Cancer of the testicle is 1 of the less common cancers, and tends to mostly affect men between 15 and 49 years of age.
What should my testicles look and feel like?
Most men's testicles are about the same size, but it's common for one to be slightly bigger than the other. It's also common for one testicle to hang lower than the other.
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The testicles should feel smooth, without any lumps or bumps, and firm but not hard. You may feel a soft tube at the back of each testicle, which is called the epididymis.
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If you notice any changes or anything unusual about your testicles, you should see a GP.
What causes lumps and swelling in the testicles?
There are several causes of testicular lumps and swellings:
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varicocele – caused by enlarged veins in the testicles (may look like a bag of worms)
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hydrocele – a swelling caused by fluid around the testicle
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epididymal cyst – a lump caused by a collection of fluid in the epididymis
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testicular torsion – a sudden painful swelling that happens when a testicle becomes twisted (this is a medical emergency and requires surgery as soon as possible)
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epididymitis – a chlamydia infection in the epididymis can cause inflammation, swelling and tenderness inside the scrotum (ball sack); a few men will notice that the whole of the scrotum is red and tender (this is called epididymo-orchitis)
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testicular cancer - an uncommon cause of lumps
What are the signs of testicular cancer?
The early signs of testicular cancer are easy to spot. Look out for one or more of the following:
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a hard lump on the front or side of a testicle
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swelling or enlargement of a testicle
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an increase in firmness of a testicle
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pain or discomfort in a testicle or in the scrotum (the sac that holds the testicles)
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an unusual difference between one testicle and the other
When to see a GP
See a GP if you notice a swelling, lump or any other change in 1 of your testicles. Lumps within the scrotum can have many different causes and testicular cancer is rare.
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Your GP will examine you and if they think the lump is in your testicle, they may consider cancer as a possible cause.
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Only a very small minority of scrotal lumps or swellings are cancerous. For example, swollen blood vessels (varicoceles) and cysts in the tubes around the testicle (epididymal cysts) are common causes of testicular lumps.
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If you do have testicular cancer, the sooner treatment begins, the greater the likelihood that you'll be completely cured.
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If you do not feel comfortable visiting a GP, you can go to your local sexual health clinic, where a healthcare professional will be able to examine you.
Read more about the look and feel of normal testicles, the symptoms of testicular cancer and diagnosing testicular cancer.
The testicles
The testicles are the 2 oval-shaped male sex organs that sit inside the scrotum on either side of the penis.
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The testicles are an important part of the male reproductive system because they produce sperm and the hormone testosterone, which plays a major role in male sexual development.
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Types of testicular cancer
The different types of testicular cancer are classified by the type of cells the cancer begins in. The most common type of testicular cancer is germ cell testicular cancer, which accounts for around 95% of all cases. Germ cells are a type of cell that the body uses to create sperm.
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There are 2 main subtypes of germ cell testicular cancer.
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seminomas – which have become more common in the past 20 years and now account for 40 to 45% of testicular cancers
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non-seminomas – which account for most of the rest and include teratomas, embryonal carcinomas, choriocarcinomas and yolk sac tumours
Both types tend to respond well to chemotherapy.
How common is testicular cancer?
Testicular cancer is a relatively rare type of cancer, accounting for just 1% of all cancers that occur in men.
Around 2,300 men are diagnosed with testicular cancer each year in the UK.
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Testicular cancer is unusual compared with other cancers because it tends to affect younger men.
Although it's relatively uncommon overall, testicular cancer is the most common type of cancer to affect men between the ages of 15 and 49.
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For reasons that are unclear, white men have a higher risk of developing testicular cancer than men from other ethnic groups.
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The number of cases of testicular cancer diagnosed each year in the UK has roughly doubled since the mid-1970s. Again, the reasons for this are unclear.
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Causes of testicular cancer
The exact cause or causes of testicular cancer are unknown, but a number of factors have been identified that increase a man's risk of developing it.
Undescended testicles
Undescended testicles (cryptorchidism) is the most significant risk factor for testicular cancer. Around 3 to 5% of boys are born with their testicles inside their abdomen. They usually descend into the scrotum during the first year of life, but in some boys the testicles do not descend. In most cases, testicles that do not descend by the time a boy is a year old descend at a later stage.
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If the testicles do not descend naturally, an operation known as an orchidopexy can be carried out to move the testicles into the correct position inside the scrotum.
It's important that undescended testicles move down into the scrotum during early childhood because boys with undescended testicles have a higher risk of developing testicular cancer than boys whose testicles descend normally.
It's also much easier to observe the testicles when they're in the scrotum. Men with undescended testicles are about 3 times more likely to develop testicular cancer than men whose testicles descend at birth or shortly after.
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Family history
Having a close relative with a history of testicular cancer or an undescended testicle increases your risk of also developing it. For example, if your father had testicular cancer, you're around 4 times more likely to develop it than someone with no family history of the condition. If your brother had testicular cancer, you're about 8 times more likely to develop it.
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Current research suggests a number of genes may be involved in the development of testicular cancer in families where more than 1 person has had the condition.
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This is an ongoing area of research in which patients and their families may be asked to take part.
Previous testicular cancer
Men who have previously been diagnosed with testicular cancer are between 12 and 18 times more likely to develop it in the other testicle.
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For this reason, if you have been diagnosed with testicular cancer, it's very important that you keep a close eye on the other testicle.
If you have been diagnosed with testicular cancer, you also need to be observed for signs of recurrence for between 5 and 10 years, so it's very important that you attend your follow-up appointments.
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Cancer Research UK has more information about testicular cancer risks and causes.
Outlook
Testicular cancer is 1 of the most treatable types of cancer, and the outlook is 1 of the best for cancers.
In England and Wales, almost all men (99%) survive for a year or more after being diagnosed with testicular cancer, and 98% survive for 5 years or more after diagnosis.
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Cancer Research UK has more information about survival rates for testicular cancer.
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Almost all men who are treated for testicular germ cell tumours are cured, and it's rare for the condition to return more than 5 years later. Treatment almost always includes the surgical removal of the affected testicle (orchidectomy or orchiectomy), which does not usually affect fertility or the ability to have sex.
In some cases, chemotherapy or, less commonly, radiotherapy may be used for seminomas (but not non-seminomas).
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Find out more about treating testicular cancer
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information taken from www.nhs.net