Product title

ONE SURGICAL SUSPENSORY RECOVERY BANDAGE FOR YOUR BALLS – PROVIDES ‘COMFORT’ AND STABILITY

Product features

• Item: Surgical suspensory bandage
• Quantity: 1
• Size: XX large 65a
• Type: 3
• Material: 95% cotton
• Condition: Used
• Manufacturer: Sallis Healthcare
• Origin: Nottingham, England

Product purpose

This surgical suspensory bandage is typically used in medical settings, particularly after testicular cancer surgery, to provide support and stability to your scrotum during recovery.

The purpose of this type of bandage is to:

• Provide postoperative care
• Support and immobilise
• Prevent swelling
• Provide comfort and pain relief
• Position your nuts properly
• Protect the wound

Product description

This sexy piece of ball-strangle-wear is exactly as uncomfortable as it looks! With a peephole for your penis and an adjustable waist strap, you will look absolutely ridiculous whilst your balls are propped up by this itchy, sweat-catching garment that is bound to drive you around the bend. It’s like your nuts have their own hammock! If you like feeling restricted, prickly and irritated then look no further – and going to the toilet will never be the same again! You can combine this sling with a tight fitting thong for increased strangulation and heightened discomfort. It’s the budgie-smuggling spectacle you’ve been searching for!

Reason for selling

Fully recovered from testicular cancer and no longer need the sling! Great news! Considering this is for your balls, it doesn’t half get on your chest! So I have no desire to keep it. Imagine a white, lacey thong but with no undercarriage. You just have the strap around the waist to hold it in place, and then the compartment for your balls.

This bandage may be necessary for your recovery if you have had testicular cancer surgery, as it ensures you heal properly and everything is in the right place. However, after a few days wearing a net curtain nappy and feeling like a perverted sex pest, I am now more than willing to part ways with it!

Product cost

I am of course joking! I am not selling this – and it would be disgustingly wrong to do so! If you have had the pleasure of experiencing this, I can guarantee that you can’t wait to throw it in the bin! And I don’t blame you!

However, if you are currently recovering from testicular cancer and already have one of these, or are due to be given one following surgery – it is really important that you stick with it! Following testicular cancer surgery your scrotum will be tender, sore and delicate. It’s not a good idea to just let them hang freely, as they need stability to recover properly.

So stick with it! It will be worth it! You may simply push back your recovery time if you do not use this bandage or follow the other instructions your oncologist or urologist gives you.

And don’t think about selling it afterwards! No one wants it! Trust me, I’ve tried! Joking! Perhaps…

Ian Arnison-Phillps (BTUK Trustee)

An X-ray is a type of medical test that uses invisible rays of energy (radiation) to take pictures of your insides. It helps doctors see your bones, organs, and other tissues to check for problems like broken bones, infections, or tumours. In this case, it can be used to check if you have signs or symptoms of testicular cancer.

The X-ray machine sends out a special kind of energy, called radiation, that passes through your body. Some parts of your body, like bones, block more of the radiation, while softer tissues, like muscles or organs, let more pass through. A sensor on the other side of your body captures the radiation that comes through. The results appear as a black-and-white image on a computer screen or film.

Since bones block more radiation, they show up as white on the image. Softer tissues show up as darker shades. Doctors can then look at the image to find any issues, like fractures, infections, or other health problems. X-rays are quick, non-invasive, and usually safe, with the amount of radiation used being very low.

When do you have an X-ray?

An X-ray is commonly used to check for testicular cancer when a lump or swelling is found in the testicle, often alongside an ultrasound scan. The latter will help a doctor to distinguish between cysts, benign (non-cancerous) lumps, or solid masses that may indicate cancer. If there is an indication of cancer, an x-ray will tell the doctor if it has spread.

You will also usually have a blood test, known as a tumour marker test. This can be done in tandem with an X-ray, or afterwards depending on the severity of your symptoms.

Find out more on what to expect from blood tests.

Find out more on what to expect from an ultrasound scan.

What is an X-ray looking for?

In the case of a testicular cancer diagnosis, an X-ray is typically used to look for signs that the cancer has spread beyond the testicles. The focus here is mainly on the lungs and your bones. CT scans or ultrasounds are more commonly used to diagnose and evaluate testicular cancer directly. X-rays are generally used as part of the overall process to monitor or check for metastasis.

Testicular cancer can sometimes spread to the lungs. An X-ray of the chest can help doctors look for abnormal growths, such as small nodules or masses, which could indicate cancer has spread there.

