Testicular cancer is rare, but it most often affects men between the ages of 15 and 40. It is one of the most treatable types of cancer when detected early and accounts for a small percentage of all cancer cases.
Recognizing the signs early is essential, and regular self-exams and medical check-ups play a key role in early detection and successful treatment.
This article provides general information on testicular cancer, including symptoms, risks, and treatment options, to support informed discussions with healthcare providers.
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What's Testicular Cancer?
Testicular cancer occurs when abnormal cells grow uncontrollably in the testicles the male reproductive glands in the scrotum. While relatively rare overall, it is the most common cancer in young men.
There are two main types:
- Germ Cell Tumors (GCTs): The most common type, including seminomas (slow-growing) and non-seminomas (faster-growing, more aggressive).
- Non-Germ Cell Tumors: These are rare and develop in the supportive tissues of the testicle.
How Common Is It?
Although testicular cancer is rare, cases have been increasing worldwide. It makes up 1% of all male cancers and 5% of urological cancers.
In the U.S., it is most frequently diagnosed in men aged 20 to 34 and is more common in white men than in other racial groups. The five-year survival rate is over 95%, which is highly treatable if caught early.
What Increases the Risk of Testicular Cancer?
Testicular cancer is linked to both genetic and environmental factors.
Genetic Factors
Some men inherit a higher risk of testicular cancer due to their family history or specific genetic conditions.
- Family History: Having a father or brother with testicular cancer increases risk.
- Genetic Mutations: Changes in specific genes, especially those affecting chromosome 12p, have been linked to testicular cancer.
- Testicular Dysgenesis Syndrome (TDS): A condition where the testicles don't develop normally, increasing the likelihood of cancer.
Environmental and Health-Related Factors
Certain medical conditions, exposures, or infections may increase the risk of developing testicular cancer.
- Undescended Testicle (Cryptorchidism): If a testicle does not move downward into the scrotum before birth, the risk of cancer is 2 to 4 times higher.
- Previous Testicular Cancer: If you've had cancer in one testicle, there is a higher risk of developing it in the other.
- Hormonal Exposure Before Birth: Some research suggests that exposure to high estrogen levels in the womb may contribute to testicular cancer.
- Viral Infections: Certain viruses, including human papillomavirus (HPV) and Epstein-Barr virus (EBV), may increase risk.
- Testicular Injury: While not a significant cause, repeated trauma to the testicles may be linked to cancer development.
Symptoms of Testicular Cancer
Testicular cancer often develops without causing pain, so it's essential to recognize any unusual changes.
The most common early sign is a painless lump or swelling in the testicle. Other symptoms may include:
- Enlargement or noticeable change in one or both testicles
- A feeling of heaviness in the scrotum
- Sudden scrotal fluid buildup
- A dull ache in the lower abdomen or groin
- Discomfort or pain in the testicle or scrotum
- Shrinking of a testicle (testicular atrophy)
These symptoms don't always mean cancer, but it's important to see a doctor right away for further evaluation if you notice any changes. Early detection significantly improves treatment success.
How Testicular Cancer Is Diagnosed
To diagnose testicular cancer, doctors use a combination of exams and tests, including:
- Physical Exam: A doctor checks for lumps, swelling, or other testicular abnormalities.
- Ultrasound: An imaging test involving using sound waves to create detailed pictures of the testicles, helping determine whether a lump is solid (potentially cancerous) or fluid-filled (likely benign).
- Blood Tests (Tumor Markers): Certain proteins—alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and lactate dehydrogenase (LDH)—can be elevated in testicular cancer.
- Orchiectomy (Testicle Removal and Biopsy): If cancer is suspected, the affected testicle is surgically removed and examined under a microscope for confirmation.
- Imaging Tests (CT Scan, X-ray, MRI): These tests help determine whether cancer has spread beyond the testicles.
Treatment for Testicular Cancer
Testicular cancer is highly treatable, mainly when detected early. Treatment options depend on the type and stage of the cancer and overall health.
The main treatment approaches include surgery, chemotherapy, radiation therapy, and immunotherapy.
Surgery
Surgery is often the first-line treatment for testicular cancer. The most common procedures include:
- Radical Inguinal Orchiectomy (Testicle Removal): This procedure removes the impacted testicle through an incision in the groin. If cancer hasn't spread, this might be the only treatment needed.
- Retroperitoneal Lymph Node Dissection (Lymph Node Removal): If cancer has spread beyond the testicle, nearby lymph nodes in the abdomen may also be removed. Surgeons try to avoid nerve damage to preserve ejaculation function.
Chemotherapy
Chemotherapy involves using strong medications to kill cancer cells. It is often recommended after surgery to eliminate remaining cancer cells or when cancer has spread beyond the testicle.
Common side effects include nausea, fatigue, hair loss, and an increased risk of infection.
Radiation Therapy
Radiation therapy involves using high-energy X-rays to kill cancer cells. It is mainly used for seminoma-type testicular cancer, especially after surgery, to reduce the risk of recurrence.
Side effects may include nausea, fatigue, and lowered sperm count.
Immunotherapy
Immunotherapy is not a standard treatment for testicular cancer but may be explored in certain advanced cases through clinical trials.
Living with Testicular Cancer
Living with testicular cancer requires ongoing medical care and lifestyle adjustments, but most men maintain normal fertility, hormone levels, and overall health. Outcomes vary. Regular follow-up appointments, including blood tests and imaging, help detect recurrence early.
Maintaining a healthy lifestyle, managing stress, and staying physically active can support recovery and overall well-being.
Emotional support from counseling, support groups, or loved ones can help navigate the challenges of diagnosis and treatment.
With early detection and effective treatment, the long-term outlook is excellent, and most survivors lead healthy, fulfilling lives.
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Key Takeaways
- Testicular cancer is rare but most commonly affects men between 15 and 40. Early detection leads to highly successful treatment.
- The most common symptom is a painless lump or testicular swelling. Other signs include changes in size, heaviness, or discomfort.
- Diagnosis involves a physical exam, ultrasound, blood tests for tumor markers, and imaging to assess the spread of cancer.
- Treatment varies and depends on the cancer type and stage, with surgery as the primary approach, often followed by chemotherapy, radiation, or immunotherapy.
- With early diagnosis and proper treatment, survival rates exceed 95%. Most men maintain normal hormone levels, fertility, and long-term health with regular follow-ups.
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