Kuala lumpur: Testicular cancer is the most common solid cancer affecting young men, yet awareness of the disease remains relatively low. It affects about one in 250 males globally, with the average age of diagnosis at 33, but is also among the most curable cancers today.
According to BERNAMA News Agency, Consultant Urologist and Robotic Surgeon at Sunway Medical Centre, Sunway City, Dr Murali Sundram Mikaail Abdullah, stated that advances in medical treatment have resulted in a five-year survival rate of approximately 95 percent for testicular cancer, especially when it is diagnosed and treated early. He emphasized that testicular cancer often presents with early warning signs that can be subtle and easily overlooked as the condition is usually painless. Dr Murali advised that any painless lump in the testicle should be promptly assessed by a doctor and referred to a urologist.
Dr Murali further explained that the earliest sign of testicular cancer is typically a painless swelling or lump in one testicle, which may be noticed by the patient himself or, in some cases, by his sexual partner. To support early detection, he advises men, especially those in younger age groups, to perform regular testicular self-examinations. Once a lump is detected, diagnosis is usually straightforward.
'A simple ultrasound has a 90 percent accuracy rate for diagnosing testicular cancer. If a test is positive for cancer, then a more in-depth test like blood tests to check tumour markers and CT scans of the abdomen and lungs are also performed to determine the stage of the cancer, which shows whether it has spread beyond the testicle,' Dr Murali said.
He highlighted that when detected early, testicular cancer is usually limited to the testicle, known as Stage I disease, while more advanced stages indicate spread to nearby lymph nodes or organs such as the lungs or bones. Stage I testicular cancer is treated with an orchidectomy, a surgical procedure to remove the affected testicle, typically involving just a one-day hospital stay.
Dr Murali added that outcomes at this stage are highly reassuring, with 70 to 85 percent of patients cured with surgery alone, while in some cases, a single course of chemotherapy may be advised as an added precaution. He noted that orchidectomy usually does not affect sexual function or fertility if the remaining testis has normal function, adding that patients are monitored closely for at least five years through regular check-ups following treatment.
For patients with Stage II or Stage III disease, chemotherapy remains the cornerstone of treatment and is very effective for testicular cancers. Dr Murali emphasised that even when testicular cancer is diagnosed at a more advanced stage, outcomes remain encouraging, with about 70 percent of patients being completely cured with chemotherapy, even at advanced stages.
He explained that for some patients, chemotherapy may leave behind enlarged lymph nodes, and in these cases, a specialised procedure known as retroperitoneal lymph node dissection (RPLND) may be recommended to remove the remaining cancerous tissue. While traditionally, RPLND is performed as open surgery, today, robotic-assisted surgery is available in selected centres for carefully chosen patients. This approach involves smaller incisions and shorter recovery time, allowing many patients to return to their normal daily activities within weeks.
However, he cautioned that careful patient selection and surgical expertise remain essential, and open surgery continues to be considered the gold standard for more complex cases. Dr Murali concluded by saying, 'For young Malaysian men, awareness is the first line of defence. Taking a moment to perform a simple self-check and seeking medical advice when something feels unusual could make the difference between early treatment and a more serious diagnosis.'