Updated: Jun 19, 2019
by Richard Brierley
I frequently have discussions with men who are anxious about this condition and it is often not well understood. Testicular cancer is relatively rare as cancers go, but it is still very important because it mainly affects younger men between the ages of 15 and 40, and it is easy to pick up early because you can feel it easily. The problem is most men don’t examine themselves often enough and it should really be a regular part of every man’s routine, around once a month.
It usually starts with a painless lump in the testis, but most testicular lumps are not cancer. In 20 years of full time general practice I have seen 2 cases of testicular cancer but I see someone with a testicular lump every 2-3 weeks and almost all of them are benign epididymal cysts.
Men should be examining their testes on a monthly basis. It’s best done in the shower or bath when you’re warm and relaxed. You will feel the testis as a firm smooth oval shaped structure with a soft frill of tissue running up behind it called the epididymis. Most lumps occur in this structure and are benign epididymal cysts that don’t need treatment unless they are particularly large. Cancers form in the body of the testis itself and are felt as hard lumps in this structure. The important thing is to get to know what your testes feel like so that you’ll easily recognise a change. If you do feel a lump, book in to see your GP as soon as you can, and don’t be embarrassed. GPs examine people with testicular lumps very frequently and think nothing of it.
There are a few things that increase the risk of testicular cancer and should make men more alert for it. It is 4 times more common in white men than African or Asian men. The risk is higher if you have a brother or father who has had the condition, and a history of an undescended testis in childhood or a fertility problem due to a low sperm count also increase the risk.
As I said, most lumps are benign epididymal cysts and the patient can be reassured straight away. Sometimes there is some uncertainty and clarification is needed by referring for an ultrasound scan of the testis, and sometimes the examination is more concerning and the patient needs to be sent urgently to the Urology specialists for further tests.
The good news is that with modern treatment, testicular cancer can be completely cured in 95% of cases, even if it has started to spread. It is one of the most responsive cancers to chemotherapy, and most men remain fertile after they have been treated.
So the take home message is “get to know your balls better”. Examine them regularly, and if you feel something that doesn’t seem right, don’t panic, but get it checked.
Richard Brierly is a freelance GP who works in the Eastbourne area.
Richard is married with three sons, and is particularly interested in the natural world; he loves spending time out in the beautiful Sussex countryside.
Richard and his family live in Eastbourne, East Sussex.