Testicular cancer is relatively rare, although annually, around 150 Kiwis are diagnosed with the disease, and at least seven die from it. Testicular cancer is most common among males aged 18 to 39.
Testicular cancer occurs when abnormal cells begin growing in one of your testicles (the small organs found inside the sac below the penis).
Testicular cancer treatment can be very successful, even if the cancer has spread to other parts of the body. But as with all cancers, early detection is key, and the disease has a particularly good survival rate if diagnosed in its early stages. Over 95% of patients will survive for at least five years.
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Types of testicular cancer
There are two types of testicular cancer: germ cell tumour and stromal tumour. Most testicular cancers begin in the cells that make sperm (called ‘germ cells’).
Germ cell tumours
These account for more than 90% of testicular cancer cases. There are two subtypes of germ cell tumours which occur in roughly the same numbers.
- Seminoma cancer cells - this type is more common in males aged 25 to 45. Seminoma cancer usually grows slowly and does not normally spread beyond the testes or the lymph nodes.
- Non-seminoma cancer cells -more common in young men under the age of 25 and tend to grow more quickly.
Stromal tumours
These account for less than 5% of testicular cancer. The abnormal cancer cells grow in tissues that surround the germ cells. Many of these cancers are benign (relatively harmless).
Testicular cancer signs
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Signs of testicular cancer may not be obvious at first and they can also resemble other conditions.
You should see a doctor if you notice any of the following signs:
- Small but firm swelling in one testicle (often painless)
- Any noticeable shrinking or enlargement of a testicle
- Persistent pain in the scrotum or lower abdomen
- Tenderness or enlargement of the breast area
Even if you detect a lump, it doesn’t necessarily mean you have cancer. But these are major symptoms for testicular cancer, so get them checked out.
Testicular cancer–diagnosis
Remember, early diagnosis (as with any cancer) is important for your survival. Your doctor will begin with a physical examination.
Blood and urine tests help screen out other possible causes, such as infections. Blood tests can also measure a number of protein indicators (markers) that indicate the presence of cancer.
There may be a need for more conclusive tests, including:
- Ultrasound or CT scan - these images help doctors assess the size and spread of any tumours. If a potential cancer is identified, you’ll be referred to an oncologist and a urologist.
- Biopsy - tissue samples are essential for analysis. Usually, the entire testicle will be removed for a definitive cancer diagnosis.
Further tests, such as x-rays, scans, additional blood tests, and tissue analysis, form a clear picture of the cancer’s size and spread. This is known as staging, and it helps doctors map out the best treatment programme for each individual.
Testicular cancer – staging
- Stage 1 – cancer is only found in one testicle
- Stage 2 – cancer has also spread to the lymph nodes in the pelvis or abdomen
- Stage 3 – the cancer has spread to lymph nodes as far away as the lungs, bones, or brain
Doctors will also give your cancer stage a letter (A, B, C, or S) to give more precise information. Your medical team will discuss your staging results with you and recommend a treatment plan.
Treatment for testicular cancer
The ideal treatment for testicular cancer will depend on a number of factors, including the cancer type and stage, your age, health, and desire to have children.
Treatment of testicular cancer may include:
Surgery
Surgeons will always remove the testicle (regardless of the cancer stage). This is known as an orchidectomy and was probably already performed when taking your biopsy.
After chemotherapy, doctors will often remove lymph nodes in the abdominal area to stop the cancer from advancing further.
Surgeons may also need to remove tumours from other parts of your body if the cancer has spread.
Side effects of surgery: The removal of a testicle will not usually impact normal sexual function or fertility. Removing both testicles is rarely necessary - however, this process will invoke infertility.
Sometimes the surgical removal of lymph nodes may affect the ability to ejaculate, although there are procedures that can reduce this risk and medications that can help.
Chemotherapy
Chemotherapy uses powerful drugs to kill cancer cells. Chemotherapy is often used with more advanced cancers or to reduce the risk of the cancer returning.
Side effects of chemotherapy: Because the drugs used in ‘chemo’ will often damage healthy cells there can be a number of side effects including:
- Nausea and vomiting
- Fatigue
- Numbness and tingling
- Tinnitus (ringing in the ears
- Kidney and lung damage
- Infertility–less than 50% if other testicle is healthy
- Increased susceptibility to infection
Some of these side effects are only temporary, but others are more serious, and may cause long-term issues.
Radiation therapy
Radiation therapy is only used for specific types of cancers. Doctors usually prefer chemotherapy because it’s more effective for treating testicular cancer.
After treatment
Your doctors will put a regular monitoring programme in place after your treatment to check for signs of recurrant testicular cancer.
What causes testicular cancer?
We don’t know what causes testicular cancer but there are a number of risk factors that mean you are more likely to develop the disease.
The following factors increase your risk of having testicular cancer:
A testicle that is undescended
A small number of male babies are born with their testicles inside the abdomen. Usually the testicles will descend into the scrotum within the first year of life. If this doesn’t occur naturally, the male may be up to 3 times more likely to develop testicular cancer.
Family history of testicular cancer
Close male relatives, such as a brother or your father, who have had testicular cancer raise your risk by 4 to 8 times.
History of testicular cancer
If you’ve already had testicular cancer, then you're 12 to 18 times more likely to develop it in the other testicle.
HIV/AIDs infection
Some evidence suggests that men infected with HIV / AIDs have an increased risk of developing testicular cancer.
Are you prepared for life’s uncertainties?
You might not have testicular cancer today, and it may not even run in your family, but that’s no guarantee it won’t happen to you or someone you love.
Think about how how much your testicular cancer treatment will cost and how health insurance can help you cope.
Not all health insurance plans are the same. Some plans will only pay for a tiny fraction of your testicular cancer treatment cost.
Don’t let this happen to you. When buying health insurance, talk to a Policywise adviser about maximum benefit amounts for cancer treatments, non-Pharmac cover, inclusions, and any exclusions.
We provide clear, easy-to-understand plan comparisons from different insurers so you can choose the policy with the best cover. Our service is free - and it might just change your life for the better.