Testicular Cancer

On examination  - palpable hard testicular lump.

An ultrasound scan -  gives more information about the nature of the lump in your testes. 

Blood test for tumour markers - AFP, bHCG, LDH may be abnormal.

Additional tests / arrangement prior or after surgery 

Staging CT scan -  to see whether the cancer has spread to other areas of your body

Sperm analysis and cryopreservation - an appointment with the Assisted Conception Unit to check your sperm levels / activity /morphology  and  we may get you to freeze sperm in order to allow you to father children at a later date. If we cannot see any sperm, we will offer you an Onco-TESE surgery. 

Are there any alternatives?

There are very few circumstances when it is safe or advisable to take a biopsy or remove only part of your testicle in tertial centre {very small tumor in favorable position , only one testicle}. 

Radical orchidectomy 

Radical inguinal orchidectomy is a surgical removal of the testicle with spermatic cord (the bundle of tissues/fibers/vessels/nerve/sperm tube run through your tummy/groin in to your testicle) because an abnormal testicular lump is likely to be cancer (2% came back as benign pathology - infection/Tuberculosis etc.).

Usually performed under full general anesthesia by a small incision in the groin (about 5-8 centimetres long) your testicle will be removed and the prosthesis will be inserted if personal preference/agreement prior surgery. The surgery takes about half an hour and the patient is usually going home the same day.  Afterwards you will feel discomfort in the groin and scrotal area requiring regular painkillers for a few days. You will have a small dressing covering the incision site and dissolvable sutures (stitches) which can take up to 90 days to dissolve. You can have a shower normally after 24 hours, not wiping. It is advisable to wear close fitting underwear  while you recover and  to avoid heavy lifting and strenuous exercise for the first few weeks. You may begin your normal sexual activity again four weeks after your operation.

But finally  - after the surgery examine the tissue and cells under a microscope by pathologist (if cancer - then type, grade and stage of the testicular cancer).

Will having one testicle removed affect my fertility or my sex life?

Having one testicle should not affect your ability to achieve an erection, or father a child. Your remaining testicle will take over the function of the removed testicle. You will be able to discuss with your doctor the possibility of having a prosthetic or artificial replacement testes inserted. 

Will I need further treatment?

If all your tests confirm that you have a cancer, the oncologist will also see you. An orchidectomy may be the only treatment that you need to cure you of the cancer. However, you may need to have chemotherapy as well. Testicular cancer responds very well to chemotherapy despite of advanced stage. You will be followed up by the oncology team for at least five years.