My name's David Neal.
I'm a professor of surgical oncology here at the University of Cambridge
and also a consultant urological surgeon
dealing with cancers that affect mostly men.
Testicular cancer's an unusual cancer in that it affects mainly young men
aged between 22 and 35 most commonly.
It's an uncommon cancer compared with other common ones like prostate.
Men are at risk if they're young
and particularly if they have a family history,
if they have a father, brother or uncle who's had testis cancer.
There is a familial effect of it, too.
The most common way that testicular cancers present
is with a swelling or a sense of heaviness in the scrotum.
Frequently men will notice this when having a shower,
in the bath or sometimes their partner will notice it,
but that's the common way that testicular cancer presents.
The process is that they go and see their GP.
Hopefully, the GP would send them on what we call a fast track.
That means they would be seen in the urology clinic within two weeks.
When they go there, the urologist will examine them,
confirm that there is a swelling within the scrotum.
Quite often we get an ultrasound scan done.
This is straightforward. It's nothing to be frightened of.
It just means putting a small probe over the testis.
That gives us a picture of whether the swelling
is, for instance, a cyst, which may be very benign,
or whether it's a solid lump which may indicate it's a tumour.
I think men, when given this diagnosis, are very scared.
They're worried whether they're going to survive,
worried about their sexual function and worried about their fertility.
One can be pretty reassuring about most of those things.
Sexual function should be preserved entirely normally.
So far as fertility's concerned,
nowadays a man should be offered sperm banking
when they go to see the urologist.
There's a very, very high chance that men will be cured,
even if they've got very widespread and advanced cancer.
This is a very important message
that men need to be given at the beginning.
The main treatment initially that all men will have
is surgery to remove the testicle.
That's the standard way of dealing with the disease.
In fact, for many men, that will prove to be curative.
Many men will not need any additional treatment to that.
Some other men, where there's a risk that the tumour may have spread,
will be given either chemotherapy or will be given radiotherapy,
depending on the particular subtype of the tumour involved.
The initial orchidectomy, the operation to remove the testis,
is a relatively minor job.
It's a bit like having a hernia repair, usually done as a day case.
There'll be a bit of soreness in the groin,
but usually people recover quickly.
Often the man should also be offered
the placement of a prosthesis or an artificial testis,
if the man wants that doing at the same time.
It looks pretty normal. It feels a bit different.
It's a bit harder than a normal testis, but from a distance it looks OK.
It's very important that men check their testes from time to time.
They're just near the surface of the skin, they're easy to feel.
Men actually do feel them from time to time pretty well most days,
so if you find a lump and you're worried,
go to see your GP, that's the main message.