Movember has come and gone, but the month gave us many take-home lessons when it came to a host of men’s issues. We sat down with Dr Greg Hart, an oncologist for leading cancer treatment facility, Cancercare. Dr Hart, who is based at the Rondebosch Oncology Centre at The Christiaan Barnard Memorial Hospital, talked to us about testicular cancer. This is what we learnt.

1. It’s the most common cancer in young men

As a whole, testicular cancer makes up a small percentage of the total amount of cancers in men, says the oncologist. But the problem lies in men aged between 15 to 40 years old.

“It only makes up about 1% in the cancers in men. But in young men it’s a different story,” says Dr Hart. “It makes up about 13% of cancers in young men. So, it’s the most common cancer in men between the ages of 15 and 40. At that time in your life, you’re not expecting to have to deal with a malignancy.”

In your lifetime, however, men only have a 0.4% chance (one in 250) of getting the disease.

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2. It’s very treatable

“The other very important thing about testicular cancer is that it’s very treatable and almost always curable,” says Dr Hart. “But your chances are better the earlier the cancer is picked up. That is the case with all cancers, but particularly with testicular cancer.”

There are two types of testicular cancers: Seminoma and non-seminoma. “Seminomas have an excellent prognosis,” says Dr Hart. With all the other testicular tumours (the non-seminomas) also having an excellent prognosis, “but slightly less excellent than with the seminomas.”

Seminoma or non-seminoma, there is a high chance of survival, even if your cancer is picked up at a later stage. “You would expect, even in patients with advanced disease, with cancers that have spread to other parts of the body, you would expect to be able to cure them with chemotherapy drugs that we have at our disposals.”

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3. Awareness is key

The most important thing is to be aware of testicular cancer, its occurrence in young men, and to be aware of the symptoms. Dr Hart notes that awareness is the most important factor when it comes to picking up the cancer early.

“It’s not like other types of cancers like prostate cancers in men, or cervical cancers in women, where you need to go for regular check-ups and blood tests to pick the cancer up. The easiest way to pick it up is just to keep an eye on yourself. Young men need to familiarise themselves with their testicles and examine them on a regular basis.”

And that’s why initiatives like Movember cannot go unheard. Especially with testicular cancer’s high occurrence in young men. But there’s also other great initiatives out there, too — all year round. “The guys at Love Your Nuts are very active,” says Dr Hart. “It’s a local NGO that was started by testicular cancer survivors, and it’s there to raise awareness and put you in touch with the right people [if you have testicular cancer].”

Read more: Guys, why aren’t you checking your balls for testicular cancer?

4. Checking for symptoms is easy

When it comes to testicular cancer, men don’t have to visit the doctor for regular check-ups and blood tests. They just have to go into the shower, jokes the doctor. “Often the only symptom that a young man will have is a lump or an area of firmness in the testicle,” says Dr Hart.

“There is a misconception that a lump has to be painful in order to be cancerous. Often the majority of testicular lumps are painless or associated with slight pain. According to Dr Hart, “regular examination of one’s testicles needs to be done. Look in particular for any lumps, but any unexplained testicular discomfort should also be followed up on.”

5. Our public and private healthcare system is well equipped for treatment

When it comes to cancer, one of the challenges in South Africa is the under-reporting of testicular cancer. Hence, stats are hard to find. But Dr Hart says that as a whole, the country is well-equipped to treat and cure cancer, both publicly and privately.

“I work in the private healthcare system, where there is generally a higher awareness among patients, so many patients will present with earlier disease,” Dr Hart says on the challenges faced. “Unfortunately, in the public sector, because of patient education and a patient’s access to public healthcare, they often present with disease that’s more advanced and is spread elsewhere in the body. They then require more intense treatment.

“The drugs that we use that are likely to cure prostate cancers are drugs that have been around for a long time,” Dr Hart adds. “So they’re not expensive and are available throughout the country in the private and public sector. So the prognosis is still good in the public sector, although those patients present [the disease] much later.”

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6. When you need to see an oncologist

“Because I’m an oncologist, we are less involved on the diagnostic side of cancers — that side is filled by our urology colleagues,” says Dr Hart. Rather, testicular cancer is picked up by a general practitioner, then you’re referred to a urologist, where the testicle will be removed and diagnosed with cancer. “It’s really there where oncologists like myself and the Cancercare team would get involved,” says Dr Hart.

“Often, in a lot of patients, surgery is all that’s needed, and my job is to supervise their surveillance with regular scans and regular examinations to make sure the cancer doesn’t come back.”

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About Cancercare

“We at Cancercare are experts in the administration of chemotherapy, but we provide a holistic approach to our patient’s support,” says Dr Hart. “So we have in-house counsellors and social workers who are able to help our patients, and their families, manage the psychological and emotional trauma that comes with a diagnosis of cancer, and who supports them through the treatment process as well.”

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