Men’s health: Testicular cancer

TESTICULAR cancers are malignant growths of the male testicles located in the scrotum.

These cancers overall are quite rare; however, they are the most common cancer in young men aged 15 to 35 outside of leukaemia/lymphomas.

According to internist Dr Jomo James, testicular tumours usually present as painless nodules/bumps in one testicle which is often usually discernible by the patient or patient’s sexual partner.

Dr James said some of the more common symptoms include new swelling in one scrotum, fullness or heaviness in one scrotum, with one major feature being that it is painless.

Additionally, some men feel a dull ache or heavy sensation in the lower belly or around the anus or scrotum. This is the first symptom in approximately 10 per cent of men.

The internist said though advancement in treatment in the past few decades have made testicular cancer one of the most curable cancers especially if caught early, in other instances, if the cancer is advanced and has spread, then signs and symptoms will vary based upon the site involved.

“There may be nodules in the neck, shortness of breath from lung involvement, bone pain from deposits in the bone, among other things,” Dr James said.

“New onset growth in the male breast referred to as gynaecomastia can also be a manifestation of testicular cancer that produces sex hormones.”

Dr James added that any new or abnormal growth in the scrotum should warrant a visit to a doctor. He said further evaluation will include a testicular exam, ultrasound, blood test and surgery.

“Further investigations are done to determine the extent of spread of the cancer. Biopsies are not good for fear of aiding spreading of the tumour, but complete removal of the testicles is involved. Despite only one testicle involved, to help preserve fertility, a sperm count and banking is done prior to surgery,” Dr James said.

In relation to a diagnosis, Dr James said a testicular ultrasound is conducted.

“The testicular ultrasound is an imaging test that uses sound waves to measure the size and characteristics of the testicle and mass (lump), and can determine whether the mass is inside or outside of the testicle and whether it contains fluid or is a solid mass. Testicular cancers are solid and begin inside the testicle. Often, the ultrasound will strongly suggest the diagnosis of testicular cancer,” Dr James said.

But the only way to know for sure if a man has testicular cancer, according to Dr James, is for a doctor to remove the abnormal testicle and send it to a lab to be checked for cancer. Surgery to remove a testicle is called an orchiectomy.

For men with testicular cancer, Dr James said cancer staging is a way in which doctors find out if the cancer has spread beyond the testicles to other parts of the body. This usually involves blood tests, CT scans, or other imaging tests.

With regard to treatment, Dr James said removing the testicle is the first part of treatment and further care depends on the type of cancer that is found, risk of it returning, and whether it has spread outside the testicle.

Treatment options include chemotherapy, radiation therapy, surgery to remove nearby lymph nodes or masses in parts of the body, and a comprehensive follow-up schedule which monitors the body for changes indicating the cancer has returned.

He said where having children is concerned, most treatments for testicular cancer can reduce or stop sperm production, and as a result, it is best to talk with your doctors and share these concerns.

Overall, Dr James said if diagnosed, it is important to follow your doctor’s instructions.