Testicular cancer
Testicular cancer occurs when cancer cells form in one or both testicles, the glands that produce sperm and testosterone. The main types are germ cell tumors — including seminomas and non-seminomas — and, less commonly, stromal tumors. Germ cell tumors account for most cases.
Who it affects
Testicular cancer most often affects males ages 15 to 35, though it can occur at any age. It is relatively uncommon but highly treatable, especially when detected early.
Common symptoms
- Painless lump or swelling in a testicle
- Feeling of heaviness in the scrotum
- Dull ache or sharp pain in the lower abdomen or groin
- Changes in size or firmness of a testicle
- Less commonly, breast tenderness or back pain if the cancer has spread
Causes and risk factors
The exact cause is unclear, but risk factors include:
- History of undescended testicle (cryptorchidism)
- Previous testicular cancer in the other testicle
- Family history of testicular cancer
- Certain genetic conditions
- Infertility
- White ethnicity
- HIV infection
- Prior testicular problems
How it is diagnosed
Diagnosis starts with a medical history and physical exam. Specialists may use:
- Scrotal ultrasound to detect masses
- Blood tests for tumor markers such as AFP, hCG, and LDH
If cancer is suspected, removal of the affected testicle (radical inguinal orchiectomy) often serves as both a diagnostic and initial treatment step. Additional imaging, like CT scans, and ongoing tumor marker monitoring help determine disease stage.
Treatment and prognosis
Treatment depends on tumor type and stage and may include:
- Surgery (orchiectomy)
- Radiation therapy, mainly for seminomas
- Chemotherapy, often for non-seminomas or advanced disease
- Surgery to remove lymph nodes in select cases
Fertility preservation, such as sperm banking, may be discussed before treatment. When detected early, most patients are cured.
When to seek care
Contact a healthcare provider if you notice a new lump, swelling, persistent pain, or sudden change in the size or feel of a testicle. Early evaluation improves treatment success.
Support and next steps
If diagnosed, ask about tumor type, disease stage, treatment plans, fertility options, and available support services. Emotional support, sexual health guidance, and survivorship planning are part of comprehensive care.
What are the first signs of testicular cancer?
A painless lump or swelling is the most common early sign. Other signs may include heaviness in the scrotum, dull lower abdominal or groin ache, or sudden pain.
Who is at risk?
Higher risk occurs in males with undescended testicles, prior testicular cancer, family history, certain genetic conditions, or infertility. Most common in ages 15–35 but can occur at any age.
How is testicular cancer diagnosed?
Diagnosis begins with a physical exam and scrotal ultrasound. Blood tests for tumor markers (AFP, hCG, LDH) help guide care. Surgical removal of the testicle confirms the diagnosis and begins treatment.
Can testicular cancer be cured?
Yes. It is highly treatable, especially when detected early. Many are cured with surgery alone or with additional radiation or chemotherapy.
What treatments are used?
Treatment may include orchiectomy, radiation (mainly for seminomas), chemotherapy (for advanced or non-seminomas), and sometimes lymph node surgery.
Will treatment affect fertility or sexual function?
Chemotherapy and radiation can impact fertility. Sperm banking before treatment is recommended. Most men retain normal sexual function, as the remaining testicle usually produces sufficient hormones and sperm.
Should I perform testicular self-exams?
Regular self-exams help detect changes early. Seek care if you notice lumps, swelling, or persistent pain.
When should I see a doctor?
See a provider for any new lump, swelling, ongoing pain, or sudden change in testicle size or feel. Early evaluation offers the best outcomes.
What tests will I have after diagnosis?
Follow-up may include CT scans of the chest, abdomen, and pelvis, along with blood tests for tumor markers to check for spread and guide treatment.
How is follow-up handled after treatment?
Follow-up depends on stage and treatment, typically including regular physical exams, tumor marker tests, and imaging. Long-term support addresses fertility, hormonal health, emotional needs, and monitoring for late effects.
Early evaluation is crucial, and TidalHealth offers effective treatments and comprehensive support.
