Testicular Cancer

You can get cancer in one or both testicles. Testicles, or testes, make male hormones and sperm.

Testicles are the two egg-shaped organs inside the scrotum, the loose sac of skin behind the penis.

Testicular cancer mainly affects young men between the ages of 20 and 39.

It is also more common in men who:

  • Have had abnormal testicle development
  • Have had an undescended testicle
  • Have a family history of the cancer

Symptoms include pain, swelling, or lumps in your testicles or groin area. Doctors use a physical exam, lab tests, imaging tests, and a biopsy to diagnose testicular cancer. Most cases can be treated, especially if found early. Treatment options include surgery, radiation, and/or chemotherapy. Regular exams after treatment are important.

Treatments may also cause infertility. If you may want children later on, you should consider sperm banking before treatment.

 

Performing a testicular self-examination (TSE) each month may help detect testicular cancer at an early stage, before it spreads. Finding testicular cancer early is important to successful treatment and survival.

The exact cause of testicular cancer is unknown. 

Factors that may increase a man's risk of developing testicular cancer increases if he has: 

  • Abnormal testicle development
  • Exposure to certain chemicals
  • Family history of testicular cancer
  • HIV infection
  • History of testicular cancer
  • History of an undescended testicle (one or both testicles fail to move into the scrotum before birth)
  • Klinefelter syndrome

Testicular cancer is the most common cancer in men between the ages of 15 and 35. It can occur in older men, and in rare cases, in younger boys.

White men are more likely than African American and Asian American men to develop this type of cancer.  

There is no link between vasectomy and testicular cancer.

 

There may be no symptoms.

If there are symptoms, they may include:

  • Discomfort or pain in the testicle, or a feeling of heaviness in the scrotum
  • Pain in the back or lower abdomen
  • Enlarged testicle or a change in the way it feels
  • Excess amount of breast tissue (gynecomastia), however this can occur normally in adolescent boys who do not have testicular cancer
  • Lump or swelling in either testicle

Symptoms in other parts of the body, such as the lungs, abdomen, pelvis, back, or brain, may also occur if the cancer has spread outside the testicles.

 

A physical examination typically reveals a firm lump in one of the testicles. When the health care provider holds a flashlight up to the scrotum, the light does not pass through the lump.

Other tests include:

  • Abdominal and pelvic CT scan
  • Blood tests for tumor markers: alpha fetoprotein (AFP), human chorionic gonadotrophin (beta HCG), and lactic dehydrogenase (LDH)
  • Chest x-ray
  • Ultrasound of the scrotum

 

Treatment depends on the:

  • Type of testicular tumor
  • Stage of the tumor

Once cancer is found, the first step is to determine the type of cancer cell by examining it under a microscope. 

The next step is to determine how far the cancer has spread to other parts of the body.

This is called "staging."

  • Stage I cancer has not spread beyond the testicle.
  • Stage II cancer has spread to lymph nodes in the abdomen.
  • Stage III cancer has spread beyond the lymph nodes (it could be as far as the liver, lungs, or brain).

Three types of treatment can be used.

  • Surgical treatment removes the testicle and may also remove nearby lymph nodes. This is usually performed in the case of both seminoma and nonseminomas.
  • Radiation therapy using high-dose x-rays or other high-energy rays may be used after surgery to prevent the tumor from returning. Radiation therapy is usually only used for treating seminomas.
  • Chemotherapy uses drugs to kill cancer cells. This treatment has greatly improved survival for patients with both seminomas and nonseminomas.

 

Testicular cancer is one of the most treatable and curable cancers.

The survival rate for men with early-stage seminoma (the least aggressive type of testicular cancer) is greater than 95%. The disease-free survival rate for Stage II and III cancers is slightly lower, depending on the size of the tumor and when treatment is begun.