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Testicular Cancer awareness, advice and support for men in the UK affected by testicular cancer.


about orchid

Orchid exists to save men’s lives from testicular, prostate and penile cancers through a range of support services, pioneering research and promoting awareness.

Formed in 1996 by former testicular cancer patient, Colin Osborne, Orchid is the only UK registered cancer charity to focus entirely on the male-specific cancers; prostate, penile and testicular. We offer support and information to people affected by or interested in male cancer through a dedicated medical research programme, education and awareness campaigns and a range of support services.

Whether you have been recently diagnosed with a male cancer, are a family member seeking more information or a healthcare professional looking to run an information session, Orchid is here to help.

our experts

profbarua

Professor Jayanta Barua MD, MBChB, FRCSEd, FRCSEd(Urol), FEBU, Dip.MngmntOU
Jayanta is a consultant Urologist BHR  Hospitals Essex. His Honorary Title of Professor is currently held from the London South Bank University, as their Visiting Professor in Urlogy.

Tom_Powles

Professor Thomas Powles MBBS, MD, MRCP
Thomas is a Senior Lecturer in Urology Cancer and Honorary Consultant in Medical Oncology. MRC Senior Clinical Fellow.

brian

Brian Garvey
Brian is a doctoral student in Counselling Psychology at City University in London. Brian works in a psychology department in the NHS.

frank

Frank Harrington
Frank  is responsible for the Sports and Education  Programme at Orchid.

 

Katherine

Katherine Mutsvangwa
Katherine is a Orchid Male Cancer Information Nurse and Senior Research Sister a Barts.

robpic

Rob Cornes
Rob is a Orchid Male Cancer Infomation Nurse and Uro-oncology Clinical Nurse Specialist BHR Hospitals Essex




testicular health and awareness

Although still rare compared to other cancers, testicular cancer is the most common cancer in men aged between 15-45 years with just over around 2300 new cases a year. However if found at an early stage  cure rates of  98% are usually possible. Even when testicular cancer has spread to other areas of the body cure can still be achieved and recent research has suggested that 96% of all men with testicular cancer will be alive and well 10 years after treatment finishes.

 

Schools Pack

Your private’s schools pack is designed to raise awareness of testicular cancer and has been accredited by the PSHE Association. It contains an embedded PDF presentation with several informative videos. There is also a Teacher’s Guide and a Quiz.

The presentation is designed to run for 15-20 minutes with class discussion.

There are also two supplementary slides at the end of the presentation with videos which can be discussed if needed.

The aim of the pack is to enable students to identify the risk factors for testicular cancer and be able to perform Testicular Self Examination on a regular basis to check for any possible problems. The ideal age is from 12 years upwards, secondary school pupils.

To download the resource pack please click here.

Depending on your broadband speed this may take a few minutes.

Instructions

• Unzip file(s) using winzip
• Print and read Teachers guide
• Open presentation go to view toolbar and select Full Screen Mode – Adobe software will be needed to display the  presentation which can then be controlled similar to a Power Point presentation. To exit press ESC key.

• You will need to manually click each video to play and close the screen   afterwards.

We would like to send you a free testicular cancer booklet and 25 Z-cards on testicular cancer awareness to compliment the resource pack. If you would like these resources please could you email us with:

• your name
• role
• email address
• school address

We would also like to keep you informed of any future projects that we are undertaking.

self examination

  • Perform Testicular Self Examination (TSE) once a month.
  • The best time to perform TSE is after a warm bath or shower.
  • Get to know your balls and if you find something abnormal, get it checked out.
what are testicles?

  • Hang behind the penis, packed in the scrotum or ball bag.
  • Normal for one testicle to be slightly larger than the other and hang lower although the size and shape of each should be roughly the same.
  • Start growing around the age of 11-12 and by early adulthood are ripe and ready at about 2 inches long (5cm), nearly one inch in breadth (2.5cm) and about 1.2 inches ( 2.7cm) in height.Weighing in at around 10-14 grams.
  • They produce your sperm and approximately 90% of your testosterone, the male sex hormone and are located outside of the body in your ball sack.
  • Sperm develop best at a temperature several degrees cooler than normal internal body temperature, at around 94.6 ° Fahrenheit. Ball sweating helps your ball bag stay cool.

