Testicular cancer may be rare but people should be aware of the symptoms and men should see their doctor if they feel that something is wrong.

This is the message from Sein Aung, the director of oncology at King Edward VII Memorial Hospital, who spoke to The Royal Gazette as part of Testicular Cancer Awareness Month.

“It is a cancer basically developed from the testes — the organ located in the scrotum underneath the penis,” he said.

But Dr Aung said it accounts for only about 1 per cent of male cancers and, with an early diagnosis, the survival rate lies at about 95 per cent.

“This is rare but if it happens, most of the patients are cured nowadays because of the effective chemotherapy and also the radiation therapy,” he said. “If you come at the very early stage, you’re more likely to be in that category. Patients may not even need the chemotherapy, just surgery.”

Testicular cancer is four times more likely to affect white men than black men, and in the United States, about 8,500 new cases are diagnosed every year.

In Bermuda, the number is so small it is not even included in the national tumour registry, but it can still affect men of all ages.

Dr Aung said: “I’ve been following about six cases here — some diagnosed last year, some were diagnosed before — so I cannot say how many in one particular year.

“Usually, testicular cancer is common in the young-adult age, between age 15 and 35,” he added.

According to Dr Aung, risk factors include having undescended testes at birth and a personal or family history of testicular cancer.

HIV infection also heightens the likelihood and there is some suggestion that a high-fat diet presents a minimal increase in risk for testicular cancer. Men with Klinefelter syndrome, which means having two or more x chromosomes along with a y chromosome, are also at higher risk. Symptoms of testicular cancer include enlarged testes and an abnormal mass or nodule.

Dr Aung said: “Partners should be aware and also patients. Sometimes the partner diagnoses because the partner may not be aware first.”

A feeling of discomfort, heaviness or a dragging pain can also indicate cancer, and while some patients can experience severe pain, most do not.

“Sometimes, because of the location, they may have the pain in the lower abdomen, pain in the groin or pain in the back — that can happen,” Dr Aung said.

In later stages, the cancer can spread, resulting in pain in other parts of the body, as well as enlarged lymph nodes.

Dr Aung said that men who feel that something is out of the ordinary should go see a doctor for further evaluation.

“The main drawback for the patient not to come to the physician quickly is because it is not painful most of the time,” he added. While not all testicular swelling points to cancer, tests including an ultrasound and blood tests are done to determine if it is present. If it is, treatment depends on the type and stage.

“There are different types of testicular cancer, but there are two main common types: seminoma and non-seminoma germ cell tumours,” said Dr Aung, who added that the treatment is slightly different. But surgery is the first step after diagnosis. “Usually we remove only the affected testis,” Dr Aung said, adding that some patients opt for the protheses.

“One testis is good enough for men to live a normal life for the testicular function; the hormone and they can be fertile.”

Dr Aung said it is possible that both testes are affected, but chances of this happening are less than 0.5 per cent.

“As long as we monitor the other side, we are OK,” he said before adding that some patients may not need any further treatment after surgery. Others require chemotherapy or radiation therapy and, because these can affect fertility, sperm-banking is recommended.

“Pay attention and catch it early because the early diagnosis is better,” Dr Aung said.