Testicular cancer occurs when malignant cells form a tumor in the tissues of the testicles, part of the male reproductive system. These tumors can affect one or both testicles and are the most common cancer among young men ages 15 to 35. Treatment typically includes surgery and chemotherapy or radiation, if needed. Testicular cancer has a promising cure rate, especially if detected early.
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What Is Testicular Cancer?
Testicular cancer is a malignant (cancerous) tumor in one or both testicles. The testicles are the male sex glands located inside the scrotum, the sac of skin that hangs underneath the penis.
The testicles, also called testes, are responsible for the production and storage of sperm and are the main source of male hormones.
Testosterone, the most abundant male hormone, controls the development of the reproductive organs and other male characteristics, such as facial and body hair, deep voice, and sex drive.
What are the types of testicular cancer?
There are two types of testicular cancer tumors:
- Nonseminomas – Known to grow and spread quickly.
- Seminomas – Typically slower to grow.
Some cancerous tumors contain both seminoma and nonseminoma cells.
Understanding the specific type of cancer helps doctors decide the best treatment method moving forward.
What are the stages of testicular cancer?
There are four stages of testicular cancer, ranging from stage 0 to 3. /p>
- Stage 0 and 1 testicular cancer – are tumors that only impact the testicle and are usually easily removed with surgery and then actively surveilled for two years post-surgery.
- Stage 2 testicular cancer – means the cancer has spread to the surrounding lymph nodes, and chemotherapy or radiation may be suggested after surgery.
- Stage 3 testicular cancer – can mean the cancer is in the lymph nodes and the tumor markers are showing high levels, or that the cancer has spread to other organs or areas of the body. In this stage, you can expect surgery and radiation or chemotherapy as part of your treatment plan.
How common is testicular cancer?
Testicular cancer is not very common — an average of 7,000 cases of testicular cancer are diagnosed in the United States each year. It is the most common cancer in young men between the ages of 15 and 35, although the disease can occur at any age.
Testicular cancer is highly treatable, even if diagnosed in a later stage. Treatment depends on the stage and type of cancer, but typically includes surgery, chemotherapy, radiation, and active surveillance.
Testicular cancer risk factors
You may be at a higher risk of testicular cancer if you:
- Are a male aged 15 to 35 — Testicular cancer can affect men of any age, but this age group in particular is known for higher rates.
- Are Native American, Alaska Native, or White — Experts don’t know why these races are much more likely to get testicular cancer than Asian American, Black, and Pacific Islander men.
- Have an undescended testicle (cryptorchidism) — If one or both testicles fail to move from the abdomen into the scrotum before birth, they are undescended. It’s more likely that cancer will develop in the undescended testicle, though experts aren’t sure why.
- Have a family history — While most men diagnosed with testicular cancer don’t have a family history of the disease, the risk increases if an immediate family member has been diagnosed in the past.
Complications from testicular cancer
Like any cancer, a testicular cancer diagnosis can come with complications. While losing one testicle does not impact a man’s ability to maintain an erection or have sex, it can impact fertility. Some men notice a change in their sperm production after having testicular cancer surgery, and the cancer itself or cancer treatments can cause infertility.
Patients who may want children in the future are encouraged to freeze sperm in a sperm bank before starting any kind of treatment. Men who lose both testicles to testicular cancer cannot produce sperm and become infertile.
They may also experience symptoms of low testosterone, such as:
- Decreased sex drive.
- Erectile dysfunction.
- Fatigue.
- Hot flashes.
- Loss of muscle.
Testosterone supplements in the form of a patch, shot, or gel can help with these symptoms.
What Are the Signs and Symptoms of Testicular Cancer?
Many men may not notice their testicular cancer at first. The most common symptom is a painless lump in either testicle, which may grow over time.
Other symptoms may include:
- Change in testicle appearance/feel.
- Dull, achy pain in the groin area.
- Extra fluid in the scrotum.
- Pain in the testicle or scrotum.
- Swelling of the testicle.
Performing self-exams on your testicles at least once a month can help catch tumors and testicular cancer early. This self-exam includes looking for any appearance changes and gently feeling around both testicles for any lumps or abnormalities.
When should I see a doctor about my testicular cancer symptoms?