Also known as

acorns, baby-makers, back wheels, baubles, bum balls, bum or bang buddies, chestnuts, cods, conkers, cream crackers, doodads, figs, globes, goolies, hairy conkers, heirlooms, jingle berries, knackers, Knob nuts, love apples, love nuts, love spuds, marble halls, meaty bites, nads, nobby halls, nuggets, nutmegs, nuts, plums, pounders, rocks.

what is testicular cancer?

 

what is not testicular cancer?

what are the risk factors in getting TC?

Testicular cancer is the most common malignancy in men aged between 15-45 years with around 2300 new cases a year. It is becoming more common and is found more often in Caucasian men.

  • Undescended testicle – when a male baby is born its testicles are situated in the abdomen.  By the time of birth or by about 3-months after, they should have dropped down into the scrotum. In about 6% of male babies this doesn’t happen. There is a simple operation to correct this but around 5-10% of men who develop testicular cancer have a history of this condition. (Incidentally the reason that the pain radiates to your groin when you get kicked in the plums is because it travels up the nerve pathway to the abdomen where your baubles came from).
  • Family history – if your father had testicular cancer then you may be up to 4 times more likely to get it. If your brother had it then your risk may increase up to to 9 times.
  • Tall men – some research suggests that men over 6 ft have an increased risk of developing testicular cancer while shorter men have a slightly less risk.
  • Repeated trauma – repeated injury to your bum balls may increase the risk of developing testicular cancer.
  • Sedentary lifestyle – sitting around on your testicles for long periods of time will not do them any good. An inactive lifestyle with little exercise may contribute to the development of testicular cancer.
  • Having HIV increases the risk of developing testicular cancer.

Recent research has suggested that men who smoke cannabis on a regular basis and develop testicular cancer may end up with a more aggressive type.

what are the signs and symptoms of TC?
  • A lump can be felt in 97% of cases and in approximately 86% of cases this will be painless. A malignant testis may not feel unduly uncomfortable or painful whereas a testis inflamed by infection will usually be very tender and painful.
  • Dragging sensation 29%.
  • Recent history of trauma 10%, leading to examination and discovery of a lump.
  • Breast swelling or tenderness (called gynaecomastia). This is rare but may be caused by hormones, which are produced by some types of testicular cancer.
  • Enlarged lymph nodes in the groin area, which have enlarged either due to spread of cancer or where infection is also present.
what is testosterone?

Testosterone is essential to the development of the reproductive organs and other male characteristics such as:

  • body and facial hair
  • low voice
  • muscle development
  • the ability to have an erection
  • sex drive (libido)

Without enough testosterone a man may lose his sex drive, suffer from fatigue, depression, hot flushes and osteoporosis (thinning of the bones). Keeping fit and avoiding too much fatty fried food, sugar and caffeine all of which can reduce testosterone levels, can keep your testosterone healthy.

diet and exercise
  • There is plenty of evidence to suggest that a healthy lifestyle can help protect against cancer in general.
  • Eating a healthy and varied diet with plenty of fresh fruit and vegetables may help reduce the risk of cancer occurring in the first place.
  • Some research has also indicated that Vitamin D, which we get from sunlight, may also play a role in the prevention of cancer. Around 15 minutes of sunshine a day is enough to keep the bodies levels healthy.
  • Exercise also helps strengthen the body’s immune system to fight off infections and protect against cancer.
  • Your testicles function best at a certain temperature and too much heat caused by sitting for long periods as well as an unhealthy sedentary lifestyle may increase the risk of testicular cancer. Therefore if you are playing on your games console or computer for long periods of time it is important to get up and do something active. Lazing around all day is not going to do you or your conkers any favours.

just diagnosed with testicular cancer

Tips

  • You will usually be given the details of a specialist nurse who will act as a point of contact and support. They will be able to discuss your treatment and provide you with the right information
  • Plan ahead and involve you family in managing your everyday life while you are having treatment
  • Talk to your boss or Human Resources department about needing time off work. They will usually be very supportive
  • Always remember that the likelihood is you will be cured.

 

clinical diagnosis

Once you have had an ultrasound scan of your testicles you will be reviewed by a urologist who will be able to interpret the results. If testicular cancer is identified or suspected, your doctor will want you to have some further tests to see if there has been any potential spread of the cancer to other parts of the body.

