Testicular cancer survivors may be at added risk of their disease returning after surgery because of unnecessary follow up scans, according to research from Cancer Research UK. 

Currently, men who have had one testicle removed after being diagnosed with stage one cancer have seven CT scans over five years to check for signs of a return.

However, CT scans use a barrage of X-rays, a high-energy form of radiation which itself can cause health issues such as cancer in large doses.

New data from a clinical trial show that having just three MRI scans — a lower risk technique — was just as effective at spotting a return of the disease as seven CT scans.

Mainly affects young men

More than 1,000 men a year are diagnosed with the cancer in the UK and around half are stage one, which has an almost 100 per cent survival rate and mainly affects young men.

Wilhelm Conrad Röntgen first discovered X-rays by accident in 1895 and Thomas Edison worked with the mysterious new imaging tool and used it to photograph the hand of his assistant, Clarence Dally, more than 1,000 times over eight years.

The radiation exposure ravaged his hand and led to finger, hand and arm amputation before his eventual death from metastatic carcinoma aged 39.

In modern practice, exposure to X-rays is strictly limited, with radiographers shielding behind lead barriers and wearing protective garments.

Professor Robert Huddart, lead author of the study and professor of urological cancer at the Institute of Cancer Research, told The Telegraph: “When looking at a young population of men who are unlikely to die from testicular cancer, avoiding unnecessary radiation exposure is vital.

“We found that the benefit of having continued CT scans beyond three years was outweighed by the potentially harmful exposure to radiation, given the small number of men who relapse and our success at treating those patients.

He added: “Our study also found that MRI could have real benefits for men with testicular cancer in achieving similar outcomes to CT but with lower doses of radiation.”

“Reducing the number of scans men have could help alleviate the anxiety that some patients experience, as well as easing pressure on the NHS.

“We are now collecting health economic data to see if using three MRI scans could be recommended as the standard surveillance plan.”

Researchers from UCL and the Institute of Cancer Research studied 669 men with stage one testicular cancer between 2008 and 2014 with an average age of 39.

Patients were then monitored for five years with either seven CT scans (the current standard of care), seven MRI scans, three CT scans, or three MRI scans.

No significant impact

Data show that having fewer tests and using MRI scans instead of CT scans had no significant impact on cancer detection.

Around one in eight (82) of the participants had their cancer return, but less than one per cent of cases occurred after three years.

Just ten of the identified cases were at an advanced stage, the study found, and nine were identified in a streamlined three-scan group with just one having seven scans.

All men who had the cancer return were successfully treated, which the scientists said showed that the risks of more scans outweighed the benefits.

“MRI can be recommended to reduce irradiation; and no adverse impact on long-term outcomes was seen with a reduced schedule,” the researchers write in their study, published on Thursday in the Journal of Clinical Oncology.

Michelle Mitchell, chief executive of Cancer Research UK, said: “We will be eagerly following the next steps of this trial to see whether using fewer CT scans or MRI could be the new standard of care.”

Dr Fay Cafferty, study co-author at the Medical Research Council Clinical Trials Unit at UCL, added: “These are relatively young men and, for most, their cancer won’t return.

“So striking the right balance with monitoring is crucial to avoid unnecessary radiation exposure and stress associated with hospital visits.

“These results will help to shape care for men with this type of cancer in future, allowing us to reduce their exposure to potentially harmful radiation whilst still providing effective monitoring.”