X-rays of the bones can help detect any changes or abnormal areas, especially if the cancer has spread to the bones, which can sometimes happen in advanced stages.

Where do you have an X-ray?

You can have an X-ray at various healthcare settings, depending on the type of test needed. Some common places where X-rays are done include:

• Hospitals
• Clinics
• Imaging Centres
• Urgent Care Centres

In most cases, your doctor will refer you to a location for the X-ray, so you don’t have to worry about arranging the appointment.

What happens next?

Ultrasound scans and x-rays are not enough to confirm you have testicular cancer, even if a lump or abnormality is found. If the ultrasound suggests that a lump may be cancerous, further tests, such as an MRI scan or a biopsy, may be recommended to confirm the diagnosis. You will know the results and whether or not you need to be seen further within a matter of days or weeks.

You can find more information on MRI scans in our next blog post in the series!

If you have been diagnosed with testicular cancer you will need to have a surgical procedure called an orchidectomy. This procedure removes the affected testicle and the tumour. This blog will let you know what to expect on the day of your surgery, as well as what will be involved in your aftercare and recovery.

An orchidectomy will confirm:

• the diagnosis of testicular cancer
• the type and stage of testicular cancer

Surgery by itself can cure testicular cancer for some men, meaning no further treatment is required. For others, further treatment such as chemotherapy or radiotherapy may be required, if the cancer has spread to other areas of the body.

What happens during an orchidectomy?

You will usually have the operation under a general anaesthetic, which means you are asleep throughout the procedure. However, sometimes a spinal anaesthetic may be used, which means you are awake but will not feel anything from the waist below.

The operation typically takes between 30 minutes and 1 hour. For the surgeon, this is a relatively simple procedure in comparison to many others.

The surgeon will:

• make an incision in the lower abdomen area
• cut the spermatic cord
• take out the affected testicle

In some very rase cases where men have extremely small tumours, the surgeon may remove just a part of the testicle. This is called a partial orchidectomy, but again this is extremely rare.

The removed testicle will be sent to a laboratory for examination under a microscope. This usually takes a few days to get results.

Possible risks

The usual risks of any surgical procedure and using anaesthetic apply, such as having a reaction or getting an infection. There are some minor risks post-operation that may apply:

Pain and discomfort:This is pretty standard after any surgery. You can expect to have some soreness and bruising around the cut/stitched area for a couple of weeks after your operation. 

Sex and fertility: Having a testicle removed will not affect your ability to get an erection and for most men it will not affect your ability to have children. In some rare cases, the remaining testicle might not work so well, which can reduce your fertility. If having kids is important to you, your doctor or urologist may suggest sperm banking before having surgery.

Removing both testicles: If you have cancer in both testicles then both will need to be removed. This isn’t common, but in order to maintain your sex drive and have the ability to get an erection you will need testosterone replacement treatment.

Arriving at the hospital

Before getting to the hospital on the day of your surgery you will typically be given a set of instructions.

These may include:

1. Eat a light breakfast 4 or 5 hours before your surgery.
2. No food or liquids that aren’t plain water after this time.
3. Still, plain water is fine up until 1 to 2 hours before your surgery.
4. At a precise time (usually an hour or so before your surgery) you are asked to drink 250ml of still, plain water.
5. No chewing gum.
6. No smoking 48 hours before surgery.
7. No drinking alcohol 48 hours before surgery.

The option of a prosthetic testicle

Before your surgery you will have the opportunity to meet your surgeon, who will explain the procedure and do an initial examination of you before continuing. At this point you will also be given the option of having a prosthetic testicle replacement. This is an artificial (human-made) testicle that replaces the one lost due to testicular cancer.

A prosthetic testicle doesn’t produce sperm of testosterone, but it has a similar shape, weight and feel to a human testicle. Many men choose to have one of these to mimic the appearance and feel of a testicle, improving self-confidence and calming and psychological fears.

Read our blog on the ‘The Nuts and Bolts of Prosthetic Testicles’for more information.

Going to sleep and waking up

We’re not meaning to be blase or facetious about it, but this is essentially true. The surgeon and the anaesthetist will talk you through what is about to happen and get you prepared for it. But then after that, your experience of the surgery will be going to sleep and waking up again – typically within about 2 or 3 hours’ time. It is literally over in a flash.

This is of course, unless you have a spinal anaesthetic, in which case you will be awake for the procedure – and therefore it will seem definitely longer for you.