If you notice a lump in your testicle or any other symptoms of testicular cancer, schedule a call with your primary care provider immediately. They will help you find the right doctor for a proper diagnosis.
How Do You Diagnose Testicular Cancer?
Several tests can help diagnose testicular cancer. First, your doctor will ask for your health history and your symptoms. They will perform a physical examination that includes checking the testicles for lumps and swelling.
Your doctor or specialist may run some other tests to diagnose testicular cancer, including:
- Biopsy — Removing some cells from the tumor and sending them to a lab for testing and formal diagnosis is the most accurate way to determine testicular cancer. Since a radical inguinal orchiectomy, or surgery to remove the entire testicle, is a common treatment plan even if the tumor is not cancerous, this step usually comes after surgery. A biopsy can help diagnose the stage and type of cancer and provide information for a personalized treatment plan.
- Serum tumor marker test — This blood tests measures certain substances in the blood that are linked to certain types of cancer, called tumor markers. The tumor markers used to help detect and diagnose testicular cancer are known as alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (beta-hCG). Higher tumor marker scores can mean a higher likelihood of cancer.
- Ultrasound exam — During an ultrasound exam, you can expect doctors to use high-energy sound waves to produce a picture of the tissues in the testes to look for tumors.
Testicular cancer prognosis
Fortunately, testicular cancer has a very high cure rate and a positive prognosis.
Like any disease, though, prognosis and treatment results vary on several factors, including:
- Health of the lymph nodes around the tumor.
- Size and number of tumors.
- Stage of cancer.
- Type of cancer.
How Do You Treat Testicular Cancer?
Treatment for testicular cancer varies depending on several factors.
The most common types of treatment are:
Nonsurgical treatments for testicular cancer
Chemotherapy
Chemotherapy uses drugs to kill and freeze the growth of cancer cells in the body. It can be taken orally or injected through an IV. Depending on the diagnosis, chemotherapy could be ordered after surgery to make sure any cancer cells still in the body are killed off./p>
Radiation
Radiation uses high-energy x-ray technology to kill and freeze the growth of cancer cells, targeting the tumor precisely while sparing healthy tissue around it.
Surgical treatments for testicular cancer
Radical inguinal orchiectomy (testicle removal surgery)
The most common and first treatment for testicular cancer, radical inguinal orchiectomy (testicle removal surgery) involves removing the entire testicle through an incision in the groin area. This procedure takes the tumor out, but also removes the entire testicle, which could impact fertility and sperm count.
Surveillance
Surveillance means that doctors are ordering and interpreting scans on a schedule to monitor the body for any signs of leftover or recurring cancer. This treatment method is noninvasive and can continue for two years or more after surgery.
Other treatments
Clinical trials and new cancer-killing technologies are being created all the time.
Some newer therapies for treating testicular cancer include:
- High-dose chemotherapy.
- Stem-cell transplant – Involves removing some of your stem cells before starting cancer treatment and then giving them back to you after treatment. Healthy stem cells are meant to help restore the body’s depleted blood cells.
What happens during testicular cancer surgery?
During surgery to remove a testicle, also called a radical inguinal orchiectomy, an anesthesiologist will administer anesthesia for the procedure. You will remain asleep for the duration of the surgery.
A surgeon will make an incision in your groin area on the side of the body from which the testicle is being removed. The tumor, entire testicle, and spermatic cord are carefully removed from the scrotum. The spermatic cord contains several important structures that cancer could use to spread to other parts of the body.
If lymph nodes around the testicle were impacted by cancer, they may also be removed through a larger incision in the abdomen, an area where testicular cancer is most likely to spread.
After surgery, you may feel some pain and discomfort at the surgery site. You can prepare to go home following surgery without an overnight stay, depending on the success of your surgery.
Is testicular cancer treatment right for me?
If you have been diagnosed with testicular cancer, it is best to listen to your care team’s recommendations about treatment. Depending on the stage of your cancer and the size of the tumors, surgery, chemotherapy, radiation, or a combination of these treatment methods can help eliminate cancer from your life completely.
Testicular cancer has very high cure rates, and many men live long, cancer-free lives after treatment. It’s important to know the symptoms and talk to your doctor right away if you think you may have testicular cancer.
