Just because testicular cancer is one of the less common cancers, doesn't mean we should pay no attention to it.
Checking your testicles for early signs of cancer can help improve survival rates though early diagnosis. And while nearly all men survive testicular cancer, if the cancer has spread, survival for five years or more can reduce to 65%.
While mammograms and cervical screenings help identify common tumours in women, testicular cancer has no national screening programme, making it all the more important that men know what is normal for them, to be able to spot when something isn't.
Spotting the disease before it becomes advanced could help a patient avoid chemotherapy, preserve fertility and even save a life. Here's what you need to know about signs and symptoms, how to check for lumps, and the best time to do it.
Testicular cancer signs and symptoms
The NHS says typical symptoms are a painless swelling or lump in one of the testicles, or any change in shape or texture of the testicles.
"The swelling or lump can be about the size of a pea, but may be larger," the site explains. "Most lumps or swellings in the scrotum are not in the testicle and are not a sign of cancer, but they should never be ignored."
an increase in the firmness of a testicle
a difference in appearance between 1 testicle and the other
a dull ache or sharp pain in your testicles or scrotum, which may come and go
a feeling of heaviness in your scrotum
For Wayne, 33, a cancer survivor from Cornwall, it was noticing an unusual lump on his testicle that lead to him making an appointment with his GP. Within two weeks was undergoing surgery and three years later, Wayne has the all-clear.
"Getting diagnosed early really can make all the difference, so remember, if something in your body doesn’t feel right, contact your GP," he said, as part of an NHS and Morrisons partnership earlier this year to put cancer awareness messaging on underwear labels.
How to check your testicles for cancer
A recent study of more than 2,500 men found over three in five (62%) of those aged 18 to 34 were in the dark about how to check their testicles. Just under a third (28%) had not examined their testicles in the past year.
The NHS stresses men should "be aware of what feels normal" for them. "Get to know your body and see a GP if you notice any changes," it adds.
Macmillan Cancer Support says normal testicles should feel smooth and firm, but not hard. "Hold the scrotum in the palm of your hand. Use your fingers and thumb to examine each testicle."
You should feel for:
lumps or swellings
differences between the testicles.
As well as lumps, cancer can cause the testicles to change shape or texture, or feel unusually firm or heavy. One may also look different to the other.
A dull ache or sharp pain, which may come and go, should also raise alarm bells.
"It is possible to have testicular cancer without a lump," Mr Vivek Wadhwa, Consultant Urological Surgeon at Spire Little Aston Hospital explains. "You may instead notice that your testicle looks swollen and larger than usual. Most men naturally have one testicle that is slightly larger than the other, so it is important to look for a change in the size of your testicle from what is normal for you."
While a painless lump or swelling in one or both testicles can be a tell-tale symptom, testicular lumps are relatively common, often due to swollen blood vessels or cysts in the tubes around the testicles.
When to check your testicles
Checking them whenever you can is great, but one part of the day may be more effective than the other.
"Some people think you should check for abnormalities in the morning, but even though you should check your testicles for abnormalities once every month, ideally after a warm bath or shower is best, as your scrotum will be relaxed, making it easier to feel for any changes in your testicles," says Mr Wadhwa.
"It is important you know what is normal for you. Just as women are recommended to self-examine their breasts regularly, men should also regularly examine their testicles so any change can be immediately noted."
When to see a doctor
Although rarely caused by cancer, any swelling or unusual signs should always be checked by a GP.
"Performing a self-examination is as simple as rolling one testicle between [the] thumb and fingers, and feeling for what's normal for you," Sam Gledhill, Movember's global director of testicular cancer, previously told Yahoo UK.
"Repeat this technique with the second testicle. If something changes, starts to hurt, wasn't there before or generally worries you, please don't panic, but do get in front of a doctor and discuss it with them."
Mr Wadhwa adds, "If you notice blood in your semen, you should always see your doctor. In most cases, it’s not likely to be anything serious. However, you may still need treatment e.g., if you have an infection or inflammation."
For support, you can call the Macmillan Support Line on 0808 808 00 00 (open seven days a week, 8am to 8pm).
Watch: Morrisons' underwear to include NHS cancer check labels