— The Josh Carrick Foundation

The number of men diagnosed with testicular cancer has doubled in the last 20 years. Research suggests that in the UK around 1 in 200 men will develop testicular cancer and there are approximately 2000 new cases in the UK every year. Testicular cancer is one of the more curable cancers and 95% of men diagnosed with testicular cancer during the early stages of disease development go on to make a full recovery.

Your chances of being cured are significantly increased if the cancer is detected early which is why it is so important to regularly check your testicles for changes in appearance and how they feel. Some men are more at risk than others and if you fall into any of the following categories it is especially important to regularly check your testicles.

Who is most at risk?

  • Individuals under the age of 35

Unlike most cancers the risk of developing testicular cancer decreases with age. It is the most common cancer in men aged 15-44, however over 50% of individuals who develop testicular cancer are aged below 35.

  • Individuals of Caucasian descent.
  • Individuals with a personal history of testicular cancer or those with immediate family (brothers or fathers) who have a history of testicular cancer.
  • Individuals born with an undescended testicle.

Even if you have surgery to correct the position of the testicle in the scrotum at an early age, you remain at increased risk of developing testicular cancer.

  • Individuals who experienced abnormal testicular development or are infertile.
  •  Individuals who suffer from Klinefelter’s syndrome.
  • Individuals with a personal history of viral infections, for example mumps.

What should my testicles feel like?

A healthy testicle should feel like a smooth, firm ball inside a loose sack of skin called the scrotum. To ensure you have the best chance of detecting any cancerous lumps that may have developed in one or both your testicles it is advised that all men thoroughly check their testes at least once a month so that you can become familiar with how your testicles feel when they are healthy and are more likely to detect any lumps that appear quickly.

If when you begin checking your testicles you notice a lump or your testicle feels hard you should not panic. It is not uncommon for even healthy testicles to have imperfections which feel like lumps. However, it is very important that if you do feel a lump, you get this checked as soon as possible and it is advised you book an appointment with your GP.

How should I examine my testicles?

You should aim to check your testicles on a monthly basis and the best time to check is after a warm bath or shower since the your scrotum sack will descend when you are warm and this will make it easier to find any lumps. Follow the steps below to ensure you thoroughly check your testicles:

  1. Using a mirror, check for any swelling on the scrotum. It is perfectly normal for one testicle to be larger than the other and typically the left testicle hangs lower than the right, so do not be alarmed if your testicles vary in size.
  2. Cup your scrotum in the palm of one hand and using your other hand check each half of the scrotum separately. This should be done by rolling each testicle in turn between your thumb and forefinger. Make sure you check the entire testicle and if you notice any lumps, swelling or a change in the consistently of one of your testicles, stay calm and book an appointment with your GP.

When examining your testicles you may feel a narrow, tightly coiled structure located at the rear of each testicle. It is soft and can be tender to touch. This is called the epididymis and its job is to store and transport sperm. Attached to the epididymis is the spermatic cord, a tube like structure which you should also be able to feel. You should try to find the epididymis and the spermatic cord when you examine your testicles so you do not confuse these with abnormal lumps. If you have any doubt about what is and isn’t normal, don’t be embarrassed to ask your doctor to check.
A video demonstration of how to properly check your testicles can be found here.

What should you look out for?

During the early stages, testicular cancer typically presents as a hard lump or swelling in a testis. The lump is usually painless and can vary considerably in size but is typically the size of a pea and located on the front or side of the testicle.

Not all individuals with testicular cancer will present with a lump in their testicles. Other signs to look out for include:

  • Any enlargement or change in the way the testicle looks or feels
  • A sensation of heaviness in the scrotum
  • A dull ache in the testicle, lower abdomen (stomach) or groin (where your legs meet) region.
  • A collection of fluid in the scrotum.

Symptoms can be subtle and therefore easily missed which is why it is so important to familiarise yourself with how your testicles feel when they are healthy.

Symptoms not in the testicle

If the cancer is not detected early, it may spread to other parts of the body and you may develop symptoms in parts of the body other than the affected testicle.
These include:

  • Back pain
  • Shortness of breath
  • A decreased libido
  • Fatigue
  •  A cough
  • Swelling and tenderness in the chest

Don’t be afraid to get symptoms checked out

Don’t be tempted to ignore any symptoms. Testicular cancer is curable, especially if detected early so you don’t need to be afraid to get your symptoms checked. It is important to remember that if you have any of the listed symptoms the chances are you do not have cancer. Fewer than 4% of individuals who present with a lump in one of their testicles are diagnosed with testicular cancer. Nevertheless, it is still very important to have symptoms checked because your chances of making a full and speedy recovery are significantly higher if the cancer is detected early and doesn’t have the chance to spread. Remember, even if the cancer has already spread you still have a good chance of being cured.

How is testicular cancer diagnosed?

Your GP will examine your testes and may ask you to identify where you felt the lump. If they have any reason for concern they will refer you to a specialist. The specialist will examine you again and may decide to carry out some tests. The most common tests include:

  • An ultrasound scan. This is a painless test which uses sound waves to examine the testes and is capable of detecting any regions of dense tissue which may be cancerous lumps.
  • Blood tests may also be carried out to check for tumour markers which are chemicals that are produced by the cancerous cells. It is possible to have testicular cancer but not be able to detect any tumour markers in the blood so if your blood test comes back negative but your symptoms persist, book another appointment with your GP.

 

Trust your body, you know your body best. If something doesn’t feel right don’t ignore it. The symptoms of testicular cancer can be extremely subtle which is why like Josh, some individuals are not diagnosed until the cancer has spread making it more difficult to treat. Please don’t ignore the signs!