Salesman Matt Inman-Shore first heard about testicular cancer when he was a boy — his father, grandfather and uncle had all been through it.
‘I was nine when my dad, Steven, now 60, got his diagnosis and 12 when the men in my family began having cringy conversations with me, telling me to check myself,’ says Matt, 31.
‘I always wondered when it was going to be my turn. But unlike my grandad, who waited five years to see the doctor, and my dad and uncle who both waited a year, I saw someone within 24 hours of feeling a lump,’ he says.
Salesman Matt Inman-Shore first heard about testicular cancer when he was a boy — his father, grandfather and uncle had all been through it. He is pictured centre with his Grandad, left, and his Dad, right
‘In August 2018, Dad thought his cancer had come back. He didn’t find a lump, but he just didn’t feel right and that’s what prompted me to check myself.
‘His turned out to be nothing, but that day I discovered a lump about the size of a Cadbury’s mini egg in my left testicle. I was so alarmed, I made sure I was in my GP’s surgery the next day.
‘My doctor immediately referred me to the urology department at Nottingham City Hospital because of my family history, and I had an ultrasound scan four days later.
‘Two weeks later, I had a biopsy and two weeks after that, the cancer was confirmed. It was a weird moment — I’d just moved from London to Nottingham and got engaged to my now wife, Stefanie, 34, so everything else in my life was going forward.’
The cancer most linked to genes
Genetic inheritance plays a much more important role in testicular cancer than in most other cancers, according to new research published in the Scientific Reports journal.
Researchers found that 50 per cent of the risk of developing this cancer comes from our DNA — with environment and lifestyle contributing to the rest. In most other types of cancer, genetics typically account for less than 20 per of the risk.
Scientists studied patterns of testicular cancer in family groups in nearly 16 million Swedes, and the genetic code of 6,000 UK men.
This analysis showed the risk came from a large number of minor variations in DNA, rather than one faulty gene. Fewer than 10 per cent of mutations have so far been identified, however.
But this new research could help diagnose those at greatest risk and help them to manage that risk.
A follow-up CT scan showed a second, smaller cancer in his other testicle. ‘I could feel nothing, so I had no idea it was there,’ says Matt.
With no family history, men have a one-in-200 chance of developing testicular cancer, but the odds increase to 1 in 50 if you have a father who has had the disease and to 1 in 25 if your brother develops it.
No single faulty gene has been identified for testicular cancer, although the risk is higher in those born with an undescended testicle, and those who develop an inner groin (or inguinal) hernia.
Over the past 20 years, rates have increased with no obvious cause. Incidence for those aged 25 to 49 is up by 28 per cent, aged 50 to 59 by 56 per cent and 60 to 69 by 46 per cent.
According to Cancer Research UK, rates are set to rise by another 12 per cent by 2035, which will mean there are ten cases per 100,000.
The main symptom is a small lump or masses in one or both testicles.
‘If there is a significant difference in how one testicle feels compared with the other, get yourself to the doctor,’ advises Clare Turnbull, senior researcher at the Institute of Cancer Research and professor of genomic medicine at Queen Mary University of London.
All testicular cancer is treated surgically, and advanced cases — stages 3 and 4, where the cancer has spread beyond the lymph nodes, to the bones and organs — will require chemotherapy and radiotherapy as well.
Chemotherapy is also used for stage 1 and 2 if the cancer recurs after the lump has been removed. It is highly effective and works for more than 90 per cent of patients.
Although diagnosed early, at stage 1, Matt had one round of chemotherapy as a precaution.
Men still produce sperm and testosterone with one testicle and can father children, but if both have been removed, they produce no sperm or testosterone and will need hormone replacement therapy for life.
Matt recalls: ‘I kept a journal and I wrote that if it was just one I wasn’t that bothered because I’d seen three men in my family survive. I was diagnosed at stage 1 and knew how curable it was. But when I found out I had cancer in both testicles, my chances of becoming a father evaporated.’
Matt (pictured) said: ‘It has been a real life-changer for me. I will never escape the fact I’ve had cancer, but there have been positives’
Matt, a salesman, recalls: ‘Stefanie and I both wanted children, so to have that option removed overnight was devastating. I had planned to freeze a sperm sample to use for IVF later, but my sperm count was low, down to one healthy sperm in ten million,’ he says.
‘The specialist said the tumour was strangling the tubes that carry sperm so the quality was unlikely to be good, so I decided not to freeze a sample.
‘Not becoming a father was the one thing that really got to me.’
Matt had both testicles removed and replaced with prosthetics in September 2017. Clearly the best option is to catch the cancer early — not least to reduce the need for chemotherapy, as it can affect fertility and, more rarely, cause complications. including heart damage, says Professor Turnbull.
‘It potentially gives young men consequences they have to live with for the next 50 years.’
But as Matt’s family’s experience demonstrates, men can be reluctant to go to the doctor.
He says: ‘Because my dad had left it a year to get a diagnosis, his treatment when he was 36 was much more severe. He was quite ill during six months of chemotherapy, lost all his hair, was vomiting and was very frail.
‘With my grandad John, now 86, avoiding the doctor was more a case of ignorance I think.
Spot the difference
These four options may contain slightly different compounds to make them easier to swallow, but all have the same active ingredient to treat diarrhoea: loperamide.
It works by reducing the speed of the gut, which slows down how quickly the contents pass through, and so food remains in your intestines for longer. This allows more water to be absorbed back into your body and results in firmer stools that are passed less often.
Two 2mg capsules should be taken initially and then one after every loose stool, up to a maximum of eight in 24 hours. Hydration is vital to stop you becoming dehydrated.
‘My uncle Gary, now 61, was diagnosed aged 39. He only checked himself because my father had just been diagnosed, and then Gary discovered he had a lump, too. He needed chemo, too,’ says Matt.
‘I was the youngest and feel lucky that I acted fast.’
Dr Richard Roope, cancer spokesman for the Royal College of General Practitioners, says: ‘There’s a culture where male adults don’t go to their GPs.
‘All men, from the age of 15, should check their testicles for lumps about once a month. Peak age for diagnosis is 30 to 34, but it can strike at any time.’
Matt adds: ‘It has been a real life-changer for me. I will never escape the fact I’ve had cancer, but there have been positives.
‘With the help of my family, my friends and the MoBro brotherhood [men who connect through the male cancer charity Movember], I asked for help and cried.
‘My friendship circle is full of alpha males. Talking about emotions is a thing we’ve never done, but my experience has made it possible for us to all open up.
‘My best friend went for a check after he found a lump. Thankfully it was only a cyst, but that shows the power of telling your friends and the value of going to see the doctor promptly.’