  • Blood tests – some testicular cancers produce chemicals, which are released into the bloodstream. These are called tumour markers. They are sometimes found to be abnormal in the presence of particular types of testicular cancer. They can also be used to measure the effect of your treatment and may be repeated after orchidectomy after 48-96 hours if they were abnormal before your operation.
  • Occasionally if the tumour markers are very abnormal and there is obvious evidence that testicular cancer has spread to other areas of the body, a referral may be made to an oncologist to see if chemotherapy should be given before any surgery.
  • Chest X-ray – This can identify any cancer which may have already spread to the lungs.
  • Computerised Tomography (CT)  – A CT scan is performed to check for any signs that the cancer has spread to your lungs or to the lymph glands in your abdomen.  The scan is painless, but it will mean lying still for 10-20 minutes.

Sometimes if there is a strong suspicion that testicular cancer is present but no definitive proof, a decision may be made to remove the affected testicle.  This decision will not be taken lightly but will be in your best interest.

what is an orchidectomy?

what to expect after an orchidectomy
  • You will have dressing covering the incision site on your groin. This can usually be removed at about 24 hours after the operation
  • The stitches (sutures) you will have in your wound will be dissolvable but can take up to 3-months to fully dissolve
  • You can have a bath or shower, normally after 24 hours, but it is important not to rub soap on the wound area. Dry the wound area by gently patting it with a clean towel / gauze pad afterwards.
  • Your groin and scrotal area can feel bruised and swollen after the operation. It is advisable to wear close fitting underwear, such as briefs or ‘Y’ fronts or a scrotal support rather than boxer shorts while you recover. This will help the bruising settle. Take any painkillers you have been prescribed on a regular basis, (not just when you get pain) for the first 48 hours or until you feel comfortable. Always read the instructions to ensure you administer them correctly. Often simple Paracetamol combined with an anti-inflammatory medication (such as Ibuprofen) are effective at reducing discomfort.
  • Although this is a minor operation, it is important to take things easy for the first week. You should be able to return to work within a few weeks. However if you are being reviewed in an outpatient clinic or referred to an oncologist for further treatment; it may be a good idea to await these arrangements before returning to work as you may need to take further time off.
  • Occasionally a collection of blood may form under the surgical wound (haematoma) or your wound may become infected. If you think that this is the case it is sometimes useful to phone the unit that performed your operation or contact your GP.
  • It is important to avoid heavy lifting and or strenuous exercise for the first few weeks. Only start driving when you are able to do an emergency stop without hesitation.
  • You may begin your normal sexual activity again two weeks after your operation, as long as you feel comfortable. Having an orchidectomy should not affect your ability to have an erection, but the psychological stress associated with a potential diagnosis of a cancer may affect your performance.
  • You should be given a follow up appointment within a few weeks of your operation for the tissue results of your operation, blood and scan results. At this time any further recommended treatment will usually be discussed.
results and confirmed diagnosis

The most common type of testicular cancer is called a seminoma, a slow progressing type of cancer that does not usually spread to other areas of the body. This type of cancer is more common in men between the ages of 25-45, with a peak age of 35 years old.

A rarer type of testicular cancer is called a non-seminoma. It used to be called a teratoma. This tends to affect men between the ages of 15-35, with a peak age of 25 years old.

Both of these tumours are also known as germ cell tumours. About 95% of testicular cancers will be germ cell cancers. Germ in this term means “seed” and refers to the sperm making process. Other tumours (mixed cell tumours) may contain elements of both types of the above.

Once your testicle has been analysed by a histo-pathologist (tissue laboratory specialist), it will be possible to identify the type of testicular cancer that is present and whether there was any evidence that it may have spread beyond the testicle. The results of the tumour markers and CT scan an also be used to determine if other areas of your body have been affected. This is called “staging”. For more information on the stages of testicular cancer please see here.

what is the lymphatic system?

Cells that the body no longer uses travel along the lymphatic drainage system. Lymph nodes which are found all over your body act as filters and break down the substances which are transported. Cancerous cells can sometimes travel along this system and become deposited in lymph nodes meaning that the cancer has spread. The most common lymph nodes which can be affected by testicular cancer are the ones situated in your groin and back.

surveillance vs one dose chemotherapy

For more information on the types and duration of chemotherapy as well as coping with any side effects please see here. To find out about chemotherapy for non localized/high risk disease, click here.

what is chemotherapy?

