Testicular cancer diagnosis

what happens next?

Please remember that this process can take up to six weeks before you see a cancer doctor , please join our group if you are worried and need a rant!

Ultrasound scan

The ultrasound procedure involves you lying on a bed with your trousers and undies down. They cover your scrotum with a gel and move a probe over your testicles to see if they can find anything suspicious such as a mass. Most men do get a bit embarrassed having this done, but overall it's very easy and over quickly. You will notice the nurse or doctor taking photos of the scan this is normal. It's unlikely that they will tell you if they have found something on the day and more than likely tell you the results will be sent to a urologist for further investigation. 

Get in there, get it done, walk out with your head held high!!

The scan results will be seen by a specialist and this could take a few weeks. Most men admit in our support group that waiting for news on results is especially hard mentally. It's important that you try to carry on as normal, try not to read the internet to much and wait to be contacted, 

We do suggest that once the scan is done you see your GP and let them know that it's done and if possible they could keep you informed of anything they receive ASAP because waiting is pretty hard when you've been told you may have cancer.  

orchiectomy- removal of testicle

When the specialist has looked over your scan and has concerns that it shows a tumour he will contact you to advise that removing the testicle with an operation is the best way to move forward. Although the ultrasound scan is very accurate in showing tumours on testicles the only real way to know is to take it out and send it away for further investigation. There are a few types of Testicular cancer so they will examine the testicle and make a decision on what type it is.

 

Men do wonder why do they remove the testicle and not just cut out the tumour?, the simple answer is if it is testicular cancer then your testicle is no good for you anymore and complete removal MAY stop it spreading if found early enough. It's best out and gone.

 

Losing a testicle is can be an emotional experience and thoughts of feeling less of a man can creep in. This is normal and understandable just like women who lose breasts to cancer, men are no different. Some men feel " just get it out, get rid of it" as they know its cancer and it's for the best. 

 

The operation to remove the testicle is in most men's experience allot easier than they expect. The cut just above your penis and to the left or right of your penis and take it out through the front of the groin.

You will be put to sleep for the operation, it takes about an hour. Once you wake up you may find that although you feel a bit groggy there is very little pain and you can walk about normally within an hour. It is important you take it easy for a week or two, DO NOT lift anything and try not to wear tight pants that might rub on the wound. Ask your nurse about cleaning the wound and showering. You can get an infection in the area which normally shows by the area swelling and getting hot but its rare. Make sure you get the number of the ward in case you have any trouble or need to ask advice. Overall most men find the whole experience easier than they expected and are up and about within a week.

Your testicle is sent away to see if it is a tumour and if so what type of cancer. Once they have the results the urologist will contact you to come in and discuss the results. this could take up to 3 weeks and the waiting to know is not easy. Please be patient and also contact your GP and ask if possible could they keep you informed of any news.

 

If the Doctors confirm that is cancer they will also refer you to the oncology department (cancer). They may book you into to have blood tests and a CT scan so the oncologist has all the results ready for when you see them.

CT SCAN

A Computed Tomography (CT) scan, also referred to as a CAT Scan, uses special x-ray equipment and computers to provide uniquely valuable cross-section images of soft tissue, bone and blood vessels inside the area of the body being examined.

You will be asked to drink an amount of water which has a contrast dye in it. 

You lie on the bed and it moves inside the scanner. You will be asked to hold your breath at some moments but only for a few seconds. It's a bit noisy and can get a bit claustrophobic but in all its not anything to worry about.

The scan will be looking at first from your testicles upwards in the tummy and lung area to see if there are any signs of any tumours. Testicular cancer in most cases spreads through the Lymphatic system. The lymph nodes are a system of baked bean-shaped lumps that help fight infection. It's common for the nodes behind the tummy area to be the first place a spread. A ct scan is very accurate and helps your oncologist decide what the next action will be.

Blood tests

About half of testicular cancer cases can have raised tumour markers. Tumour markers are found in the blood and can be used to determine what type of cancer you may have.

 

There are different types of testicular cancer and they are classed as

 

Pure seminoma -  a tumour with no signs of any other type, only seminoma. This has a very high survival rate. it is less aggressive and more often found in older men but not unique to them. Pure Seminoma in most cases does not show up in the blood. When the lab looks at your testicle after it's removed they can see that it's pure seminoma with no signs of any other type of testicular cancer. They then will check CT scan results to see if it has spread into the body because in most cases of pure seminoma the blood tests come back normal.

 

 

Non-seminoma - It can be the most aggressive type of testicular cancer but has a very high survival rate. It can be a mixture of other types of tumors including seminoma so its called non-seminoma because it's not pure seminoma. This type of cancer can raise certain blood markers which are

 

  • alpha feta protein (AFP)

  • human chorionic gonadotrophin (HCG)

  • lactate dehydrogenase (LDH)

 

If your blood tests show any raised tumour markers from the above, it can help the Oncologist know which type of cancer you have and how to move forward in the treatment. Many men get scared by having raised markers but it's helpful to the process as if they start to return to normal after removal of the testicle and if you go on chemo then it can show that the cancer is going away.

 

 

Once all the tests are done your oncologist will have an idea of what treatment you will need. Again it could be up to 6 weeks before all the results are in and you are seeing the cancer specialist 

Waiting can be a stressful time. Please join our support group as there are many men who have been in this situation and will gladly listen and chat.