Testicular cancer predominantly afflicts young adult males, notably those aged between 20 and 40, with the median age of diagnosis being 33. Although not a widespread malignancy—approximately one in 250 chaps will receive a diagnosis in their lifetime—it ranks among the most common cancers for younger men. The condition seldom impacts gentlemen under 20 (roughly 6% of instances) or over 55 (about 8% of cases).

Fortunately, testicular cancer responds exceptionally well to treatment, boasting survival rates of up to 99%, even when detected at an advanced stage. The management of testicular cancer may encompass a blend of surgical intervention, radiotherapy, chemotherapy, and participation in clinical trials.

In the UK, the incidence of testicular cancer has been on the rise, with approximately 2,300 new cases diagnosed annually. Despite this uptick, the prognosis remains favourable, thanks to advancements in medical care and increased awareness leading to earlier detection.

It’s worth noting that whilst the disease is relatively uncommon, it’s crucial for blokes to be vigilant about their health and perform regular self-examinations. Any unusual lumps, swelling, or changes in the testicles should prompt a swift consultation with a GP.

Testicular cancer that advances to a late stage may spread, or metastasise, to distant parts of the body. Unlike most cancers, which are categorised from stages 1 to 4, testicular cancer is classified into stages 1 to 3. Stage 3 testicular cancer might remain localised in one or both testicles, or it may have spread to nearby or distant bodily areas. When it extends to remote regions, it is termed metastatic testicular cancer. Certain areas of the body are more prone to metastatic testicular cancer. The lymph nodes closest to the testicles are often the first affected area. In more advanced cases, the cancer may also be found in distant lymph nodes in the neck, chest or pelvis. Beyond the lymph nodes, the lungs are the most common site for testicular cancer metastasis. In advanced cases, the cancer may infiltrate the bones, a condition known as testicular cancer bone metastasis. The liver is another potential site for advanced testicular cancer spread. In some instances, particularly with a type of tumour called choriocarcinoma, testicular cancer may extend to the brain. This variety of tumour typically does not grow large but can swiftly spread through the bloodstream. Despite the potential for metastasis, it’s important to note that testicular cancer generally responds well to treatment, even in advanced stages, with early detection and prompt medical intervention remaining crucial for favourable outcomes.

Testicular cancer may recur after remission, though the risk is generally low for early-stage cases. It’s crucial to attend follow-up tests and examinations, as these help your doctor monitor for signs of cancer recurrence. For instance, your physician might check for elevated levels of specific tumour markers in your blood, potentially continuing these tests for up to a decade. Whilst radiation therapy can be an effective treatment, it’s worth noting that it may increase the risk of other cancers later in life. Fortunately, for some early-stage cancers, radiation therapy isn’t always necessary. When planning your treatment, it’s important to discuss the advantages and disadvantages of radiation with your doctor. Open communication with your healthcare team about your concerns and understanding the potential courses of action should your cancer return can help alleviate anxiety about your future. Remember, even if recurrence occurs, testicular cancer generally responds well to treatment, and many men go on to lead healthy, fulfilling lives post-diagnosis.

Should you notice a lump or experience an unusual or painful sensation in your testicle, it’s paramount to seek attention from a specialist such as an oncologist or urologist. They will arrange a professional examination to determine whether there’s cause for concern or, more likely, provide reassurance. It’s worth noting that certain infections of the epididymis or testicle can present with symptoms similar to those of testicular cancer.

If an abnormal swelling is detected, your specialist should refer you for a testicular ultrasound, which is the most sensitive method for distinguishing between a cystic lesion (fluid-filled) and a solid lesion (potentially cancerous). Should a testicular swelling be identified on ultrasound, a CT scan is typically recommended to fully stage a potential cancer. For those opting for private healthcare, self-referral for a scan is possible if concerns arise.

The primary treatment for localised testicular tumours involves an orchidectomy, or removal of the affected testicle. This is typically a straightforward procedure. For patients with cosmetic concerns, prosthetic testicles are available for insertion.

It’s exceedingly rare for the removal of one testicle to cause infertility, as the remaining testicle is seldom affected. This would only occur in severe cases where a significant lump has been neglected for an extended period, allowing it to invade the opposite side. Hence, regular self-examination, at least monthly, is crucial.

Upon diagnosis, the cancer is staged, which determines the subsequent treatment plan. Often, a simple orchidectomy is curative, but nowadays, a single course of adjuvant chemotherapy is frequently administered to enhance overall survival rates.

In cases of more locally advanced cancer or when lymph nodes in the groin are involved, 3 to 5 courses of chemotherapy may be prescribed. However, this scenario is uncommon, and the success rates for such treatment remain above 90%.

Most importantly, should you discover a lump on your testicle during your monthly self-examination (best performed in the shower with soapy fingers for optimal detection), it’s vital to consult a specialist promptly. Often, immediate reassurance can be provided or, in rare cases, cancer can be detected at an early, highly curable stage.