Let’s talk about testes

Testicular cancer is the second most common cancer for young men in Australia. We talk to an expert about causes, symptoms and the most fun you’ll ever have in a self-examination.

We love our balls like we love our cars. They’re a key player in some of our best weekends, it’s fun to show them off, and there’s usually lubricant involved somewhere. And, just like our cars, a lot of us don’t think about what keeps them running until something goes wrong.

Testicular cancer can affect men at any age, from infancy through to your senior years. It isn’t, generally speaking, very common. In Australia, only about 800 men are diagnosed each year, though this number has grown by 50 per cent in the last 30 years. But it does affect young men more – it’s the second most commonly diagnosed cancer (after skin cancer) for men aged 18-39.

We had a chat to Associate Professor Declan Murphy, Urologist at Peter MacCallum Cancer Centre in Melbourne, about how to recognise testicular cancer, some possible causes, and some good ways to look after your party bag.

1. First up, what are the symptoms of testicular cancer?

“The most common symptom is a painless lump on the testicle,” says Murphy. “But it’s important to point out the vast majority of lumps are caused by other things – I spend most of my time reassuring men that they don’t have cancer.”

But testicular cancer can also have very general symptoms like fatigue, aches and pains, and just feeling unwell – or no symptoms at all.

2. If I do have a lump, what happens next?

“You should always get it checked by your GP. They will then get an ultrasound done, and if there’s anything to be concerned about, they’ll refer you to a urologist and get a blood test,” Murphy explains. “There’s nothing to be afraid of. It’s all very quick and most of the time it will be nothing to worry about.”

3. How is it treated?

If the tests give a strong indication of cancer, the testicle will be removed (this is also the only way to definitively diagnose it). Some men require no further treatment, but if you do, your medical team will work out a treatment program. This will depend on how advanced it is and whether it has spread to other parts of your body.

It’s important to note that most men don’t experience any reduction in sex drive or fertility with the removal of a testicle. You can even get a prosthetic one to even out your profile.

Testicular cancer is curable the vast majority of the time. “The prognosis is very good for testicular cancer,” says Murphy. “95 per cent of patients make a full recovery and are still cancer free five years after treatment.”

4. What causes testicular cancer?

“The biggest risk factor is having had an undescended testicle,” says Murphy. “If a testicle doesn’t descend out of the abdomen and into the scrotum when you’re a child, it doesn’t form properly and problems can occur later in life.”

But there are other factors as well. “A family history of testicular cancer can be another warning sign,” he adds. “There are some genetic abnormalities which can predispose you as well, but these are associated with other medical conditions, so you would know about them if you had them.”

And there’s good news for cricketers and Y-fronts enthusiasts. “Contrary to popular perception, there’s no evidence of increased risk if you’ve had a testicular injury, or if you wear a certain sort of underwear.”

5. So why is testicular cancer more common in younger men?

“It’s what we call a germ cell cancer,” says Murphy. “Germ cells are cells we all have, from when we’re developing in the uterus, which will turn into other cell types, like skin or hair or bone. With testicular cancer, there is an abnormality in these germ cells in the testicle, which has been present since early childhood and then becomes cancerous in adulthood.”

This means that unlike prostate cancer, which is more common in older men, testicular cancer is primarily associated with pre-existing factors – i.e. it doesn’t become more likely as you age.

6. How to check your testes

This is the fun part. While we don’t know of any ways to help prevent testicular cancer, it’s simple to check yourself (or your partners, if you’re looking for a little bit of fun?).

“Early detection is crucial. We encourage regular self-examination to feel for any lumps or abnormalities,” says Murphy.

The key is knowing what ‘normal’ feels like for you, so you can tell if anything changes. This means getting to know what your testes and scrotum feel like, regularly and intimately:

1. Use your fingertips to lift your penis up and let your testes hang naturally.
2. Roll each testicle between the forefingers and thumb of both hands so you can feel it all the way around. Check for any unusual lumps or swelling, including in the scrotum. Be aware that it’s normal for one testicle to be bigger than the other, and that each will have a bump on the outer side near the top. This is the epididymis, which is the tube that carries sperm.
3. Be gentle but thorough. Take your time. Turn off the phone.
4. Repeat once a month, or more often if you like.

For a very instructive demonstration, have a look at the testicular self-examination how-to guide below and remember: BE A MAN – SELF-EXAM!

Testicular Self-Examination How-To Guide