Testicular Cancer: The Basics

When cells in a testicle grow out of control, it is called testicular cancer. As the number of cells grow, they form a tumor. Most testicular cancers are germ cell tumors and there are two types:

• Seminoma: Tend to grow and spread more slowly than non-seminomas and there are two types: classical and spermatocytic.
• Nonseminoma: Often happens in men in their late teens to early 30s. There are four sub-types: Embryonal carcinoma, yolk sac carcinoma, choriocarcinoma, and teratoma. 

Your providers will need to figure out what type of testicular cancer you have to create a treatment plan.

Risk Factors

Risk factors for testicular cancer are:

• History of an undescended testicle or testicle that does not develop normally.
• History of Klinefelter’s Syndrome.
• HIV infection/immunosuppression.
• Caucasian race.
• Family history of testicular cancer.

Screening

There are no routine screening tests for testicular cancer. You should examine your testicles monthly. Call your healthcare provider if you feel any lumps, changes in how your testicles feel, or changes in the shape/size of your testicles.

Symptoms of Testicular Cancer

Symptoms may be:

• A painless lump or swelling in either testicle or a change in the way it feels.
• A feeling of heaviness in the scrotum.
• A collection of fluid in the scrotum.
• Pain or discomfort in the scrotum.
• Breast growth or pain. This is because of changes in hormone levels.

These can also be signs of other issues. If you have any of these symptoms, talk to your healthcare provider.

Diagnosis of Testicular Cancer

When your healthcare provider thinks you may have testicular cancer, they will order more tests, like:

• Ultrasound.
• Blood tests.
• Imaging tests: Chest x-ray, CT/MRI scan of the belly, bone scan and PET scan.
• Surgery to remove the affected testicle (called an orchiectomy).

Testicular cancer and its treatments can affect your ability to father a child. Talk with your provider before treatment about your options to be able to father a child in the future.

Staging Testicular Cancer

To guide treatment, testicular cancer is "staged." The stages are based on:

• Size of the tumor and where it is.
• If cancer cells are found in the lymph nodes.
• Level of serum tumor markers.
• If cancer cells are found in other areas of the body.

This information is combined to give a stage from 0-IIIC, with IIIC being the most advanced.

Treatment

Testicular cancer treatment depends on the tumor type, how aggressive it is, and the stage. A second opinion can help you learn more about your options. Your oncology team will help you figure out the treatment that is best for you.

• Surgery: Removing the testicle and cancer, in some cases, area lymph nodes to see if the tumor has spread. Surgery may also be used after chemotherapy.
• Radiation: Radiation therapy may be used after surgery in seminomas to treat known disease or to prevent recurrence (the cancer coming back).
• Chemotherapy: Chemotherapy may be used after surgery to kill any remaining cancer cells and prevent recurrence. In some cases, high dose chemotherapy is given followed by an autologous stem cell transplant.

This article is a basic guide to testicular cancer. Learn more about testicular cancer.