Testicular Cancer: Overview

What is testicular cancer?

Cancer starts when cells change (mutate) and grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas. They can spread to other parts of the body, too. This is called metastasis.

Testicular cancer is cancer that starts in the cells that make up your testicle.

The testicles are the male sex glands and are part of the male reproductive system. Testicles are also called testes or gonads. They're inside a pouch of skin (scrotum) that's under the penis. The testicles make sperm. Sperm are the male cells needed to fertilize a female egg cell. The testicles also make male hormones, including testosterone. These hormones control the development of the reproductive organs. They also control other things, such as body and facial hair and a lower voice.

Who is at risk for testicular cancer?

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. But risk factors can make it more likely for a person to have cancer. Some risk factors may not be in your control. But others may be things you can change.

The risk factors for testicular cancer include:

• Being in your 20s or 30s, though it can happen at any age

• Being white

• History of cancer in the other testicle

• Undescended testicle

• A family history of testicular cancer, which can put you at a higher risk

• HIV infection

• Using marijuana often or over a long time

Talk with your healthcare provider about your risk factors for testicular cancer and what you can do about them.

Can testicular cancer be prevented?

Researchers don’t yet know how to prevent this type of cancer.

Are there screening tests for testicular cancer? 

There are no blood tests used to screen for testicular cancer in men without symptoms. But doing a testicular self-exam (TSE) regularly may help you find cancer early. Some healthcare providers advise a TSE once a month after puberty. The American Cancer Society (ACS) doesn't have advice for how often it should be done. The ACS does advise that men be aware of testicular cancer and see a healthcare provider right away if a lump on the testicle or any of these other symptoms are found:

• Swelling of a testicle

• Pain or aching in a testicle or the scrotum

• Changes in how a testicle feels

• Dull ache in the lower belly (abdomen)

• Heavy feeling in the lower belly

Have your healthcare provider check any swellings or lumps you find.

What are the symptoms of testicular cancer?

Symptoms of testicular cancer can include:

• A lump on your testicle that may not hurt, but can be uncomfortable

• Swelling of a testicle

• A feeling of heaviness or aching in the scrotum or lower belly (abdomen)

• Swelling in your breasts (rare)

• Pain in your lower back, which can be a sign that the cancer that has spread

• Shortness of breath, pain in the chest, or a cough, which can be signs that the cancer may have spread to your lungs

Many of these changes can be caused by other health problems. But it's important to see a healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

How is testicular cancer diagnosed?

If your healthcare provider thinks you may have testicular cancer, exams and tests will be done to be sure. Your healthcare provider will ask you about your health history, your symptoms, risk factors, and family history of disease. A physical exam will be done. During the exam, your testicles will be checked for swelling, sore areas, or lumps. If there is a lump, your healthcare provider will note its size and where it is. The provider may also carefully check your belly (abdomen), groin, and other parts of your body. This is to look for signs of any tumors that may have spread.

You may also have one or more of these tests or procedures:

• Ultrasound

• Blood tests

• Surgery to remove the affected testicle

After a diagnosis of testicular cancer, you may need more tests. These help your healthcare providers learn more about your overall health and the cancer. They're used to find out the stage of the cancer. The stage is how much cancer there is and how far it has spread (metastasized) in your body. It's one of the most important things to know when deciding how to treat the cancer.

Once your cancer is staged, your healthcare provider will talk with you about what this means for your treatment. Ask your provider to explain the details of your cancer to you in a way you can understand.

How is testicular cancer treated?

Your treatment choices depend on the type of testicular cancer you have, test results, and the stage of the cancer. The goal of treatment may be to cure you, control the cancer, or help ease problems caused by the cancer. Talk with your healthcare team about your treatment choices, the goals of treatment, and what the risks and side effects may be. Other things to think about are how your body will look and work after treatment, if treatment will affect your fertility, and your overall health.

Types of treatment for cancer are either local or systemic. Local treatments remove, destroy, or control cancer cells in one area. Surgery and radiation are local treatments. Systemic treatment is used to destroy or control cancer cells that may have traveled around your body. When taken by pill or injection, chemotherapy (chemo) is a systemic treatment. You may have just one treatment or a combination of treatments.

Several types of treatment can be used for testicular cancer. These include:

• Surgery

• Chemotherapy

• Radiation therapy

Talk with your healthcare providers about your treatment choices. Make a list of questions. Think about the benefits and possible side effects of each choice. Talk about your concerns with your healthcare provider before making a decision.

What are treatment side effects?

Cancer treatments, such as chemo and radiation, can damage normal cells. This can cause side effects like hair loss, mouth sores, and vomiting. Talk with your healthcare provider about side effects linked with your treatment. There are often ways to manage them. There may be things you can do and medicines you can take to help prevent or control many treatment side effects.

Testicular cancer and its treatment may affect your fertility, the way your scrotum looks, and your interest in sex. This may last a short time, or might be permanent. The effects vary from person to person. It's important to talk about this before starting treatment. For instance:

• You may want to save your sperm so you can have children later. This is called sperm banking. It needs to be done before treatment starts.

• You may choose to have a testicle implant put in your scrotum after your testicle is removed. This can help your scrotum look and feel more natural.

• Testosterone supplements may be needed. Keeping your testosterone level in the normal range can help your mood, sex drive, and ability to get erections. It can also help maintain your bone and muscle mass.

Coping with testicular cancer

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be hard on your mind and body. Keep talking with your healthcare team about any problems or concerns you have. Work together to ease the effect of cancer and its symptoms on your daily life.

Here are some tips:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group in person or online.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet with a focus on high-protein foods.

• Drink plenty of water, fruit juices, and other liquids.

• Keep physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

When should I call my healthcare provider?

Your healthcare provider will talk with you about when to call. You may be told to call if any of the following occur:

• New symptoms or symptoms that get worse

• Signs of an infection, such as a fever

• Side effects of treatment that affect your daily function or don't get better with treatment

Ask your healthcare provider what signs to watch for and when to call. Know how to get help after office hours and on weekends and holidays.

Key points about testicular cancer

• Testicular cancer is cancer that starts in the cells that make up your testicle.

• The testicles are the male sex glands and are part of the male reproductive system. They're inside a pouch of skin (scrotum) that's under the penis.

• Symptoms can include a lump on the testicle, swelling of a testicle, or a heavy feeling or ache in the scrotum or lower belly (abdomen).

• Treatment may include surgery, chemotherapy, or radiation therapy.

• Testicular cancer and its treatment may affect your fertility, the way your scrotum looks, and your interest in sex. Talk about this before starting treatment.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends.