screening for testicular

Overview

Screening for testicular cancer means checking the testicles for any unusual changes that could be an early sign of cancer. Unlike screening for some other cancers, there is no routine national test for testicular cancer. Instead, the main way to screen is to be aware of how your testicles normally look and feel, and to see a doctor if you notice anything different.

Testicular cancer is relatively rare compared to other cancers, but it is the most common cancer in young and middle-aged men.

It mainly affects men between the ages of 15 and 35, but it can occur at any age, including in older men and (very rarely) young boys.

Symptoms

Common symptoms

• A painless lump or swelling in either testicle
• A feeling of heaviness or dragging in the scrotum
• A dull ache in the lower belly, groin, or scrotum
• A sudden collection of fluid in the scrotum
• A testicle that becomes larger, smaller, or feels different from usual

Causes

Main causes

• The exact cause of testicular cancer is unknown. It starts when healthy cells in a testicle develop changes in their DNA, causing them to grow out of control. Most cases begin in the germ cells that produce sperm.

Risk factors

• An undescended testicle at birth (not lowered into the scrotum)
• A father or brother who had testicular cancer
• A previous cancer in the other testicle
• Being between the ages of 15 and 35
• A condition called Klinefelter syndrome or a history of testicular atrophy (shrinking)

When to see a doctor

See a doctor urgently if:

• If you find a new lump or swelling in your testicle, book an appointment the same day.
• If you have sudden severe pain in the scrotum, call your local emergency number or go to an emergency department.
• If you have a dull ache in your testicle or groin that lasts more than a few days, see a doctor.

Book a routine appointment if:

• If you notice any change in the size, shape, or feel of a testicle, even without pain, mention it at your next appointment or schedule a check-up.
• If you have risk factors like an undescended testicle, ask your doctor about regular check-ups.

Diagnosis

To find out if symptoms are caused by cancer, your doctor will examine your testicles, ask about your medical history, and usually arrange an ultrasound scan of the scrotum. Ultrasound uses sound waves to create an image of the testicles and can show if a lump is solid or fluid-filled. Blood tests may also be taken to check for certain proteins that can be raised by testicular cancer.

Tests that may be done

• Ultrasound of the scrotum
• Blood tests for tumour markers (such as alpha-fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase)
• Removal of the whole testicle through a small cut in the groin (for examination under a microscope) if cancer is suspected

What to expect at your appointment

You will usually be referred to a urology specialist at a hospital. The appointment will include a physical exam and an ultrasound scan. You can eat and drink normally before these tests. If cancer is found, you will be given detailed information about your type and stage of cancer, and a team of specialists will discuss your treatment options with you.

Treatment

If testicular cancer is diagnosed, treatment depends on the type of cancer and how far it has spread. The main treatment is surgery to remove the affected testicle. You may also need chemotherapy or radiotherapy if the cancer has spread. Even when testicular cancer has spread, it is one of the most curable cancers.

Self-care at home

• Keep the surgical area clean and dry until it has healed.
• Wear supportive underwear to reduce discomfort after surgery.
• Avoid heavy lifting or strenuous exercise until your doctor says it is safe.
• Follow all your doctor's advice about wound care and activity.

Medical treatments

Chemotherapy uses anti-cancer drugs that are given in cycles, either by mouth or through a vein. Radiation therapy uses high-energy rays to kill cancer cells. These treatments are planned by a specialist team, and your doctor will explain the benefits, side effects, and schedule in detail.

When is surgery considered?

Surgery to remove the affected testicle (called a radical inguinal orchidectomy) is usually the first treatment. In early-stage cases, it may be the only treatment needed. In some cases, lymph nodes in the abdomen may also need to be removed if they contain cancer.

Living with this condition

After treatment, you will have regular follow-up appointments, including blood tests and scans. Most men return to their normal activities within a few weeks. With one healthy testicle, you can still have a normal sex life and can still father children, though you may need fertility support.

Lifestyle tips

• Avoid smoking and limit alcohol intake.
• Get regular physical activity and try to maintain a healthy weight.
• Attend all follow-up appointments to check for any recurrence.

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, whole grains, and lean protein. Aim for at least 150 minutes of moderate exercise each week, but ask your doctor what is safe for you after surgery or during other treatments.

Mental health and emotional wellbeing

A testicular cancer diagnosis can bring up feelings of anxiety, body image concerns, and worries about relationships and fertility. These feelings are normal. Talking with your partner, friends, or a professional counsellor can make a big difference. You are not alone.

Prevention

There is no known way to prevent testicular cancer. The best way to protect yourself is to know what is normal for your testicles and to see a doctor promptly if you notice any change.

Vaccines

There is no vaccine for testicular cancer.

Screening programmes

There is no official screening programme for testicular cancer, but you can do a simple self-exam once a month. Check each testicle gently with both hands. Feel for any bumps, hard spots, or changes in size. If you have a high risk (for example, an undescended testicle), your doctor may recommend regular ultrasound or check-ups.

Complications

If left untreated

• If testicular cancer is left untreated, it can spread to other parts of the body, including the lymph nodes, lungs, liver, or brain.
• Advanced cancer can cause serious health problems, but even advanced testicular cancer is often treated successfully.
• Delaying diagnosis can mean more extensive treatment and a lower chance of cure, but the overall cure rate remains very high.

Long-term outlook

The outlook for testicular cancer is excellent. It is one of the most curable cancers, with cure rates above 95% overall, and even men with advanced disease often achieve a full cure. After treatment, most men live long, healthy, and active lives.

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