If you have a general anaesthetic, you will feel a tiny scratch on the back of your hand as they put an oxygen mask over your face. You’ll drift off within a matter of seconds. The next thing you will know, you will wake up in another room (outpatient/recovery room) feeling rather groggy, and perhaps a little sickly. This is a hangover from the surgery and anaesthetic, which is normal.

At first you may have a cold burning sensation around your testicles, and the area around your wound/scar will be extremely sensitive and perhaps a little swollen. This is all normal and shouldn’t last more than a few days.

Leaving the hospital

Once you have fully woken up, a nurse will usually offer you some water, a piece of toast and some pain relief. They will let you know how the surgery went and make sure you are feeling okay. Typically, at this point, you may be told that if you can eat the piece of toast and pass water (pee) then you can go home within the hour. You must have someone come pick you up though, or have someone that can take you home.

It is as quick as that. You can be in and out, and back home, within 4 to 5 hours if everything goes as planned. You are not usually given any medication to take with you, but are advised to stock up on paracetamol and ibuprofen. Despite the quickness of this procedure, it is still a major operation and therefore it is important you rest up and do as little as possible for a few weeks as your body heals.

Aftercare and recovery

You should start to feel normal again in around 3 to 5 days’ time, but you should not be fooled into this false sense of security. The risk of infection or bleeding in the scrotum continues past this, and if you do not take it easy you increase the risk significantly.

You may be told to avoid:

• any exercise at all for 3 to 5 weeks
• lifting anything or housework for at least 1 week
• removing the bandaging for at least 5 days
• showering for at least 5 days
• rubbing or soaping the affected areas for at least 5 days
• having sex until you are fully recovered

The results of your histology report on the tumour should be with you within 1 week of your surgery.

Reach out and get support

Changes to your physical appearance, as well as potential changes to your sex drive and becoming infertile (as rare as that may be), can be difficult to come to terms with. Talking to someone about this can really help, especially those that have been through this before themselves.

If you are currently going through a testicular cancer diagnosis, are waiting for surgery, or are a survivor and would like some support – please email support@baggytrousersuk.org.

In this second instalment of the Caregiver Chronicles series, we’ll discuss the urologist’s role in a cancer diagnosis. As discussed in the first blog (Caregiver Chronicles: Going to Your GP) the first medical professional you will see if you have signs or symptoms of testicular cancer is your GP.

Signs and symptoms of testicular cancer

Signs and symptoms of testicular cancer can include:

• enlarged testicles
• testicles that change shape in any way
• a dull ache or pain in the abdomen, groin or scrotum
• back pain
• a heavy feeling in the scrotum
• a sudden collection of fluid in the scrotum

If you are experiencing any of these, it’s vitally important that you visit your GP to have them checked.

GP appointment

You will typically have a blood test at your GP surgery, and perhaps be sent for an ultrasound scan. The blood test checks for tumour markers in your blood. The ultrasound scan uses sound waves (much like a pregnancy scan) to investigate your symptoms, to see if any further tests or treatment is required.

If you do show signs of raised tumour markers and/or your ultrasound scan shows signs of cancer, you will be sent to meet a urologist.

In this blog we will discuss what to expect and what may happen next.

Meeting the urologist

A urologist is a medical professional that specialises in diagnosing and treating conditions affecting the urinary tract and reproductive system. At this point in your diagnosis, the urologist you meet may already suspect that you have testicular cancer due to your test results.

This will be just a suggestion at this point, not a confirmation, but the urologist will ultimately make the final call. One of the reasons this is just a suggestion at this stage is because a biopsy is required before it can be confirmed.

Nevertheless, hearing that you likely have cancer can be an extremely surreal and frightening experience. The urologist and your care team will do everything in their power to make sure you get the treatment and aftercare you need throughout your journey with testicular cancer. The chances of survival are extremely high too, with a survival rate of 95% after 5 years. But this is not to say it won’t have an effect on your mental health.

Dealing with cancer is tough, and you may feel like you are alone during many moments of your treatment. There are lots of services and people out there you can reach out to for help and support pre, post or during your cancer treatment – so you are never alone.

Support from Baggy Trousers UK

The team here at Baggy Trousers UK are here to ensure you feel as though you have nothing to be afraid or embarrassed about. The vast majority of us have been through the journey ourselves, and want you to be proud of who you are and your fight back!

Please do get in touch if you need any help, advice, or just someone to talk to!

What happens next?

A biopsy cannot be carried out unless the tumour is removed, it is not possible otherwise. This means the urologist will usually book you in for surgery to remove the affected testicle. It will be sent to a pathology department, where it will be examined to confirm the type and stage of cancer.

