Testicular Cancer

Overview 

The testicles (testes) are responsible for the production of male hormones such as testosterone and sperm for reproduction. They are the male sex gland. Cancer of the testicles can occur in one or both of the testicles. This type of cancer is more common in men who have had abnormal testicle development, have an undescended testicle or have a family history of testicular cancer. 

Testicular cancer starts in the germ cells – cells within the testicles that produce sperm. There are two types of testicular germ cell tumors: seminomas and nonseminomas.

Testicular cancer causes

Researchers continue to work to uncover the causes of testicular cancer. But today, there is no known exact cause. Certain risk factors may contribute to the development of testicular germ cells becoming cancer cells. What we do know is that testicular cancer occurs when changes in the DNA of normal testicular cells occur. 

Testicular cancer risk factors

Understanding what raises your risk for certain cancers can help you make an informed decision about the risk factors you can change. Other risk factors, such as a person’s age or family history, cannot be changed.

Several factors may influence the risk of getting testicular cancer. These include:

• Having an undescended testicle
• Having had abnormal development of the testicles
• A family history of testicular cancer

Testicular cancer symptoms

Many testicular cancers can be found early – especially when they are small and haven’t spread. Testicular cancer is usually found when symptoms, such as a lump, are felt. Some testicular cancers might not cause any symptoms. The most common symptoms include: 

• A change in how the testicle feels
• A dull ache in the abdomen or groin
• A feeling of heaviness in the scrotum
• A lump or swelling in either testicle
• A sudden build-up of fluid in the scrotum
• Back pain
• Pain or discomfort in a testicle 

Testicular cancer diagnosis

With testicular cancer screening, doctors recommend that men examine their testicles monthly after puberty. If you feel any changes, please talk with your doctor. Your urologist may use the following methods to help determine the cause of your symptoms:

• Medical history and testicular exam - this helps doctors understand your current symptoms and how long you’ve had them.
• Advanced imaging - imaging such as an ultrasound of the testicles uses sound waves to produce images of the inside of your body. 
• Blood tests for tumor markers - some blood tests can help diagnose testicular cancer since many testicular cancers have high levels of certain proteins.

Testicular cancer treatments

One of the most important factors in treatment is the stage of testicular cancer. Staging is based on how much cancer has spread when first diagnosed. For cancer that hasn’t spread, urologic oncologists determine treatment based on the growth of the tumor. Age, overall health and personal preferences are also considered. Treatment may include:

• Chemotherapy - therapy that uses drugs injected through IV, taken orally (by mouth) or applied to the skin to attack and kill cancer cells.
• Radiation therapy - therapy that uses high-energy radiation to shrink tumors and kill cancer cells.
• Radical inguinal orchiectomy - a surgery to remove a testicle with cancer. 

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing an oncologist for more specialized treatment.