Testicular cancer, although relatively uncommon, can be one of the most serious health concerns that young men face. Predominantly affecting those aged 15 to 49, testicular cancer can be deadly if left untreated. However, despite this potential severity, it is also one of the most treatable forms of cancer when detected early.

Awareness is your first line of defence against testicular cancer. Recognising symptoms promptly and undergoing timely treatment can lead to exceptionally high rates of successful treatment. For this reason, it is so important for anyone at risk of testicular cancer to know what it is, what might cause it, and how to spot the signs of testicular cancer when they appear.

To coincide with Testicular Cancer Awareness Month, JMW has created an infographic to help explain everything there is to know about the most common testicular cancer symptoms and how to detect them. To learn more, take a look at the full infographic below, or read on.

What is testicular cancer?

Testicular cancer is caused by abnormal growth and proliferation of cells within the male reproductive system. It is a relatively rare type of cancer, accounting for just 1% of all cancers that occur in men. However, it is also unusual in that it affects younger people more frequently, and is the most common type of cancer to affect men between the ages of 15 and 49.

Around 2,300 people are diagnosed with testicular cancer each year in the UK. The majority of testicular cancer cases begin as what are known as germ cell tumours. These tumours develop from the germ cells that are supposed to produce sperm. Testicular cancers are classified into two main types: seminomas, which typically grow more slowly, and non-seminomas, which are more likely to spread at a quicker pace.

If testicular cancer spreads, it typically follows a path to the lymph nodes in the abdomen, known as retroperitoneal lymph nodes. From there, it can move to other parts of the body, including the lungs, liver, brain and bones. The spread of testicular cancer can lead to more severe symptoms, which complicates treatment and may reduce the likelihood of a successful outcome. Therefore, early detection through regular self-exams is vital.

What causes testicular cancer?

While the exact causes of testicular cancer are not fully understood, several risk factors may increase the likelihood of developing the disease:

• Genetic factors: one of the most significant risk factors for developing testicular cancer is a family history of the disease. Those with family members who develop testicular cancer are at a higher risk of being affected themselves.
• Undescended testicles: normally, testicles descend into the scrotum before birth, but in some cases, one or both may not descend at the proper time - a condition also known as cryptorchidism. Men with a history of undescended testicles, even if surgically corrected, are at an increased risk of developing testicular cancer.
• Age and race: testicular cancer most commonly affects young and middle-aged men. Additionally, the rates of testicular cancer are higher in white people than those of other ethnicities.
• Other medical factors: men with a personal history of cancer in one testicle are at an increased risk of developing cancer in the other testicle. Conditions that suppress the immune system, such as HIV, have also been associated with a higher risk of testicular cancer.

Despite these risk factors, many cases of testicular cancer occur in men without any of these risks. This highlights the importance of regular screenings and maintaining awareness of the early signs of testicular cancer.

What are the signs and symptoms of testicular cancer?

Recognising the signs and symptoms of testicular cancer is crucial for early detection and effective treatment. The most common symptom is a painless lump or swelling in one of the testicles. This lump can vary in size, and while it is usually painless, it might feel uncomfortable due to its presence.

Other symptoms of testicular cancer include:

• Increased firmness: One of the testicles may feel significantly harder than usual. This increase in firmness can be an early indicator of abnormal cell growth within the testicle.
• Changes in appearance: there might be noticeable differences between the two testicles in terms of size, shape or texture. Any disparity in appearance that develops over time should be taken seriously.
• Pain and discomfort: while many testicular cancers do not cause pain at first, some individuals may experience a dull ache or a sharp, intermittent pain in the testicles or scrotum. This pain may come and go, but any persistent or recurring pain should be evaluated.
• Heaviness in the scrotum: a feeling of heaviness or dragging in the scrotum can be another symptom of testicular cancer. This sensation might be caused by the growth of the tumour or a buildup of fluid that often accompanies the cancer.
• Sudden buildup of fluid: known as hydrocele, a sudden increase in fluid within the scrotum can cause swelling and discomfort and, although it can be caused by other conditions, it is associated with testicular cancer.

These symptoms, particularly the early signs of testicular cancer like a lump or swelling, should never be ignored. If you notice any of these symptoms, you should always seek medical advice promptly.

How is testicular cancer diagnosed?

There is no routine screening for testicular cancer, so it is important to be alert to any changes and see your GP if you have any concerns.