You may wish to ask the urologist some questions at this stage, such as:

• When will surgery take place?
• What are the risks?
• Do I need to do anything to prepare?
• What is the aftercare process?
• How long will the operation take?
• How long will I be in the hospital?

The surgery itself will be done by an oncologist. We will be highlighting the details of that, what to expect, and what happens next in our next instalment of this series.

Again, this is one of the most harrowing parts of your diagnosis, and you may feel as though your head has fallen off and rolled away. So it is important to get as much information as you can, verbal and written.

We have lots of information on our blog that may help, but again please do get in touch if you need any additional support. You are not alone.

Quick reminder on how to check your nuts

1. Take a warm shower or bath so your skin is relaxed.
2. Examine one testicle at a time by taking the testicle between your thumb and first two fingers and roll with consistent gentle pressure.
3. Feel for any lumps or changes in shape, size or consistency.
4. Make sure to also check the epididymis towards the back of the testicle.
5. If you notice a change or you feel a lump, don’t panic, but do get checked out.

Testicular cancer is most common in men aged 15 to 49. While this form of cancer has a high survival rate, understanding its progression and potential spread is vital for effective treatment. In this blog we will highlight where testicular cancer can spread, the likelihood of this happening, the impact the stage of cancer has, and the treatment options available.

Testicular cancer overview

Testicular cancer accounts for around 1% of all male cancers in the UK, with approximately 2,400 cases diagnosed each year. The good news is that survival rates are high. Around 98% of men diagnosed with testicular cancer live at least 10 years post-diagnosis. Of course, survival rate is highly impacted by how early you detect the signs and symptoms, and the cancer’s responsiveness to treatment.

In some cases, testicular cancer can spread (or metastasize) to other parts of the body. Keep reading to understand where it can spread and the stages involved.

Chances of testicular cancer spreading

If testicular cancer spreads, it usually moves first to the lymph nodes located in the abdomen, near the kidneys. This is because the testicles are connected to the body’s lymphatic system, which can carry cancerous cells from the original tumour to other parts of the body.

In some cases, testicular cancer may also spread to other lymph nodes, the lungs, liver, bones, or even the brain.

The chances of testicular cancer spreading largely depends on the stage of cancer at diagnosis.

Stage 1 – Localised cancer

Cancer is limited to the testicle and hasn’t spread. At this stage, around 99% of patients are successfully treated and remain cancer-free after 5 years. Sometimes, only surgery is required to remove the tumour, and no further treatment is required.

Stage 2 – Regional spread

Cancer has spread to nearby tissues or lymph nodes. Treatment at this stage is still highly effective, with over 95% of patients achieving long-term remission. In some cases, the affected lymph nodes can be removed with a procedure known as retroperitoneal lymph node dissection (RPLND).

Stage 3 – Distant spread

Cancer has spread beyond the lymph nodes to other tissues or organs in the body. For example, your lungs or liver. This is the most advanced stage, but survival rates are still quite high. Around 70-80% of patients survive for at least 5 years post-treatment.

Read more information on the types and stages of testicular cancer.

Where testicular cancer can spread

• Lymph Nodes: Testicular cancer typically spreads to the lymph nodes around the abdomen area first.
• Lungs: If cancer has spread to the lungs you may experience symptoms such as persistent coughing, shortness of breath, or chest pain.
• Liver: The liver may also be affected, especially in advanced cases of metastatic testicular cancer.
• Bones: This is quite rare, but testicular cancer can spread to the bones.
• Brain: Again, this is incredibly rare but if it does spread here you may experience symptoms like headaches, dizziness, or changes in vision or speech.

Treatment options for testicular cancer

• Surgery: Most patients will undergo an orchidectomy or orchiectomy. These are essentially the same thing – a procedure to remove the affected testicle. It is not possible to remove just the tumour, so the whole testicle must be removed. If cancer has spread to the lymph nodes, further surgery may be needed to remove those as well.
• Chemotherapy: This is typically used for stage 2 and stage 3 cancer. This treatment uses drugs such as bleomycin, etoposide, or cisplatin to kill cancer cells.
• Radiotherapy: This option is typically reserved for early-stage cancer. For example, it is often used for seminomas, one of the two types of testicular cancer. A seminoma tumour translates as ‘semen tumour’ and they tend to spread slowly. Non-seminoma tumours are found in younger men and they tend to grow more quickly in comparison.
• High-dose chemotherapy with stem cell transplant: For cases of advanced cancer that has spread beyond the abdomen or lungs, high-dose chemotherapy may be required. This can also be followed up by a stem cell transplant.

