testicular Cancer

Treatment will depend on the type of cancer, how far it has spread, and how likely it is to spread further. Treatment will usually be one or a combination of:

Orchidectomy – a surgical procedure to remove the whole of the affected testicle. This will be done first no matter what the type or stage of the cancer

Chemotherapy – medication is given to kill the cancerous cells

Radiotherapy – radiation is targeted at the cancer cells to destroy them

If the cancer is in its early stages, the removal of the whole testicle may be the only treatment needed. A single dose of chemotherapy may be recommended to ensure that the cancer does not return.

If the cancer has spread to the lymph nodes (bean-shaped glands), then multiple treatments of radiotherapy or chemotherapy may be necessary, depending on the size of the lymph nodes and type of cancer. It may also be necessary to have surgery to remove the affected lymph nodes. Similar surgeries are performed if the cancer has spread into other parts of the body.

A recommended treatment plan will always be discussed with the patient and whether they wish to follow the recommended treatment is entirely their choice.

After treatment, patients are monitored for several years to make sure the cancer has not returned.

Remember that the outlook for testicular cancer patients is very good, with over 95% of cases curable, but it is important to see your health professional as soon as you suspect something is not right.

So be sure that you, or the man in your life, makes this Tuesday and the first Tuesday of the month a #TUFNutsTuesday.

Want to keep learning?  Find out more about the author, The Urology Foundation.