Testicular Cancer

What Is Testicular Cancer?

Testicular cancer is when unusual cells grow out of control in the tissue of one or both of your testicles. Also called testes, these are the two oval-shaped organs that hang from the base of a man’s torso. They’re a little smaller than a golf ball. They rest in a sac of skin known as the scrotum, beneath the penis. They make sperm as well as hormones such as testosterone.

Testicular cancer is generally rare, but it’s the most common form in males 15 to 34. It’s also one of the easiest cancers to cure. About 95% of men who have it live more than 5 years after they’re diagnosed.

Most testicular cancers are one of two main types:

Seminomas. These are slow-growing and slow-spreading tumors.

Nonseminomas. These are usually made up of more than one type of cancer cell. They grow and spread more quickly.

Growths called stromal tumors happen in the tissues that make hormones inside your testicles. They’re often harmless but can be cancerous. They make up about 5% of cases in men and about 20% of cases in boys.

Testicular Cancer Symptoms

Signs of this type of cancer include:

  • A painless lump on your testicle
  • Swelling or a feeling of weight in your scrotum, with or without pain
  • Fluid collecting in your testicles
  • Pain or a dull ache in your scrotum or groin
  • Soreness or changes in breast tissue
  • Early signs of puberty in a younger boy

Testicular Cancer Causes and Risk Factors

Doctors aren’t sure what causes testicular cancer. Some studies suggest that you’re more likely to get it if you have:

  • Testes that didn’t form or descend the way they should
  • A father or brother who had it
  • HIV, the virus that causes AIDS

About half of all cases are in men in their 20s and early 30s. White men are as much as five times more likely than African American or Asian American men to get testicular cancer.

Testicular Cancer Diagnosis

You can often find a tumor by examining yourself. Do it during or after a warm bath or shower, when your skin is relaxed.

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While standing, gently but firmly roll each testicle between your thumb and fingers. If you find a small, hard lump, pain, or swelling, tell your doctor. Keep in mind that it’s normal for one of your testicles to be larger than the other.

You may feel a cordlike tube on top and in back of your testicle. This is called the epididymis. It’s about an inch long and is sensitive but shouldn’t be painful to touch. Don’t mistake it for a lump.

Your doctor will examine your testes during a routine physical exam. If they think something doesn’t seem right, they may order tests to rule out other conditions or confirm a diagnosis. These include:

Ultrasound . This uses sound waves to make a picture of your testicles. It can tell whether growths are more likely to be cancer or something harmless.

For this painless test, you’ll lie on your back on an exam table. A technician spreads a clear gel over your scrotum and then moves an ultrasound device over your scrotum.

Blood test. Your doctor might want to test your blood. Testicular cancers often make proteins or enzymes that can be found in your blood. If you have cancer, the tests might tell your doctor which type you have and whether it’s likely to have spread.

Biopsy . Your doctor might remove a bit of tissue from your testicle to check it for cancer. This is called a biopsy. There’s a chance that it could cause cancer to spread, so your doctor might do it only in the operating room. A technician will look at the tissue right away, and if it’s cancerous, your doctor will take out your testicle.

Often, your doctor will remove the whole testicle instead of doing a biopsy.

If your doctor finds a tumor, they’ll do more tests to make sure cancer hasn’t spread. Those tests might include X-rays or other types of scans.

Testicular Cancer Stages

A cancer diagnosis usually includes a number, called a stage, that’s based on whether it’s spread and how far.

  • In Stage 0, the cancer is found only in small tubes inside your testicle called seminiferous tubules.
  • In Stage I, cancer is limited to your testicle and tissues close to it.
  • In Stage II, it’s spread to the lymph nodes in your abdomen.
  • In Stage III, cancer has spread to distant lymph nodes or other organs like your lungs, liver, or brain. This is called metastasis.

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Testicular Cancer Treatment

Your treatment will depend on several things including your diagnosis, your overall health, and whether you want to have children later on. Talk with your doctor about what might work best for you.

If your cancer is in the earliest stages, your doctor might suggest simply keeping an eye on it for growth or other changes.

In the later stages, you could have one or more of these forms of treatment:

Surgery

Most men with testicular cancer have surgery, often to remove a testicle. This is called orchiectomy. Your doctor can replace the testicle with a prosthetic if you choose. They might also need to take out some lymph nodes.

Radiation therapy

This kills cancer cells on your testicle or in your lymph nodes. Your doctor will use a machine to send radiation into certain spots on your body.

Chemotherapy

Some drugs can kill cancer cells throughout your body or stop them from dividing. You take these medicines by mouth or through a shot in a vein or muscle. 

These drugs may also kill healthy cells, including those that make blood.

If you have chemotherapy, you may follow it up with a stem cell treatment. You’ll get stem cells that will grow into healthy blood cells. They could be your own, or they could come from another person.

Testicular Cancer Complications

About 3% to 4% of men who’ve been treated for cancer in one testicle will get it in the other. Get regular checkups, and watch for changes in your body.

Removal of one testicle probably won’t affect your sex life or your fertility, but testicular cancer can raise your risk of infertility and low testosterone. You might choose to bank your sperm before treatment. Your testosterone levels will rise again over time.

Chemotherapy can cause problems with your lungs, kidneys, heart, blood vessels, nerves, or hearing. Talk to your doctor about how to manage these risks.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on February 02, 2020

Sources

SOURCES:

National Cancer Institute: “General Information About Testicular Cancer,” “SEER Stat Fact Sheets: Testis Cancer,” “Testicular Cancer Screening,” “Testicular Cancer Treatment (PDQ) – Patient Version.”

National Center for Biotechnology Information, “Glossary Database.”

American Cancer Society, “What Is Testicular Cancer?” “How is testicular cancer diagnosed?” “Risk Factors for Testicular Cancer,” “Tests for Testicular Cancer.”

Urology Care Foundation, “How Do You Do a Testicular Self-Exam?”

National Library of Medicine.

Urology Care Foundation: “What is Testicular Cancer?”

National Organization for Rare Disorders: “Testicular Cancer.”

Mayo Clinic: “Testicular cancer.”

American Society of Clinical Oncology: “Testicular Cancer: Follow-Up Care.”

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