Chances of survival and the importance of early detection

Around 98% of men with testicular cancer in the UK survive for at least 10 years or more. Survival rates for metastatic testicular cancer are around 70-80%, depending on the extent of the spread and your overall health. So as you can see, the prognosis for testicular cancer remains optimistic, even when it spreads. Early detection is absolutely vital though, as well as regularly checking your nuts!

An ultrasound scan is a valuable tool for diagnosing and guiding treatment for various medical conditions. It is most commonly recognised as a method for monitoring pregnancy in women. However, it can also be used to check men’s testicles for any abnormalities. This is essential because it’s non-invasive and highly accurate in identifying potential issues related to testicular cancer.

The scan uses high-frequency sound waves to create images of the inside of your body. This allows doctors to see your organs, tissues, and blood flow without the use of radiation. A small device called a transducer is placed on the skin, which sends sound waves into the body. These waves bounce off internal structures, and the echoes are captured to create a real time image on a monitor. The procedure is painless, safe, and non-invasive.

When do you have an ultrasound scan?

An ultrasound scan is commonly used to check for testicular cancer when a lump or swelling is found in the testicle. This can help distinguish between cysts, benign (non-cancerous) lumps, or solid masses that may indicate cancer. If you notice any other unusual changes, like pain or discomfort in the testicle, your doctor may also recommend an ultrasound to assess the cause.

You will usually have a blood test, known as a tumour marker test, beforehand. This can be done in tandem with an ultrasound scan, or afterwards depending on the results of the blood test.

Find out more on what to expect from blood tests.

What is an ultrasound scan looking for?

An ultrasound scan provides detailed images of the testicles, allowing doctors to see the size, shape, and nature of any abnormalities. The scan is essentially checking for anything that looks out of the ordinary. Gel is applied to the skin of your scrotum, which helps the ultrasound waves pass through. A device called a transducer is then moved slowly over the area being examined.

This is a quick, painless and relatively simple procedure that should be done within a matter of 10-15 minutes.

Where do you have an ultrasound scan?

An ultrasound scan is typically conducted by a trained sonographer, which is a healthcare professional trained in using ultrasound equipment. It can also be performed by a urologist – a medical doctor specialising in conditions that affect the urinary tract in men, women and children.

Ultrasound scans are typically performed in hospitals, diagnostic centres, or specialised clinics. Your GP will usually refer or arrange this for you.

You can also have an ultrasound scan in:

• your GP surgery
• a private clinic
• a maternity unit

What happens next?

An ultrasound scan is not enough to confirm you have testicular cancer, even if a lump or abnormality is found. If the ultrasound suggests that a lump may be cancerous, further tests, such as an MRI scan or a biopsy, may be recommended to confirm the diagnosis. You will know the results and whether or not you need to be seen further within a matter of days/weeks.

You can find more information on MRI scans in our next blog post!

If you’ve been diagnosed with testicular cancer, the likelihood is by this point you’ve had various different scans and tests, and you’ve been seen by multiple medical departments. After you’ve been given the news (usually by a urologist) and all of the scans are over, the hospital automatic doors open and you walk back outside to your life. Only this time, with cancer.

Telling the people you know and love is one of the next challenges you’ll face in your journey to recovery. How do you tell them? What do you tell them? At this point, your head may be swimming and you feel as though you don’t know enough yourself to relay to anybody else coherently.

This is normal. No one expects to ever say the words, “I have cancer.” Testicular cancer is most common in men in their late 20s and early 30s. You especially don’t expect to be saying those words at such a young age.

You may feel overwhelmed, shocked and scared. This is all normal too. But it is extremely important and helpful that you tell your friends and family as soon as you are able to.

Reasons to tell your friends and family

• Your loved ones and family members care about you.
• They just want to know that you will be okay.
• It is cathartic to talk about it and will help you maintain a positive outlook.
• Making others feel comfortable and optimistic about your recovery will rub off on you.
• Talking to others normalises the subject and relieves any stigmas around it.
• Even if you break down in tears, do it, you may need it!
• It becomes easier to talk about it the more you talk about it.

The hard part about telling the people you love

One of the most difficult parts about telling people is that you find yourself repeating yourself quite a lot. People want to know the finer details so you end up repeating the words ‘I have cancer’ a lot – as well as the details of the tumour, your diagnosis, and your operation.