Chemotherapy is the use of anti-cancer drugs to destroy cancer cells. They work by disrupting the growth of cancer cells and as they circulate in the blood and can reach cancer cells all over the body. The chemotherapy drugs most commonly used to treat testicular cancer are Carboplatin (as a one off shot for localized testicular cancer which takes about an hour to have) and Cisplatin, Etoposide and Bleomycin (known as BEP) for cancer that has spread beyond the testicle.

A drip will be sited into a vein in your hand, arm or neck and the chemotherapy administered through it. Anti-sickness drugs can be given to you via the drip as well.

For more information on the types and duration of chemotherapy as well as coping with any side effects please see here. To find out about chemotherapy for non localized/high risk disease, click here.

what are the effects of chemotherapy?

While the chemotherapy drugs are acting on the cancer cells in your body, they may also temporarily reduce the number of normal cells in your blood. When these cells are in short supply, you may be more likely to get an infection and to tire easily.

During chemotherapy your blood will be tested regularly to make sure your white blood cells, responsible for fighting infection, and your kidneys are functioning correctly. If necessary, you will be given antibiotics to treat any infection.

Before chemotherapy you will also need to have a hearing test (audiogram) as chemotherapy can affect your hearing as well as a breathing test as some chemotherapy can sometimes affect your lungs. You will also be advised to sperm bank.

Semen (sperm) may contain some residual chemotherapy following treatment and if you plan to have sexual intercourse within 48 hours of finishing your chemotherapy it is advisable to use a condom.

For more information on the types and duration of chemotherapy as well as coping with any side effects please see here.

what is RPLND?

Retroperitoneal Lymph node Dissection (RPLND) is and operation performed under a general anaesthetic, and can take up to 4 hours. An incision (cut) is made from just below your breastbone to just below your navel (belly button). Your intestines and other organs are gently lifted out of the way so that the lymph nodes at the back of the abdomen can be clearly seen. Lymph nodes on the same side as your affected testicle are first removed followed by any others that look suspicious of containing cancerous cells.

RPLND can affect your fertility, as the operation can damage the nerves that control the discharge of sperm through the penis (ejaculation). If there is a possibility that you may need such surgery, and if you are fit enough to produce sperm samples for storage before treatment starts, some of your sperm can be stored. Although this further surgery may make it more difficult for you to father a child, it will have no physical effect on your ability to get an erection or have an orgasm (see our Testicular Cancer and Fertility information sheet).

what to expect after RPLND?
  • You will be given painkillers to take home. Use them as prescribed and try to eat a high fibre diet to prevent them from causing constipation which may aggravate any pain that you are experiencing. You should aim to drink 2-3 litres of fluid a day to help soften your stools. A mild laxative may be suggested.
  • Take things easy for 2 weeks after surgery. If you live alone it may be beneficial to stay with someone who can keep an eye on you as you will tire easily. Heavy lifting and vigorous exercise should be avoided for at least 6-weeks to allow your abdominal muscles to heal. Try and walk upright without stooping.
  • You should not drive for 3-4 weeks following surgery as you may not be able to stop effectively in an emergency.
  • You should be able to return to work after 4-weeks but this may need to be longer if you have a particularly physical job. You will need to obtain a sick certificate from your GP.
  • Sexual intercourse should be avoided for approximately 4-weeks after surgery.
sex, fertility and prosthetic testicles

Having one testicle removed will not normally affect your ability to have an erection or your fertility. If the cancer has spread to your lymph nodes it is likely these will be removed by surgery. This can sometimes damage the nerves that control ejaculation and may leave you unable to conceive naturally. In these cases you should consider storing your sperm before surgery. Chemotherapy may temporarily cause infertility and for either RPLND or chemotherapy it may be worth considering sperm storage. For more information on testicular cancer and fertility please download this document.

Storing your sperm, also known as sperm banking, is the preservation of your sperm by freezing. The sperm may be used in the future for artificial insemination or other assisted reproduction techniques. Even if you don’t plan to start a family, sperm banking is worth considering in case you change your mind in the future.

Your specialist healthcare team will be able to advise you if the hospital where you are being treated has sperm banking facilities. They can also provide you with information on your local fertility centre where you may be offered the opportunity to bank your sperm.