Diagnosing testicular cancer usually starts with a physical examination. If a doctor suspects cancer, they might recommend an ultrasound to look at the testicles and identify any abnormal growths. Blood tests checking for tumour markers can also help diagnose testicular cancer. These markers are substances that can appear in higher amounts when cancer is present.

If these initial tests suggest cancer, a biopsy or surgical removal of the affected testicle may be performed to confirm the diagnosis.

How is testicular cancer treated?

The methods used to treat testicular cancer are carefully tailored based on the specific type and stage of the cancer, as well as the overall health of the patient. Treatment strategies are designed to effectively manage the disease and aim to eliminate cancer, while preserving as much normal function as possible:

• Surgical removal - the most common treatment for testicular cancer involves the surgical removal of the affected testicle, a procedure known as an orchiectomy. This operation is typically performed as soon as testicular cancer is confirmed, because it not only helps to remove the primary tumour, but also provides tissue for definitive diagnosis and determining the progression of the cancer.
• Radiation therapy - for certain types of testicular cancer, particularly seminomas, radiation therapy is employed to eliminate any residual cancer cells remaining after surgery. Radiation is typically directed at the nearby lymph nodes to prevent the cancer from spreading, and allows cancerous cells to be targeted while sparing much of the surrounding tissue.
• Chemotherapy - chemotherapy is another cornerstone of testicular cancer treatment that is used frequently in treating both seminomas and non-seminomas. It involves the administration of drugs that kill cancer cells or stop them from growing and dividing. Chemotherapy is particularly vital for treating cancer that has spread beyond the testicles (metastatic testicular cancer) and may involve multiple drugs over several cycles to maximise its effectiveness against cancer cells throughout the body.

In cases where testicular cancer has spread to other parts of the body, more intensive chemotherapy treatment may be required.

After the initial treatment phase, ongoing monitoring is critical to ensure the cancer has not returned and to manage any side effects of treatment. This typically includes regular check-ups, blood tests to monitor tumour markers, and imaging tests to visually inspect areas where the cancer might recur.

How to check for testicular cancer

Regular self-examinations are the best way to detect testicular cancer at an early stage, where it is most treatable. The best time to perform a self-examination is after a warm bath or shower, as the heat relaxes the scrotal skin, making it easier to explore testicular lumps or swellings.

The three steps for doing so are easily remembered:

1. Check one testicle at a time
2. Hold the testicle between the fingers and thumbs of both hands, and roll it gently between your fingers
3. Look for hard lumps, smooth bumps or any other changes in the size, shape and feel of the testicles.

Performing a testicular self-exam at least once a month can help you become familiar with the normal size and texture of your testicles, making it easier to notice any changes or abnormalities.

What to do if you spot the signs of testicular cancer

If you notice any signs of testicular cancer, you should see a doctor as soon as you can. Do not wait to see if the symptoms resolve on their own, as early detection and treatment are key to successfully overcoming this disease.

Make an appointment with your GP as soon as possible to discuss your concerns. Be open and thorough about any symptoms you've noticed, as well as any changes in your general health, as this can aid your doctor in making a swift and accurate diagnosis.

Remember, many conditions can cause similar symptoms, and many testicular lumps are benign. Additionally, survival rates for testicular cancer are very high, even if the cancer has started to spread to other parts of the body, so it’s always best to get checked as soon as you can. Remember:

The sooner treatment begins, the greater the chance that you’ll make a full recovery.

What to do if your testicular cancer symptoms are missed

If you feel that your symptoms of testicular cancer were not adequately addressed by healthcare professionals, leading to a delayed diagnosis or misdiagnosis, it is crucial to understand your rights and options. Medical negligence, particularly in the diagnosis and treatment of cancer, can have serious consequences for your health and wellbeing. If you believe that an oversight has occurred, it may be beneficial to seek legal advice to explore the possibility of a medical negligence claim.

Consulting with a solicitor who specialises in medical negligence can provide you with an understanding of the legal process and the viability of your claim. JMW Solicitors offers expert advice and support in cases of medical negligence, and we handle every case with the utmost care and professionalism.

If you are concerned about how your testicular cancer symptoms have been managed, or if you believe there has been a failure in the duty of care owed to you, please do not hesitate to contact us. Call us on 0345 872 6666, or complete our online enquiry form and we will give you a call back to discuss your situation in more detail.