Hearing yourself say it over and over can be strange and often upsetting, but it gets easier and easier as a result. Telling yourself is as important as telling other people. Bottling it all up can otherwise affect your mental health further down the line. Being comfortable saying it will make it a lot easier to talk about with other people, and vice versa.

Choosing which method to tell people can often be difficult too. Do you call them? Visit them? Message them? This will ultimately depend on your personal preference and how you usually interact with your friends and family. There is no ‘right way’ to do this. Whichever way you choose, once you tell a few people, they will inform others and people may then start to contact you instead.

Share whatever you are comfortable with

Despite the advice so far, remember that first and foremost you do not have to tell anyone if you do not want to. This blog recommends that you do with reasons why, but it is always up to you. You decide who to share with and how much you share.

However, it is important that you do tell your employer if you are working or teachers if you are in education. They should be able to grant medical leave or anything else you may need to assist your employment or course during your treatment and recovery. They are also obliged to keep the information you share confidential.

If someone talks or wants to know about something that’s off limit for you, you can politely decline to talk or simply redirect the conversation. This is your journey so it’s up to you how you wish to talk about it and deal with it.

Don’t hide or be embarrassed about how you feel

No one is expecting you to put a brave face on and it is totally fine and normal to be scared – or even angry! Whilst it’s important to not let these emotions take over you to an extent that you affect others, it is vital that you are able to express them. There isn’t a ‘right’ way to feel when you’ve been diagnosed with testicular cancer. Don’t shut people out but set boundaries that are right for you.

Get support from others who’ve had testicular cancer

Don’t let your mental health or your emotional wellbeing take a backseat when going through testicular cancer treatment. Take advantage of the support around you, whether this is your friends and family, or seeking professional help.

A lot of men find it helpful to talk with a therapist while going through or recovering from testicular cancer. Here at Baggy Trousers UK we have a number of members that have experienced testicular cancer, and they will be more than happy to talk to you.

For more information contact us using our contact form, or get hold of us on Facebook, Instagram, or X (Twitter).

Welcome to the first edition of our new blog series, the Caregiver Chronicles. In this series we will highlight the different healthcare professionals you are likely to meet along the journey of being diagnosed with and treated for testicular cancer.

We’ll discuss what to expect, what each healthcare professional will do, what they are looking for, and what they may advise next. Hopefully, this may ease any fears, answer any questions, and prepare you mentally for each appointment if you feel you have symptoms or are going through a diagnosis currently.

Typically, the journey will start with signs or symptoms. If you have these, it’s vitally important that you visit your GP to have them checked. Therefore, your doctor is the first caregiver you will come across.

In this blog we will discuss the GP’s role in a cancer diagnosis.

Signs and symptoms of testicular cancer

First and foremost, before the doctor can help you, you must be able to help yourself. What we mean by that is, you have to check yourself regularly! It’s really important that you check your nuts often, so that if you do have signs or symptoms of testicular cancer, you notice them early. The earlier you notice the signs, the more likely it is you will have a full recovery.

Signs and symptoms of testicular cancer include:

• testicles that become enlarged or change shape in any way
• a dull ache or pain in the abdomen, groin or scrotum
• a heavy feeling in the scrotum
• a sudden collection of fluid in the scrotum
• back pain

If you have any of these symptoms and they persist, please get checked out!

Risk factors and causes

The exact causes of testicular cancer are still unknown. However, there are a number of factors that can increase your risk of developing it (based on statistics from previous patients).

Caucasian men and taller men are at higher risk, so too are identical twins. If any men in your family have had testicular cancer in the past, this can also increase your risk. If you are born with an undescended testicle you are more likely to experience testicular cancer too.

What will the GP look for?

As with any other appointment, your GP will firstly look at the symptoms you show or speak about. This will inevitably involve dropping your trousers so the doctor can have a closer look at your testicles. Don’t be shy or embarrassed though, they’ve seen it all before!

They will examine any lumps or bumps you have identified and talk to you about them. If they feel the lump cannot be explained (i.e. by something simple like a cist or build up of fat) then they will arrange for you to have a blood test. They may also arrange for you to have an ultrasound scan at the same time, or you may have one after depending on the results of your blood test.

What is the blood test looking for?

This is called a tumour marker test. If you have a cancerous tumour, you are likely to have tumour markers in your blood. These are usually proteins also known as biomarkers or molecular markers. They can also be found in urine and body tissues.

