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Topic Overview

What is testicular cancer?

Testicular cancer occurs when cells that are not normal grow out of control in the testicles (testes). It is highly curable, especially when it is found early.

The testes are the two male sex organs that make and store sperm. They are located in a pouch below the penis called the scrotum. The testes also make the hormone testosterone.

Testicular cancer is not very common. It affects mostly young males between the ages of 15 and 35 who are white.¹

This topic covers seminoma and nonseminoma cancer. It does not cover non-germ cell testicular cancers, such as Leydig cell tumors.

What causes testicular cancer?

Experts don't know what causes testicular cancer. But some problems may increase your chances of getting it. These include:

• Having a testicle that has not dropped down into the scrotum from the belly. This is called an undescended testicle. Normally, a baby's testicles drop down into his scrotum before he is born or by the time he is 3 months old.
• Klinefelter syndrome. This is a genetic problem that affects males. Normally, males have one X and one Y chromosome. Males with Klinefelter syndrome have at least two X chromosomes and, in rare cases, as many as three or four.
• A personal or family history of testicular cancer.

Most men who get testicular cancer don't have any risk factors.

What are the symptoms?

The most common symptoms of testicular cancer include:

• A change in the size or shape of one or both testes. You may or may not have pain.
• A heavy feeling in the scrotum.
• A dull pressure or pain in the lower back, belly, or groin, or in all three places.

How is testicular cancer diagnosed?

Most men find testicular cancer themselves during a self-examination. Or your doctor may find it during a routine physical exam.

Because other problems can cause symptoms like those of testicular cancer, your doctor may order tests to find out if you have another problem. These tests may include blood tests and imaging tests of the testicles such as an ultrasound or a CT or CAT scan. These tests can also help find out if cancer has spread to other parts of your body.

How is it treated?

Nearly all men with testicular cancer begin treatment with surgery to remove the testicle that has cancer. This surgery is called radical inguinal orchiectomy (say "IN-gwuh-nul or-kee-EK-tuh-mee"). Removing the testicle allows your doctor to find out the type of cancer cells you have. It also helps him or her plan any other treatment you may need.

Treatment after surgery may include:

• Surveillance. You may be able to wait and watch to see what happens. During surveillance, you will have regular checkups with your doctor to make sure that the cancer is gone.
• Chemotherapy. This is powerful medicine that destroys cancer cells that remain after surgery.
• Radiation therapy. This is a high dose of X-rays used to destroy cancer cells. It is mostly used to treat a kind of cancer called seminoma. But it is sometimes used after surgery to kill leftover cancer cells. Radiation therapy can also be used to treat cancer that has spread beyond the testes.
• Additional surgery to remove lymph nodes. This surgery is called retroperitoneal lymph node dissection (RPLND).

Chemotherapy is often used for cancer that has spread to other parts of the body. In some cases, surgery is used to remove that kind of cancer.

How will having testicular cancer affect you?

In most cases, removing a testicle does not cause long-term sexual problems or make you unable to father children. But if you had these problems before treatment, surgery may make them worse. Also, other treatments for cancer may cause you to become infertile. You may want to think about saving sperm in a sperm bank. Talk to your doctor if you have any questions or concerns about sexual problems or whether you can father children.

Some men choose to get an artificial, or prosthetic, testicle. A surgeon places the artificial testicle in the scrotum to keep the natural look of the genitals.

Unlike many other kinds of cancer, most testicular cancers grow slowly and respond well to treatments such as chemotherapy and radiation therapy. But these treatments can cause side effects. Most of the time, the side effects last only a little while, but there also are longer-term side effects from treatments.

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