The young man’s cancer

It starts as an abnormal growth or tumour that develops in one or both testicles. It is a highly treatable type of cancer with a very good cure rate (over 95%) if found and treated early.

Testicular cancer accounts for approximately 1% of all cancers in men and is one of the least common forms of cancer with an estimated incidence of approximately 7 in every 100 000 men (in Africa).

This figure does, however rise in parts of Europe where the incidents is about 20 in 100 000 men.

African and Asian men appear to have a much lower incidence of testicular cancer but the rate of men being diagnosed with testicular cancer has grown by more than 50% over the past 20 years

What is testicular cancer?

Cancer begins when cells in a part of the body begin to grow abnormally. As these cancer cells grow and divide, they invade normal tissue and form a tumour.

As the tumour grows, it is possible that some cells will get into the bloodstream or lymph vessels, travel to other parts of the body and begin to grow and form new tumours in a process called metastasis.

Testicular cancer, which may affect one or both testicles, commonly presents as a small hard lump, with swelling or a change in the consistency of the testicle. Some men also experience a dull ache in the testicle or lower abdomen.

In the majority of cases, only one testicle is affected.

Men, regardless of age, who find such an abnormality should go to the doctor immediately.

Testicular cancer can be grouped into three types of tumours: germ cell tumours; stromal tumours; and secondary testicular tumours. More than 90% of testicular cancers develop in germ cells.

Risk factors

Young men between the age of 15 and 40 years are at the highest risk of developing testicular cancer.

The causes of testicular cancer are unknown, however possible factors that may increase a man’s risk include:

• Undescended testes at birth;
• Family history (father or brother with testicular cancer);
• Previous incident of testicular cancer – around one in 25 men who have had cancer in one testicle are likely to develop cancer in the other testicle at some stage;
• Down syndrome may also increases a man’s risk.

There is no known link between testicular cancer and injury to the testicles, sporting strains, hot baths or wearing tight clothes.

What are the symptoms?

Men may experience few or no symptoms of testicular cancer. Important symptoms to watch for include:

• Swelling or a lump in either testicle (usually painless);
• A feeling of heaviness in the scrotum;
• Change in the size and shape of the testicles;
• Aches or pain in the lower abdomen or groin;
• A sudden build-up of fluid in the scrotum;
• Pain or discomfort in a testicle or in the scrotum;
• Enlargement or tenderness of the breast tissue.

Regular self-examination of the testicles is important for young men, particularly those at risk of this cancer.

Being familiar with the size, shape and usual level of lumpiness can help you determine if something is not quite right.

A self-examination can help a man find any changes in the testes early, so that if treatment is needed it can start as early as possible.

A step-by-step guide for conducting a testicular self-examination can be found here.

Treatment

Testicular cancer is highly treatable, and can be effectively treated, and potentially cured, if diagnosed and treated early.

Advanced testicular cancer can also be cured with treatment.

If diagnosed with testicular cancer, the most important step is to talk at length with your doctor about your treatment choices.

In choosing a treatment plan, factors such as your overall health and the type and stage of the cancer should be considered.

You may consider getting a second or third doctor’s opinion.

In most cases, treatment involves the surgical removal of the affected testicle.

This may be followed with surveillance, chemotherapy or radiotherapy.

An orchiectomy (surgical removal of the affected testis) is done under general anaesthetic.

The removed testis is then sent to a pathology laboratory to confirm the stage and type of cancer.

Chemotherapy or radiotherapy is often prescribed after surgery to treat any remaining cancer cells that may have spread to other parts of the body, such as lymph nodes.

The level or amount of chemotherapy and radiotherapy will be different for each man and will depend on the stage and type of cancer.

For more information about cancer, visit the Movember site at www.za.movember.com or the Cancer Association of South Africa’s website at www.cansa.org.za