Testicular cancer

The commonest cancer in men aged 15 to 49, and one of the most curable. Checking takes thirty seconds.

What it is

Around 2,400 men are diagnosed with testicular cancer in the UK each year. It is the commonest cancer in men aged 15 to 49.

It is also among the most curable cancers there is: overall survival is around 98% at ten years, and even when it has spread, cure is usually still achievable.

That survival rate depends on presenting, and the barrier is entirely social. Young men do not check, do not want to make a fuss, and are embarrassed. The average delay between noticing a lump and seeing a doctor is measured in months.

Higher risk: undescended testicle at birth, a family history, and previous testicular cancer in the other testicle.

Signs you might notice

A painless lump or swelling in a testicle. Painless is the important word, because people wait for pain.

A change in size, shape or firmness.

A dull ache or heaviness in the scrotum.

Occasionally a sudden sharp pain.

Later: back pain, breathlessness, or a cough, from spread.

Breast tenderness or swelling, from hormones produced by some tumours.

How it can affect day-to-day life

Fertility is the practical decision that comes early. Sperm banking should be offered before treatment, and it is sometimes not raised until it is too late.

Treatment for early disease is often surgery alone, and losing one testicle does not affect fertility or testosterone in most men.

The psychological side, body image and masculinity, is real and rarely addressed in a routine follow-up appointment.

Follow-up is intensive for several years, which is reassuring for some and anxiety-provoking for others.

Supporting someone well

Check monthly, in a warm bath or shower when the scrotum is relaxed. Roll each testicle between thumb and fingers. Know what normal feels like for you, including the epididymis at the back, which is a normal lump people frequently panic about.

Present immediately for any painless lump. Do not wait for it to hurt, because it usually will not.

Ask about sperm banking before treatment starts. Insist if nobody raises it.

Attend the follow-up scans and blood tests.

Check the remaining testicle for life, since risk in the other one is raised.

For anybody supporting a young man with a learning disability, include this in personal care awareness and in the annual health check.

Where to get help

See a GP for any testicular lump; ask for an urgent ultrasound.

Orchid and Movember both provide information and support for men's cancers.

Sudden severe testicular pain is different: it may be torsion, and that is a surgical emergency within hours.