Testicular cancer

Testicular cancer mainly affects men in their 20s and 30s, although it can occur at any age. At Atrium Health Floyd and Harbin Clinic, our cancer care program is an accredited Comprehensive Community Cancer Program. Our specialists work with you to ensure you get the care you need.

What is testicular cancer?

Testicular cancer is a rare type of cancer that develops in the testicles (testes), which are part of the male reproductive system. The testicles produce hormones and sperm.

Causes of testicular cancer

It’s not clear what causes testicular cancer. In general, cancer happens when there’s a change in one or more genes that control cell growth. Cells begin to divide too fast, forming a tumor.

Doctors have identified specific genetic changes that often occur in testicular cancer cells. Research is focused on understanding why these changes happen and how they cause cancer.

Testicular cancer types

More than 95% of testicular cancers are tumors that begin in sperm-making cells called germ cells. There are two types of germinal tumors:

• Seminomas: Cancer starts in cells in the early stages of sperm development.
• Nonseminomas: Cancer starts in cells that are more mature.

Seminomas tend to grow slower than nonseminomas. Some tumors are mixed and have both seminoma and nonseminoma cancer cells.

Testicular cancer symptoms & diagnosis

A lump or swelling of the testicle is usually the first sign of testicular cancer. You may notice a lump or swelling yourself, or your doctor might find it during a routine physical exam.

Other symptoms include pain or discomfort in the testicle and an ache in the lower abdomen or groin.

Tests to determine whether a change is cancer include:

• Ultrasound imaging of the testicle to evaluate the lump
• Blood tests to check for tumor markers (proteins and enzymes produced by cancer cells)
• Surgical removal of the testicle to look for cancerous cells
• Imaging tests, such as X-ray, CT, MRI and positron emission tomography (PET), to determine if cancer has spread

Testicular cancer risk factors

Factors that increase the risk of testicular cancer include:

• Age between 20 and 39
• Family history of testicular cancer
• HIV infection
• History of undescended testicles
• Previous cancer in the other testicle
• White race and American Indian and Alaska Native ethnicity

There is no evidence that previous vasectomy or testicular injury increases the likelihood of testicular cancer.

Testicular cancer prevention

Performing a testicular self-examination each month may help detect testicular cancer at an early stage, before it spreads. Medical opinions vary on the benefits of testicular self-exam. Talk to your doctor about whether a routine self-exam is right for you.

Testicular cancer treatment

Treatment for testicular cancer depends on the tumor type and stage. Staging is the process of determining how advanced the cancer is. It’s based on tumor size, the spread of cancer to lymph nodes and distant sites and the presence of tumor markers. For testicular cancer, stages range from 0 (least advanced) to III (most advanced).

Surgery to remove the testicle is usually the first step of treatment, if it wasn’t already removed for diagnosis. The surgeon may also remove nearby lymph nodes to check for cancer cells. Chemotherapy and radiation therapy are often used after surgery to prevent cancer from coming back or treat cancer that has spread to other areas.

For advanced cancers, high-dose chemotherapy with stem cell transplant may be an option. High doses of chemotherapy work well at destroying cancer cells. They also destroy the tissue inside your bones that makes new blood cells. A stem cell transplant replaces this blood-forming tissue.

Testicular cancer is highly treatable, but there is a risk of testicular cancer developing in the other testicle. Treatment can also affect appearance, fertility and overall health. Your care team will develop a plan for ongoing care to help you live a full, healthy life after treatment.