Testicular cancer is a cancer that starts in the testicles (testes), the organs that produce male sex hormones and sperm. Compared to other cancers, testicular cancer is rare. But, according to the American Cancer Society (ACS), the incidence rate of testicular cancer (mostly in the seminoma type) has been increasing in the U.S. and many other countries for several decades. It is the most common cancer in American middle-aged men or males between the ages of 15 and 35. This year alone, the ACS estimates that 9,470 new cases of testicular cancer will be diagnosed and will result in an estimated 440 deaths.

Fortunately, testicular cancer is highly treatable and the outcome for most men diagnosed is favorable. Here’s what you should know.

What are the symptoms of testicular cancer?

Signs and symptoms may include a painless lump or swelling in the scrotum, hardness, pain or discomfort in the testicle, and a dull ache in the lower abdomen, back or groin area.

How is testicular cancer diagnosed?

Sometimes testicular cancer is found by the patient during a self-exam. It can also be found by a doctor during a routine physical or by a urologist who you are seeing for symptom relief.

How is testicular cancer treated by type and stage?

If caught in the early stages, testicular cancer is generally treated with surgery. Depending on the pathologic type (seminoma vs. non-seminoma), surgery is followed by chemotherapy or radiation therapy. If the cancer is caught early enough, surgery may be all that is needed. Luckily, with the various treatment options available, testicular cancer is one of the most curable types of cancers.

Who treats testicular cancer?

Depending on the type and stage, testicular cancer is treated by urologists, medical oncologists, and radiation oncologists.

Are there side effects of treatment or surgery?

Side effects vary depending on the treatment.  

Radiation Therapy side effects:

Side effects depend on the dose but include fatigue, nausea, diarrhea, loss of appetite, and skin changes at the radiation site. It also can interfere with sperm production and may affect fertility.

Chemotherapy side effects:

Side effects are dependent on the drugs and dose, but common side effects include nausea, hair loss, fatigue, diarrhea, vomiting, chills, fever, coughing, shortness of breath, mouth sores or skin rash. Other side effects are dizziness, numbness, loss of reflexes and difficulty hearing. Men who receive very high doses of chemotherapy may experience destruction of bone marrow and require a bone marrow transplant. Some cancer drugs reduce sperm count. Most patients recover their fertility, but it can be permanent in others. This should be discussed with a doctor.

Sometimes, the cancer can be removed through small incisions in the abdomen. However, depending on the type and stage, a radical inguinal orchiectomy—removal of the tumor through an opening made just above the pubic area—may be necessary. Short-term risks would include anesthesia reactions, excess bleeding and clots, or infection. Losing a testicle will not affect sexual activity or chances of reproduction, but if both testicles are removed, sex drive decreases and a man becomes infertile.

Although testicular cancer can affect fertility outcomes, many survivors are able to maintain fertility. Information is key, and you should always talk to your doctor about all possible options and outcomes.

Can testicular cancer come back after treatment?

Over 95% of men treated with testicular cancer are cancer-free at five years. For some, the cancer may come back. Therefore, surveillance is critical. Depending upon how it presents the second time, treatment such as chemotherapy or localized radiation may be prescribed. It’s possible that surgery would be needed. 

Summit Health Care

At Summit Health, we use a multidisciplinary approach to care that is individualized to each patient’s stage of cancer. We offer a variety of treatment options including standard and minimally invasive surgery, as well as chemotherapy and radiation therapy.

Do not dismiss any pain, lumps, or changes in the testicles, and seek immediate professional care if you have any concerns.

Helpful links:

SMG Urology Department
SMG Oncology Department
SMG Radiation Oncology Department