Testicular cancer – teenagers and young men are at risk

Early treatment success rates are high, say experts

Wednesday, June 17 2015

A 23-year-old Johannesburg man was “absolutely stunned and very scared” recently when he was diagnosed with cancer of the testicles, also known as testicular cancer.

“It was the last thing I expected to hear when my doctor told me the news,” recalls the young man, who prefers not to be named. “I am young and fit, and couldn’t stop wondering how I could have developed cancer of the testicles at such an early age. I kept asking the doctor if he was sure the diagnosis was correct,” he says.

Dr Johan Venter, a urologist who practises at Netcare Pretoria East Hospital, says South Africans tend to have a better awareness of the more common cancers such as prostate and breast cancer than they have of testicular cancer.

“Although testicular cancer is relatively rare in the male population overall, it is one of the most common cancers occurring in younger men between the ages of 15 and 35, although older men can also develop it. Most of us do not expect younger men, and particularly teenagers, to develop such a cancer,” observes Dr Venter.

“There needs to be much greater awareness of this form of cancer in South Africa as early detection saves lives. Early treatment has a high success rate, with more than 95% of men who are treated timeously being cured. In addition, early treatment of this cancer, before it has had a chance to spread, or metastasise, enables doctors to better preserve a man’s reproductive and sexual functioning, so that they can retain their quality of life.”

Symptoms of testicular cancer
The most common symptom of testicular cancer is a painless lump or swelling in the scrotum, which is the sac of skin beneath the penis that encloses the testicles. In some cases the cancerous testicle may become swollen or enlarged without developing a lump, or it may hang lower than the other one. Sometimes the disease may cause a dull ache or a heavy feeling in the lower belly or scrotum, but this is unusual.

“Just as women are always encouraged to examine their breasts for unusual lumps, so all men should self-examine their testicles on a regular basis, once a month. They should get to know what their testicles normally feel like and feel for any lumps or abnormalities,” advises Dr Venter. ”If they feel any lumps or growths they should make an appointment as soon as possible to consult their doctor or a urologist, a physician who specialises in the urinary and male reproductive systems.

“It should be kept in mind that lumps in the scrotum may not necessarily be cancerous. However, we strongly recommend that any abnormalities in this area be examined by a doctor.”

The Johannesburg man says that he discovered that he had a sizable lump on one of his testicles after it started aching one day.

“That was six-months ago and I am extremely grateful that after treatment, which involved the testicle being surgically removed, I am cancer free today. I was just so fortunate that it was diagnosed early and that I had it treated before it could spread to my other testicle or to the surrounding tissue,” he says.

Treatment options
Dr Evangelos Apostoleris, a urologist who practises at Netcare Olivedale Hospital in Johannesburg, agrees that with early detection, testicular cancer can almost always be successfully treated.

“Treatment depends entirely upon how far the cancer has progressed, referred to as the stage of the cancer, and the type of testicular cancer present. In some cases it is necessary to surgically remove one or both of the testicles,” explains Dr Apostoleris.

Some forms of testicular cancer respond very well to chemotherapy, a treatment in which medication is used to destroy the cancer cells. Radiotherapy is also occasionally used for some kinds of testicular cancer. In some cases it may be necessary to employ combinations of different therapies.

Dr Apostoleris points out that testicles play a critical role in the male reproductive system, producing sperm and the hormone testosterone.

“We as doctors will always aim to preserve as much as possible of the functioning of the reproductive system. If only one testicle has to be surgically removed this will not have much of an impact on the individual’s reproductive capability and sex life. However, in the occasional case where the disease has spread to both testicles and they both have to be surgically removed, this will have a greater impact on the patient’s life preventing them from being able to reproduce.”

“This is another reason why early detection of this disease is so important; the quicker we can treat it the less damaging the impact is likely to be and the better we are able to preserve an individual’s quality of life.”

Risk factors for testicular cancer
What causes testicular cancer? Dr Apostoleris says that in most cases it is not clear what caused the condition to develop. However there are certain risk factors that may promote the development of the disease. These include the following:

  • A family history oftesticular cancer may increase an individual’s risks of developing the disease.
  • Testicular cancer occurs more commonly in white males affecting two to three individuals in every 1 000.
  • Males between the ages of 15 and 35 are particularly at risk.
  • There is a risk of testicular cancer re-occurring in individuals who have had it previously.
  • Men whose testicles have developed abnormally or who have had an undescended testicle or testicles are more likely to develop testicular cancer.
  • Men with Klinefelter syndrome are at higher risk. Klinefelter syndrome is a genetic condition that results when a boy is born with an extra copy of the X chromosome.
  • An intersex individual may be at higher risk of developing testicular cancer.

Jacques du Plessis, managing director of the Netcare hospital division, says early detection and advances in the treatment of testicular cancer are enabling more and more men to beat this type of cancer.

“Netcare seeks to make South Africans more mindful of conditions such as testicular cancer. With improved awareness and early treatment the impact of testicular cancer on men, their families and indeed on society as a whole can be reduced.”



Issued by: Martina Nicholson Associates (MNA) on behalf of Netcare
Contact : Martina Nicholson, Graeme Swinney, Sarah Wilson or Meggan Saville
Telephone: (011) 469 3016
Email: [email protected], [email protected], [email protected] or [email protected]