SCREENING FOR TESTICULAR CANCER
To understand testicular cancer, it helps to know about the normal structure and function of the testicles.
The testicles (also called the testes; a single testicle is called a testis) are part of the male reproductive system. These 2 organs are each normally somewhat smaller than a golf ball in adult males and are contained within a sac of skin called the scrotum. The scrotum hangs beneath the base of the penis.
The testicles have 2 main functions:
They make male hormones (androgens) such as testosterone and make sperm, the male cells needed to fertilize a female egg cell to start a pregnancy.
Sperm cells are made in long, thread-like tubes inside the testicles called seminiferous tubules. They are then stored in the epididymis, a small coiled tube behind each testicle, where they mature.
During ejaculation, the sperm cells are carried from the epididymis through the vas deferens to the seminal vesicles, where they mix with fluids made by the vesicles, the prostate gland, and other glands to form semen. This fluid then enters the urethra, the tube in the center of the penis through which both urine and semen leave the body.
The testicles are made up of several types of cells, each of which can develop into one or more types of cancer. It’s important to distinguish these types of cancers from one another because they differ in how they are treated and in their prognosis (outlook).
If it’s suspected that the lump in your testicle may be cancerous, you will need some to undergo a few tests.
A scrotal ultrasound scan is a painless procedure that uses high-frequency sound waves to produce an image of the inside of your testicle. This is one of the main ways your health professional will be able to determine whether or not your lump is cancerous (malignant) or non-cancerous (benign).
During a scrotal ultrasound, your specialist will be able to determine the position and size of the abnormality in your testicle.
It will also give a clear indication of whether the lump is solid or filled with fluid. A lump filled with fluid is known as a cyst and usually harmless. A more solid lump may be a sign the swelling is cancerous.
To help confirm your diagnosis, you may need a series of blood tests to detect certain hormones in your blood, which are known as ‘markers’. Testicular cancer often produces these markers, so having them in your blood may be an indication you have the condition.
Markers in your blood that will be tested for include:
- AFP (alpha feta protein)
- HCG (human chorionic gonadotrophin)
- LDH (lactate dehydrogenate)
Not all forms of testicular cancer produce these markers. There may still be a chance you have testicular cancer even if your blood test results come back normal.
The only way to definitively confirm a case of testicular cancer is to have a biopsy of the tumour taken. The cells from the tumour can be examined in a laboratory to determine whether it is cancerous.
For most cases the only way to safely take a biopsy is to remove the affected testicle completely. This is because specialists often think the risk of the cancer spreading is too high for a conventional biopsy to be taken.
Your specialist will only recommend removing your testicle if they are relatively certain your lump is cancerous. Losing a testicle will not affect your sex life or ability to have children.
The removal of a testicle is known as an orchidectomy. The main form of treatment for testicular cancer is removing the affected testicle, so if you have testicular cancer it is likely you will need an orchidectomy.
If your specialist feels it is necessary, you may require further tests to check whether testicular cancer has spread. When cancer of the testicle spreads, it most commonly affects the lymph nodes and lungs.
Once these tests have been completed, it is usually possible to determine the stage of your cancer.