These substances exist in your blood and aren’t always a sign that you have cancer. However, if the levels are higher than usual, it could be a sign that you have testicular cancer. The blood test measures the levels of these markers in your blood. This will usually be conducted at your same GP surgery or a walk in clinic. A doctor, a nurse or a phlebotomist will conduct the test.

See more information on what to expect from a blood test.

What is an ultrasound scan looking for?

An ultrasound scan uses sound waves to create an image of an area of the inside of your body, similar to a CT scan but not as detailed. They are used to monitor unborn babies and diagnose conditions, among other things.

The scan will investigate your lump (or other signs and symptoms you have) to see if any further tests or treatment is required. You may be able to do this at your GP surgery, but the likelihood is you will be sent to a clinic or a hospital to conduct the scan.

What happens next?

The results from your blood tests can be expected within a week, perhaps quicker, depending on the severity of your symptoms. You should wait no longer than 2 weeks for results from the blood test and/or ultrasound scan.

Your GP will let you know when your results are ready and book an appointment with you to discuss them. If you do show signs of raised tumour markers and/or your ultrasound scan shows signs of cancer, you will be sent to meet a urologist. You can find more information on that in the next edition of this series!

Quick reminder on how to check your nuts

1. Take a warm shower or bath so your skin is relaxed.
2. Examine one testicle at a time by taking the testicle between your thumb and first two fingers and roll with consistent gentle pressure.
3. Feel for any lumps or changes in shape, size or consistency.
4. Make sure to also check the epididymis towards the back of the testicle.
5. If you notice a change or you feel a lump, don’t panic, but do get checked out.

Most lumps are not cancerous, but if you do notice anything unusual or anything concerning you should visit your GP as soon as you can.

Testicular cancer is the most common type of cancer in young men, with the vast majority being diagnosed in their 20s or 30s. Fortunately, it is also one of the most treatable types of cancer, with a high survival rate (around 95%) if symptoms are noticed and investigated early.

There are different types of testicular cancer, and they can all be at various different stages. Type refers to the tumour itself, whereas the stage refers to the degree of which a cancer has spread from its site of origin.

Types of testicular cancer

The two main types of testicular cancer are called germ cell tumours and stromal tumours. Treatment can vary depending on what type of tumour you have. Germ cell tumours account for around 95% of all testicular cancer cases. Stromal tumours are much less common in adults, but more commonly found in minors.

Germ cell tumours

Germ cells are the cells that create sperm. Germ cell tumours are either seminomas or non-seminomas. However, it is possible for germ cell tumours to have both seminoma and non-seminoma cells.

A seminoma tumour translates as ‘semen tumour.’ These tend to spread slowly and can be treated with surgery, and chemotherapy or radiotherapy. Classic seminomas are usually found in younger males (from 20s to 50s), whereas spermatocytic seminomas are much rarer and are usually found in older men.

Non-seminoma tumours are found in younger men and they tend to grow more quickly in comparison. Most contain a mixture of different types of cancer cells, rather than just one singular type. This makes them easier to treat too.

The different types of cancer cells may include:

• Embryonal carcinoma (aggressive form of cancer cell)
• Yolk sac carcinoma (more commonly found in young children)
• Choriocarcinoma (very rare and aggressive form of cancer)
• Teratoma (extremely rare and don’t respond to radiotherapy or chemotherapy)
• Seminoma (can often be a component of non-seminoma tumours)

They are also known as ‘carcinomas’ – which refers to cancers that start within skin cells or tissues lining your internal organs.

Stromal tumours

Stromal tumours account for around 5% of all cases in adults, and are more common in children. One in five childhood cases of testicular cancer are stromal tumours. These are often benign (not harmful), respond well to treatment, and also less likely to spread to other areas of the body.

The two main types of stromal tumours are called ‘Leydig cell tumours’ and ‘Sertoli cell tumours.’ The former affects the cells that make male hormones like testosterone. The latter affects cells that allow germ cells to make sperm.

Stages of testicular cancer

The stage of testicular cancer refers to the way we measure how severe the cancer is and how much it may have spread to other areas of the body. The higher the stage, the more advanced the cancer is.

The 3 main stages of testicular cancer are:

• Stage 1 – Localised (no spread)
• Stage 2 – Regional (spread to lymph nodes only)
• Stage 3 – Distant spread (spread to areas away from the site of origin)

This is determined by an investigation of the tumour itself and the lymph nodes in your lower abdomen. It is also determined by metastases (if it has spread to other areas of the body) and the levels of tumour markers in your blood.