Prosthetic testicles

Your doctor may discuss the insertion of a false (prosthetic) ball to take the place of your old one. These are silicone implants that can be inflated with salt water. They can give a very good cosmetic result and be of great psychological value but some men may experience problems with them at a later date. Some of these possible problems include:

  • Scar tissue can form around the implant inside the scrotum. This can sometimes cause a thick growth of tissue to form which may in turn cause discomfort or give rise to worry that a second cancer has appeared.
  • It will not behave like a normal testicle, i.e. will not shrink or expand with the heat or cold
  • Rupture of the implant can rarely occur due to vigorous activities such as contact sport, cycling or physical contact including sex.
  • Sometimes the implant may move out of its original position.
  • Surgery can cause small spots of calcium in the testicle to appear usually some years following surgery. Although they are harmless they can sometimes be confused with the type of calcium deposits (microlithiasis), seen in testicular cancer.

If you are unsure of whether you want an implant or not, the procedure can always be performed at a later date.

how can testosterone be effected?

Testosterone is the male hormone responsible for sex drive and a feeling of well being. It is produced in the cells of your testicles. If you lose a testicle the remaining one should be able to produce enough testosterone to maintain normal levels in your body. Occasionally this does not occur especially if you have prolonged or further treatment such as chemotherapy. Low testosterone levels can cause symptoms such as tiredness and mood swings which can be difficult to manage without replacement therapy. Usually a simple blood test can be used to measure the testosterone levels in your body and if they remain depleted for some time after your treatment testosterone replacement therapy may be recommended. There are several types of testosterone replacement available in the form of injections, tablets or skin patches. However it may take some time to find the one that works for you.

coping with diagnosis and treatment

Your specialist nurse or health care team should be able to give you the details of a hospital based counsellor if you feel you would like to talk to someone. Alternatively your GP may be able to refer you to a counsellor locally.

what are clinical trials?

If you are having chemotherapy, you may be offered the chance to participate in a clinical trial. This does not mean you are a guinea pig for some crazy experiment. Clinical trials are aimed at improving treatment outcomes for cancer. Most of the time they will be using one or more traditionally effective treatments such as chemotherapy in conjunction with each other to try and improve cancer cure rates or reduce the possible side effects of treatment such as chemotherapy. Your oncologist or specialist nurse will discuss these possibilities with you. If you decide to take part in a clinical trial you are free to opt out at any time. For further information on clinical trials that are being used to treat testicular cancer please visit: NHS

life after treatment

individual stories

Sam Benjamins

“The whole blog idea started as wanting to create a short informative and positive film documenting the situation…. “

what if TC comes back?

Although rare, testicular cancer can reoccur. However even if it does and affects a remaining testicle or other areas of your body there is a good chance that it can sill be cured with additional chemotherapy.

If you have had an orchidectomy for testicular cancer, remember to regularly check your good testicle for any abnormalities.

links to more information

Publications that are available from Orchid:

Organisations:

Financial advice

Other

Testicular Cancer Resource Centre   http://tcrc.acor.org/

Tell us your story

If you have been affected by any aspect of testicular cancer and wish to tell your own story or provide a self made film clip documenting your experience for our YouTube channel please let us know.

Email    nurse@orchid-cancer.org.uk

 

support networks

If you have been affected by testicular cancer and would like to support other men and their families or know of other local support groups please get in touch.

  • Orchid Cancer Charity
  • St Bartholomew's Hospital
    London, EC1A 7BE
    tel. 0203 465 5766
    nurse@orchid-cancer.org.uk
  • Scotland
  • Cahonas
  • info@cahonasscotland.com
  • Coming soon!
  • Coming soon!
  • England North West
  • Check em lads
  • Liverpool
    Philly Morris
    philly@checkemlads.com
  • Coming soon!
  • Coming soon!
  • London
  • Orchid Cancer Charity
  • St Bartholomew's Hospital
    London, EC1A 7BE
    tel. 0203 465 5766
    nurse@orchid-cancer.org.uk
  • Bristol
  • It's in the Bag
  • Contact: hello@itsinthebag.org.uk
    Sue Brand 0117 342 3472
    or Pete Styles 07771710733
  • Brighton
  • Talking Testicles
  • Contact: Ryan Walshe
    Mobile: 07886 178 069
    info@talkingtesticles.org.uk
  • Coming soon!
  • Guernsey
  • MUG
  • The Male Uprising in Guernsey
    Charitable Foundation Reg No. 1
    1st Floor, Lefebvre Place,
    Lefebvre Street, St. Peter Port,
    Guernsey GY1 2JP

    E: trevor.kelham@me.com
    T: 07911 721 614