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Testicular cancer

Testicular cancer is a rare tumour, which affects 3-4 per 100,000 men in the general population per year. Most men affected are age 15 to 35, but another peak age group in their 60's and 70's can also be affected. The cause of testicular cancer is generally unknown, but it is associated with testicular anomalies such as undescended testes in infancy and childhood, small testicles, and genetic factors.

Most cancers are detected by the patient himself when self-examining, and feeling a firm lump in the testis. Sometimes pain can be the first sign, or accidental trauma can prompt the patient to examine himself and find that something is not right.

The diagnosis is confirmed by the urologist performing an examination, and through ordering an ultrasound of the testicles and blood tests, which examine certain proteins released by testicular cancers. Most testicular cancers grow quite rapidly, so generally patients are advised to have the testis removed as soon as possible, generally within a week. This is performed through a small operation in the groin (similar to a hernia incision), which involves only day-stay surgery, or one night in hospital. Following this your urologist will order a CT scan to check whether there has been any spread of the tumour, which will affect further treatment. Generally, most patients will be offered a course of chemotherapy or radiotherapy, or sometimes both, after surgery, to ensure any possible remaining disease is removed. Having said this, most testicular cancers have very good prognosis, with cure rates over 90% for most types of this cancer.

Patients are generally followed up with further imaging and blood tests for 5-10 years after treatment is complete, to ensure that there is no trace of cancer returning.