(Read our blog ‘What to Expect from Scans and Tests: Blood Tests’ for more information on tumour markers.)Top of Form

Stage 1 – Localised

The cancer is found in the testicle but has not spread. For this you may just require surgery and then post-surgery surveillance. However, in some cases chemotherapy and surgery to remove lymph nodes may also be necessary.

• Stage 1A is limited to the testicle, so there is no sign of spread anywhere else in the body. Surgery is usually all that is required for this stage of cancer and the risk of reoccurrence is low.
• Stage 1B spreads locally but is confined to the scrotum. Again, there is no sign of cancer elsewhere at this stage. Surgery is usually all that is required but there is a higher risk of reoccurrence.
• Stage 1S means your tumour markers are still abnormal following surgery. This could mean there is cancer elsewhere in the body and more treatment is needed.

Stage 2 – Regional

The cancer has spread to nearby lymph nodes in your abdomen, but no further than that. Tumour markers may or may not be elevated at this stage. Treatment may include surgery, radiotherapy, chemotherapy or a combination of all three – depending on the type of testicular cancer you have.

• Stage 2A tumours are 2cms or less
• Stage 2B tumours are 2 to 5cms
• Stage 2C tumours are bigger than 5cms

Stage 3 – Distant

The cancer has spread beyond the lymph nodes in the abdomen to other areas of your body. Treatment will usually involve surgery and chemotherapy.

• Stage 3A cancer has spread to the lungs or lymph nodes away from the abdomen. Tumour markers may or may not be slightly elevated.
• Stage 3B cancer may or may not have spread to the lungs or lymph nodes away from the abdomen, but tumour markers are moderately elevated.
• Stage 3C cancer has spread to other organs of the body like the liver or brain, or to your lungs and distant lymph nodes and your tumour markers are very high.

Do your part! Check your nuts!

If you check your balls frequently and see a doctor if you do find something unusual, then statistics suggest you will be absolutely fine, even if you do find something. Check regularly! Do not put off calling the doctor if you find a lump! You could potentially save your life!

A blood test is a relatively simple procedure that most of us will have had at least once in our lives. They can check your general health, the number of blood cells you have and how well some of your vital organs are working. They can also be used, in addition with other scans and tests, to help diagnose testicular cancer.

A blood test alone is not enough to diagnose cancer. They can give an indication of tumorous cells but not confirm cancer. We explain how and why below.

When do you have a blood test done?

Having your blood taken will be the first test you will have if you notice a lump or other symptoms of testicular cancer. If caught early enough testicular cancer is highly curable, with a 95% survival rate. So it is extremely important that you check your nuts regularly.

Check out our blog on the signs and symptoms of testicular cancer to know what to look out for.

You will also have regular blood tests during and/or following any treatment for testicular cancer, such as surgery or chemotherapy/radiotherapy. These will form part of your surveillance programme. This is where you are tested regularly during and following treatment to check it’s effectiveness and if the cancer returns.

Blood tests are usually every 1-3 months after treatment, becoming less and less frequent if you remain clear over a course of 3-5 years. After this time, you are usually discharged.

What is a blood test looking for?

The particular blood test used to detect testicular cancer is called a tumour marker test. If you have a tumour, you are likely to have tumour markers (which are usually proteins also known as biomarkers or molecular markers) in your blood. These can include beta-human chorionic gonadotropin, alpha-fetoprotein and lactate dehydrogenase.

They can also be found in urine and body tissues. Some are made only by one type of cancer, whilst others can be made by several types. Some cancers don’t have any tumour markers at all.

These substances exist in your blood and aren’t necessarily a sign that you have cancer. However, levels that are higher than usual could be a sign that you have cancer. This is what the test is for – to measure the levels of tumour markers in your blood.

Where do you have a blood test done?

Your GP surgery or a walk in clinic. A doctor, nurse or phlebotomist (someone who is specialised in taking blood) will conduct the test. Blood is usually taken from your arm as with most other blood tests. A tourniquet is used around your arm to make it easier for them to find a vein.

A small needle attached to a syringe will draw out some blood into a small vile or bottle. The sample will then be taken away to be tested at a laboratory.

What happens next?

Results can be expected within a day or two, or perhaps a little longer, depending on the type of blood test or the severity of your symptoms. You should wait no longer than a week or two.

Your GP or healthcare provider will let you know when your results are ready and book an appointment with you to discuss them.

If you do show signs of raised tumour markers, the next step will be to have an ultrasound scan. You can find more information on that in our next blog post!