How to keep your crown jewels safe

The shape and consistency of soft-boiled eggs, with one usually larger and lower than the other — a man’s testicles should be familiar territory to him.

‘Get used to checking them once a month, preferably after a shower to relax the skin surrounding them’, says Phil Morris, a former soldier and a testicular cancer survivor who set up the website checkemlads.com

It’s a focus that young men especially find uncomfortable. ‘ Cervical screening means women get used to embarrassing examinations — men don’t,’ says Steve Robertson, Professor of Men, Gender & health at Leeds Beckett University.

So men have anxieties about possible tests and treatments or discussing symptoms, adds Rob Cornes, a specialist nurse at the male cancer charity, Orchid, based at St Bartholemew’s hospital, London. ‘Our research shows that some need a nudge to go and get medical help.’

CYSTS

Signs and symptoms: Fluid-filled lump (which you can squelch between your fingers), can be felt separately from the testicle. Possibly pain and swelling. One in three men, mainly in middle age, develop cysts on testicles. These typically form around the epididymis, the small, coiled tube that carries sperm from the testicles to the vas deferens, the tube leading to the urethra. They are probably caused by a blockage in the epididymis, but are harmless unless they cause discomfort or they become painful and swell through infection.

epididymal cysts usually occur at the top of the epididymis, separate from the testicle, explains Rob Cornes. They’re relatively easy to distinguish from a tumour, he says. ‘ They are filled with fluid and soft to feel whereas testicular cancer is usually a hard lump,’ he says.

The cysts can vary in size, from as small as a pimple to the size of a testicle or even a grapefruit.

The cyst will normally be diagnosed with a simple examination, often by a GP. ‘Because they contain fluid, a light will shine through them,’ explains Rob Cornes.

‘But if there is any doubt, an ultrasound can be performed.’ Cysts won’t go away on their own, but can be removed with a simple operation normally under a local anaesthetic. Unless they are uncomfortable, doctors usually recommend that they are left alone. If the cyst is infected, it is normally drained in an outpatient procedure.

TESTICULAR CANCER

Signs and symptoms: A hard lump on the front or side of a testicle. Swelling or enlargement of a testicle. An increase in firmness. Pain or discomfort in a testicle or the scrotum. An unusual difference between one testicle and the other. A heavy feeling in the scrotum and a dull ache in the lower stomach, groin or scrotum. THIS is a rare cancer with 85 per cent of cases diagnosed in men aged 15 to 49. Just 2,200 of the 330,000 people diagnosed with cancer in 2013 — less than 1 per cent — have testicular cancer.

It also has a high survival rate: in 2012, there were 63 deaths in the UK, 12 fewer than the number of men who died from breast cancer. And 98 per cent of adult patients diagnosed in england and Wales are predicted to survive ten years or more, reports Cancer Research UK.

early diagnosis can make a dramatic difference in reducing treatment, yet one in two men don’t feel informed about the signs and symptoms of testicular cancer, according to a recent survey by Orchid.

Risks include having an undescended testicle as a child. One in 25 boys is born with testicles that have not moved into the scrotum — most move down in infancy.

Testicular cancer is most common in white men and those with a family history. If your father had testicular cancer, you are four times more likely to develop it than someone with no family history, and if your brother has had the disease, you’re eight times more at risk.

Being infertile triples the risk, though doctors don’t know why.

Treatment: Far more straightforward the earlier it is diagnosed. The first step is to remove the affected testicle (orchidectomy). For early stage cancers, follow-up treatment normally involves one course of chemotherapy. More advanced cancers will involve surgery to remove lymph nodes around the testicles and for late-stage cancers, surgery to remove tumours from other parts of the body.

Removing one testicle won’t affect your sexual performance or fertility. If you have both testicles removed, you will need a testosterone supplement as your body will stop producing it.

Chemotherapy and sometimes radiotherapy can cause infertility — and most patients are advised to store sperm before such treatment.

TESTICULAR TORSION

Signs and symptoms: Sudden testicular pain. A RARE disorder most frequently affecting boys, often around puberty. It usually needs to be treated as an emergency. It’s a ‘ growing’ problem, frequently caused during sport or physical activity, when the tissue surrounding the testicles has not yet become firmly attached to the scrotum. If the testicle twists around, it pulls with it the spermatic cord, a narrow bundle of fibres and tissues that runs from inside the abdomen to the testicle, supplying it with blood.

If this remains twisted, it blocks blood flow, causing the testicle to ‘die’ after around six hours. Then it would have to be removed.

Treatment: emergency surgery to untwist the testicle via a small cut in the skin of the scrotum.