Understanding the Basics of Testicular Cancer
Testicular cancer is a relatively rare form of cancer, but it is the most common cancer in young men aged 15 to 35. While it can be alarming to hear the word “cancer,” the good news is that testicular cancer is highly treatable, especially when detected early. If you or a loved one has been diagnosed, or if you're simply trying to learn more, understanding the basics can help you feel more in control. This blog will walk you through what testicular cancer is, common signs and symptoms, risk factors, how it’s diagnosed, and what treatment options look like.
What is Testicular Cancer?
Testicular cancer starts in the testicles (or testes), which are part of the male reproductive system. Most testicular cancers begin in the germ cells, which are the cells responsible for producing sperm. There are two main types of germ cell tumors:
Seminomas: These grow slowly and tend to respond well to treatment.
Non-seminomas: These grow more quickly and include different subtypes like embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma.
While other, rarer forms of testicular cancer exist, germ cell tumors make up over 90% of all cases.
Who Is at Risk?
Testicular cancer can affect anyone with testicles, but certain factors can increase your risk:
Age: Most commonly affects people between 15 and 35.
Undescended testicle (cryptorchidism): If a testicle never moved into the scrotum before birth, your risk is higher—even if it was later corrected with surgery.
Family history: Having a father or brother who had testicular cancer raises your risk.
Personal history: If you’ve had cancer in one testicle, your risk of developing it in the other is higher.
Race and ethnicity: White men are more likely to develop testicular cancer compared to men of other races.
Signs and Symptoms
One of the most important things you can do is be aware of the signs and symptoms of testicular cancer. Many cases are first discovered by the person themselves through self-exams or simply noticing something unusual. Common symptoms include:
A lump or swelling in one testicle (usually painless)
A feeling of heaviness in the scrotum
A dull ache in the lower abdomen or groin
Sudden collection of fluid in the scrotum
Pain or discomfort in a testicle or the scrotum
Enlargement or tenderness of breast tissue (in rare cases)
If you notice any of these signs, it's important to speak with your doctor promptly. Early detection significantly improves the likelihood of successful treatment.
How Is It Diagnosed?
Diagnosis typically begins with a physical exam and a discussion of your symptoms. If testicular cancer is suspected, your doctor may order:
Ultrasound: This imaging test helps visualize the testicles and can show if a lump is solid (more likely to be cancer) or fluid-filled (often benign).
Blood tests: Certain tumor markers, such as AFP (alpha-fetoprotein), HCG (human chorionic gonadotropin), and LDH (lactate dehydrogenase), can help confirm the diagnosis and determine the type of tumor.
Imaging tests: CT scans or X-rays may be used to see if the cancer has spread beyond the testicles.
If cancer is confirmed, the affected testicle is typically removed through a surgery called a radical inguinal orchiectomy, which also allows for further analysis of the tumor.
Treatment Options
Treatment depends on the type and stage of the cancer but may include:
Surgery: As mentioned, removing the affected testicle is usually the first step. In some cases, additional lymph nodes in the abdomen may also be removed.
Radiation therapy: This is often used for seminomas, especially if the cancer has spread to lymph nodes.
Chemotherapy: Non-seminomas are more likely to require chemotherapy, especially if the cancer has spread. Some advanced seminomas may also be treated with chemotherapy.
Surveillance: In cases where the cancer is caught very early, your doctor might recommend active surveillance, involving regular follow-ups and testing without immediate additional treatment.
Your care team will help you decide on the best approach based on the type, stage, and specific characteristics of your cancer, as well as your overall health and personal preferences.
Fertility and Emotional Considerations
Treatment for testicular cancer, particularly surgery and chemotherapy, can affect fertility. If you are planning to have children in the future, it’s important to talk to your care team about sperm banking before treatment begins. Additionally, being diagnosed with cancer can bring a range of emotions—fear, anxiety, frustration—and it’s completely normal to need support. Counseling, support groups, and talking openly with loved ones can all play a helpful role in your emotional well-being.
When to Talk to Your Care Team
If you’re experiencing any symptoms, have a family history of testicular cancer, or just want to understand your risk better, don’t hesitate to start a conversation with your healthcare provider. Regular self-exams and knowing what feels normal for your body can go a long way in catching issues early.
Testicular cancer is highly treatable, especially when detected early. Understanding the symptoms, risk factors, and treatment options can help you feel more confident and proactive in your healthcare decisions. Whether you're navigating a diagnosis or supporting someone who is, education and communication with your care team are key to making informed choices that support your well-being.
Written By: Carolyn Vandenbroek, MSDM
Reviewed By: Srilata Gundala, MD
