Testicular Cancer
Here’s something important to know right away: testicular cancer is highly treatable. In fact, it has one of the highest cure rates of all cancers, especially when caught early. Even if it has spread, treatment is often very successful.
Who Gets It?
Unlike most other cancers, testicular cancer tends to strike younger men. It’s most common between ages 15 and 35, though it can happen at any age. It’s relatively rare overall, but it’s the most common cancer in young men.
Warning Signs
The good news about testicular cancer is that it’s often easy to find early because you can feel changes in your testicles
The most common sign is:
A lump or swelling in either testicle:
A feeling of heaviness in the scrotum
A dull ache or pain in the lower belly, groin, or testicle
Sudden buildup of fluid in the scrotum
Pain or discomfort in a testicle or the scrotum
Enlargement or tenderness of the breast tissue (rare, but can happen because some tumors produce hormones)
Back pain (if the cancer has spread to lymph nodes in the back)
Risk Factors
Doctors don’t know exactly what causes testicular cancer, but certain things can raise your risk:
- Undescended testicle (cryptorchidism): This is the biggest risk factor. Boys born with a testicle that never moved down into the scrotum have a higher risk, even if it’s surgically corrected later.
- Family history: If your father or brother had testicular cancer, your risk is higher.
- Personal history: If you’ve had cancer in one testicle, you have a higher risk of getting it in the other.
- Race: White men have a higher risk than men of other races.
- HIV infection: Some studies suggest men with HIV may have a higher risk.
- Age: Again, it’s most common in young and middle-aged men.
Types of Testicular Cancer
There are two main types, and they grow and spread differently:
Seminomas: These tend to grow more slowly and are very sensitive to radiation. They’re most common in men in their 30s and 40s.
Non-seminomas: These tend to grow faster and are more common in men in their 20s and 30s. They include several different cell types.
Some tumors have both seminoma and non-seminoma cells.
Diagnosis
If you or your doctor finds a lump, the next steps usually include:
Ultrasound
This is the main imaging test. It uses sound waves to create a picture of the scrotum and can tell if a lump is solid (more likely cancer) or filled with fluid (usually a cyst).
Blood tests
Testicular cancers often produce certain proteins that show up in blood tests. These “tumor markers” help with diagnosis and are also used to track how well treatment is working.
Inguinal orchiectomy
If cancer is suspected, surgery to remove the entire testicle through a small cut in the groin is usually done. The testicle is then sent to a lab to confirm the diagnosis. This is both a diagnostic procedure and the first step in treatment.
Treatment Options
Testicular cancer treatment is very effective. The approach depends on the type and stage.
Surgery: Removing the affected testicle (orchiectomy) is almost always the first step. Sometimes lymph nodes in the back of the abdomen are also removed.
Surveillance: For early-stage cancers, doctors may recommend regular monitoring after surgery, with no further treatment unless the cancer returns.
Chemotherapy: Drugs that kill cancer cells throughout the body. Very effective for testicular cancer.A dull ache or pain in the lower belly, groin, or testicle
Radiation therapy: High-energy beams to kill cancer cells. Used mainly for seminomas.
Stem cell transplant: For cancers that don't respond to standard chemotherapy, high-dose chemo followed by a transplant of your own stem cells may be an option.
Most men with testicular cancer can be cured. Even with advanced disease, the cure rate is still very high.
Life After Treatment
Losing a testicle doesn’t affect your ability to have children or maintain an erection in most cases. The remaining testicle produces enough testosterone and sperm. Some men choose to have a prosthetic (artificial) testicle placed for cosmetic reasons.
Fertility can be affected by some treatments, especially chemotherapy. If having children is important to you, talk to your doctor about sperm banking before starting treatment.
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