Should I worry about testicular cancer?

Mr David Hendry Mr David Hendry Consultant Urologist at Nuffield Health Glasgow Hospital
Testicular cancer is relatively uncommon and little understood. Mr David Hendry, Consultant Urologist at Nuffield Health Glasgow hospital, busts the myths and gives you the facts.

Testicular cancer doesn’t get a lot of press. That leaves many men uninformed, vulnerable to late diagnosis and unduly concerned about the condition. Here’s what you should know: 

It’s not that common

Testicular cancer is the 16th most common cancer in men in the UK with only around 2,200 cases diagnosed a year. That’s not a lot compared to other cancers. For example, the most common cancer in UK men, prostate cancer, was diagnosed in 42,000 cases in 2011.

But it’s the most common cancer in younger men

Unlike other cancers, testicular cancer comes earlier in life - usually affecting younger men, aged 25 – 49. So it’s a key cancer to be aware of throughout this life stage. Most cases of testicular cancer are found by accident by the men themselves.

Who’s most at risk?

If you have an immediate family member who’s been diagnosed with testicular cancer then your risk is 10 times higher than average. Men who have low fertility or have had one or both testicles fail to descend naturally into the scrotum also have heightened risk.

Don’t panic – the overwhelming majority survive

Today, more than 95% of men with testicular cancer are cured, compared to less than 70% in the early 1970s. This is mainly because of the introduction of combination chemotherapy which stops the cancer from spreading.

You’ll probably lose a testicle

For obvious reasons, many men are alarmed at this prospect, but it’s a small price to pay. If you have testicular cancer the first step is usually to remove the affected testicle (orchidectomy). This is the most effective way to ensure the cancer doesn’t spread, which could save your life. Removing one testicle won’t impact your sex life – you’ll still produce plenty of sperm and testosterone with the remaining testicle. A prosthetic testicle can even be inserted into the scrotum to maintain its appearance. When the cancer is more advanced, chemotherapy and radiotherapy can then be used to prevent the cancer from returning.

It’s very unlikely you’ll lose both testicles 

Bi-lateral orchidectomy, or removal of both testicles, is extremely rare and necessary in only one in every 100 procedures. Losing both testicles to cancer will prevent you from producing sperm and testosterone naturally. Testosterone can be replaced through injections or skin patches to help you maintain a healthy sex life. Sperm can also be banked before the procedure if you wish to father children in the future. 

How to self-check

Self-checking is especially important if you’re affected by one or more risk factors. But all men can benefit from understanding what feels normal for them. 

Gently roll each testicle between your index finger and thumb to help identify any irregularities. When you are checking your testicles, you may feel a rounded tube towards the back of each testicle that may be tender. This is normal and is called the epididymis. It is part of the male reproductive system. It’s easiest to check your testicles when they’re warm and relaxed – after a shower or bath is ideal.

What to look out for

Swelling or enlargement of the testicle
Pain or discomfort in the testicle or scrotum
An unusual difference between one testicle and the other

A heavy or dragging feeling in the scrotum

Don’t hesitate to see a specialist

If you are concerned that you have a lump or pain in your testicles, don’t let embarrassment stand in the way of your health. Get it checked out as soon as possible. Many lumps are non-cancerous. If there is no problem (which is most commonly the case) then you will be reassured, and if there are cancer cells found, early detection greatly improves the success of treatment.

Last updated Tuesday 2 March 2021

First published on Tuesday 8 September 2015