01 November 2017
By Mr Andrew Ballaro, Consultant Urological Surgeon at Spire Roding Private Hospital
The rise of successful charity health campaigns such as Movember is propelling men’s health issues to the forefront of public awareness. Once seldom talked about, prostate and testicular cancer are now commonly discussed openly, and educational campaigns focus on emphasising the importance of early diagnosis of both these conditions.
Testicular cancer accounts for less than one percent of male cancers, and usually develops between the ages of 15 and 50(1). Testicular cancer is eminently treatable and the earlier it is detected the better the prognosis. Most patients with early testicular cancer are cured(1).
The most common way testicular cancer presents is the finding of a lump in the scrotum. There are many non-cancerous scrotal lumps; these can usually be differentiated from cancer by careful clinical examination. An ultrasound may be required to determine whether the lump is in the body of the testicle or in one of the other scrotal structures. If the lump is found to be in the testis, it should be considered a tumour until proven otherwise. All men between the ages of 15 and 50 should examine their testis themselves once per month, and seek advice from their GP or an urologist if a lump is suspected.
The first step in treating early testicular cancer is to remove the testis. The short operation involves a small scar in the groin. A prosthetic testis can be inserted at the same time - this looks and feels similar to the real thing. Commonly, no further treatment is required, although additional scans are often performed and it is usual to see an oncologist who will discuss possible treatments to reduce the risk of further problems. Occasionally, advanced testicular cancer that has spread outside the testis is found and this is treated by either radiotherapy or chemotherapy.
Prostate cancer is a far more common male cancer, in fact nearly all men of over 80 years will have slow growing prostate cancer, the majority of these will die of something else(1). A (very) few younger men develop potentially life threatening aggressive prostate cancer, so early detection of these patients is important. Prostate cancer causes no symptoms until it grows large enough to restrict the flow of urine and at this point is quite advanced. The symptoms this produces are indistinguishable from those caused by benign (non-cancerous) enlargement of the prostate, which is also very common in older men. These include poor urinary flow, difficulty in emptying the bladder, urinary frequency and getting up in the night to pass urine.
Diagnosis of early prostate cancer is currently undergoing changes(1). Radiological scanning with MRI can now pick up small cancers, if a potentially dangerous prostate cancer is suspected biopsy is required. The treatment of prostate cancer depends on both patient and disease factors. Some patients with non-aggressive cancer do not need treatment and their disease can be monitored, others require various forms of surgery, radiotherapy or drug treatment.
Anyone with bothersome urinary symptoms should have their prostate examined by an experienced GP or urologist and discuss having a PSA blood test. They are however much more likely to have benign enlargement of the prostate than prostate cancer.
Mr Andrew Ballaro holds clinics at The Spire Roding Private Hospital on Wednesdays morning and alt Mondays evening.
To book an appointment call our Private Patient Executives on 020 8709 7817.
The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.
(1) Kaisary A, Ballaro A, pigott K. Lecture Notes in Urology 7th ed. Wiley.