You see it pop up on your social feed every November, but Movember is about much more than growing a moustache (though if you can pull it off, I say go for it!). Just as we talk about breast cancer in October, this month is about raising awareness and starting a discussion about health issues that many men can face – both mental and physical.
While male mental health is a very important topic, which I’m always keen to talk about (please do speak to your own GP if you are struggling), today I want to focus on male physical health. In particular, to discuss two types of cancers that every man should know the warning signs for: prostate cancer and testicular cancer.
From how to go about checking your testicles and spotting the symptoms of prostate cancer, to steps to take if you do notice any changes – here’s everything you need to know to be more conscious and take charge of your health.
How common is testicular cancer, and who is most at risk?
Testicular cancer is quite a rare form of cancer, accounting for less than one per cent of all cancers that occur in men. In the UK, about 2,300 men are diagnosed with testicular cancer each year.
Unlike many other forms of cancer, it’s quite unusual in the sense that it affects younger men at a higher rate – which is why getting into the habit of routine checks from a young age is crucial. Testicular cancer is most diagnosed in men between the ages of 15 and 49.
For reasons yet unknown, white males are more likely than men of other ethnicities to be affected by it. Whatever your gender identity, anyone who has testes is at risk.
How to check for testicular cancer
Just like we ask women (and men!) to check their breasts and pecs every month, we GPs also want to encourage men to check their testicles on a monthly basis. One of the most common signs of testicular cancer is a new lump, so regular checks can help to detect it early. Look out for the following changes:
Any swelling or enlargement of the testicles. Also, be aware if one testicle begins to feel larger in size, firmer or heavier than the other, or you experience a feeling of ‘fullness’.
Typically, lumps that can indicate testicular cancer are pea-sized and painless – however, they can be larger, or accompanied by a dull ache or sharp pain that comes and goes. If you are experiencing anything painful, or find lumps of any size, this is still something your GP would want to see you for.
You might notice skin changes on or around the testes, which again would warrant seeing your GP.
Try checking your testicles after a warm bath or shower, so the skin of your scrotum relaxes. Examine them one at a time – cup them under your hand to feel their weight, then roll each between your finger and thumb to check for any lumps, bumps or changes in size.
Remember that, while we encourage everyone to check themselves on a monthly basis and speak to a doctor when they spot any changes, more often than not, lumps that are found are not cancerous. Regardless, they should never be ignored.
What are the other warning signs you need to know?
As well as doing your own routine checks for the above signs, see your GP if you experience any of the following symptoms, which can sometimes be linked to testicular cancer.
• Any other pain or discomfort in the testes or scrotum
• Aches in the groin, lower abdomen or lower back
• Tenderness in or growth of breast tissue
• Swelling in one or both legs
• Shortness of breath
What happens next if you’ve spotted a lump?
If you spot anything unusual, book an urgent appointment with your GP, who will firstly perform an examination. While you shouldn’t feel embarrassed at all (we GPs examine genitalia on a regular basis), you are welcome to bring or ask for a chaperone if that means you feel more comfortable.
Following this, your GP may refer you for a scrotal ultrasound. This will allow expert professionals to determine what the lump is. Most of the time, testicular lumps prove to be fluid-filled cysts or swollen blood vessels – so non-cancerous. But it’s always a good idea to be cautious and put your mind at rest.
How common is prostate cancer, and who is most at risk?
In the UK, approximately one in eight men will develop prostate cancer in their lifetime. Typically, it affects men over the age of 50, and is more common in black men and those with a family history of prostate cancer.
Prostate cancer is most often diagnosed in men aged between 75 and 79 years.
As it’s the most common cancer in UK males, it’s a good idea for all men to be aware of the warning signs. (It’s possible for women to develop cancer of the Skene’s gland, the female equivalent of the prostate, but this is extremely rare.)
What are the early signs of prostate cancer?
Unlike testicular cancer, it’s harder to spot the early signs of prostate cancer, and there are no routine checks we can easily do at home.
Generally, it’s quite a slow-growing cancer. This means you may not spot outward signs for many years, until a growth starts to put pressure on the urethra (the tube that carries urine away from your bladder). But there are symptoms to be aware of.
Symptoms of prostate cancer
Most of the symptoms linked to prostate cancer are urinary. If you experience any of the following, speak to your GP as soon as possible:
• An increased need to pass urine, especially at night
• Any difficulty passing urine, or weak flow
• Feeling as though your bladder isn’t fully empty after passing urine
• Blood in your urine or semen
Other conditions may be linked to these symptoms, such as having an enlarged prostate (a benign condition which is common in older men). Seeing your GP to determine the cause is essential.
Signs that prostate cancer has spread can include back and bone pain, and loss of appetite.
How do doctors check for prostate cancer?
If you’re experiencing symptoms, doctors can run a PSA test, which measures levels of prostate-specific antigen (PSA) in your blood.
However, while this can help to detect prostate cancer, it is not considered a gold-standard test. This means that, sometimes, other triggers can raise the alarm (such as an enlarged prostate or an infection), or warning signs can be missed.
That’s why we use the results of this test alongside clinical symptoms and physical examinations. The latter would involve a rectum examination to feel the prostate, checking for any irregularities such as a hard prostate.
Then we can determine whether to refer patients to a urologist (a doctor who specialises in diseases of the urinary tract) on an urgent, two-week basis. Further tests would typically involve an MRI scan and a biopsy of the prostate gland (where a small sample of tissue is taken) to determine if cancer is present.
Are there routine tests on the NHS for prostate and testicular cancer?
There aren’t currently any routine tests for either condition on the NHS. This is due to the low overall risk of testicular cancer, while the NHS says that it’s not been proven that the benefits of a screening programme would outweigh the risks.
What I want to stress is that it’s very important for men to take ownership over their health – from what I see, men aren’t typically doing this as much as women.
Make sure you educate yourself to know the symptoms, check yourself monthly, and act on anything you notice accordingly. So many men avoid seeing their GP, but please remember, we’re here to help and can put your mind at ease.
Read more from Doctor Shireen and the Nature’s Truth Expert Panel.