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Cancer of the Testicle.

The testicles are part of the male reproductive system. They produce sperm and the
male hormone testosterone. They lie outside the body in a sac of loose skin (the scrotum) under the penis. They are soft and oval shaped - but they are not identical,
one normally hangs a little lower than the other. 

Cancer of the testicle (also called the testes) is quite rare - it accounts for about 1-2%
of all cancers in men.

There are approximately 2000 new cases per year in the UK. This number is rising,
but detection and new improved treatments mean the chances of recovery are high.
The survival rate is 95%.

It is important that men check their testicles regularly.

Cancer of the testicles is most common in younger men and is the biggest cause of cancer-related death in 15-35 year old males.

Symptoms:

The most common symptom of testicular cancer is a painless swelling or lump in one
of the testicles. Rarely (in about 2% of cases) the swelling can occur in both testicles
at the same time.

You or your partner may notice the swelling and assume it is caused by exercise or a minor injury.

Any lump in the scrotum or testicle should be examined by a doctor, so make an appointment to see your GP or go to your local sexual health clinic. The earlier you
seek help, the better your chances of successful treatment

Other symptoms that can be associated with testicular cancer include:

Rarely, some men experience tenderness around their nipples. This may be due to
the release of hormones that are produced by some testicular tumours, or because
the cancer has spread to the chest area.

Most lumps are not cancer, but see your GP as soon as possible to find out.

Causes:

The causes of testicular cancer are not fully understood. The main risk factor appears to be having had an undescended testicle. (where the testicle fails to reach its proper position within the scrotum naturally).

All testicles are formed in the abdomen and usually descend (drop) into the scrotum at birth or during the first year of life.

Testicular cancer is seen more commonly in men with white skin and also those from more affluent backgrounds .The reason for this is not known.

A particular gene has been found to be present in many men with testicular cancer and may account for it running in families. Men who have a brother or father with testicular cancer have a higher risk of developing it (although the risk is still small)

Hot baths, sporting injuries, riding a bike, and having a vasectomy do not cause testicular cancer.

Diagnosis:

Any lump or abnormality in the testicle or scrotum needs to be seen by your GP and, if appropriate, a hospital specialist.

A specialist will ask questions, perform an examination and organise tests. The first test is usually an ultrasound scan. This scan can usually tell the difference between cancerous lumps and benign lumps.

Some cancers of the testicle produce chemicals and release them into the blood
stream. These chemicals are called tumour markers. You may have a test to see if
these chemicals are in present in your blood. This can help tell if the cancer has spread, how the treatment is working, and later on, whether or not the cancer has come back.

As with many cancers the best way to diagnose testicular cancer is with an operation. You will have a general anaesthetic and a surgeon called a urologist will look at the testicle through an incision in the groin. They may take and examine a biopsy.

If the operation confirms cancer, then other special tests are needed to see if it has spread.

Treatment:

There are two major types of testicular cancers:

Seminomas (more common in 25-55 year olds ) and

Teratomas (usually affecting younger men )

Treatment for testicular cancer is usually very successful, especially if the cancer is
found early. About 95% of people are cured.

If cancer is discovered you will have your testicle removed (orchidectomy). This is
the best way to make sure the cancer has completely gone. A fake testicle called a prosthesis or implant, can be inserted in the same operation.

Seminomas are usually treated with radiotherapy to the lymph glands within the abdomen.

Chemotherapy may also be recommended if there are signs that the cancer has
spread.

Teratomas do not respond to radiotherapy, but chemotherapy is very effective. A short course of chemotherapy is used when there is no spread (to prevent the cancer from coming back) or longer if there is evidence of spread.

If any cancer remains in the abdomen or chest after chemotherapy, it can be treated with an operation to remove your lymph glands (lymphadenectomy).

Having only one testicle does not affect your sex life or fertility, as the remaining testicle can produce enough sperm and testosterone.

Occasionally some men may have problems with their sex life after the operation but this is uncommon and treatment such as hormone replacement therapy (HRT) is available

Prevention:

All men should examine their testicles once a month. The best place is in or after a warm bath or shower when the scrotal skin is relaxed.

Using both hands, each testicle should be gently rolled between the thumb and index finger to find any lumps or irregular areas.

You may be more at risk of testicular cancer if you have an undescended testicle, a
family history of the disease or a previous testicular tumour. In these situations it is
very important to carry out self-examination at least once a month, and report any changes to your GP.

One testicle is usually bigger than the other. All men have a lumpy tubular structure on the back of the testicle this is called the epididymis, and is where sperm is stored.

The small firm tube which passes from the testicle into the groin is called the vas deferens and is where the sperm is transported.

When you get used to how your testicles feel you will recognise these parts and not mistake them for anything abnormal.
 

Further full information is available on http://www.cancerscreening.nhs.uk