Testicular cancer might sound like a sensitive topic — and not necessarily an easy one to talk about. But there are some facts that might be helpful to know. First, it’s actually quite rare and treatable, according to cancer.org. In fact, a man’s lifetime risk of dying from testicular cancer is about 1 in 5,000.1 You may have a better shot at catching a foul ball at a Major League Baseball game.2 These odds don’t mean you shouldn’t take this seriously. Knowing the signs of testicular cancer, and when to see a doctor can increase your chances for a successful treatment.
Testicular cancer starts in the testes, which is part of the male reproductive system. In an adult male, each testis is usually a little smaller than a golf ball. They sit nestled inside a protective sac of skin called the scrotum. Their main functions are to make hormones (like testosterone) and sperm. There are different types of cells that make up the testes, and any one of those cells could potentially develop cancer. If that happens, the first step is knowing which type (or types) of testicular cancer is there.
What are the types of testicular cancer?
There are a few different kinds of testicular cancer, and more than one can pop up at the same time. To keep things simpler, let's review the two main categories of testicular cancer — germ cell tumors and stromal tumors. If you're interested in taking a closer look, you can take a look at more information on subtypes. A germ cell tumor starts in the cells that make sperm and can be classified as a seminoma or non-seminoma. Here’s what we mean:3, 4
- Seminoma: This is the most common kind. Seminomas grow slowly and may be effectively treated with surgery, chemotherapy and radiation. Sometimes, active surveillance (keeping a close eye on it) is used for low-stage, or less aggressive, seminomas.
- Non-seminoma: This kind of germ cell tumor may grow more quickly and may be less responsive to treatment.
There’s another type of tumor called a stromal tumor. These are rarer, making up less than 5% of cases. They start in the supportive and hormone-producing tissue, or stroma. These tumors are typically either noncancerous or, if cancerous, may be cured with surgery.5
Sometimes, men find a lump through self-exams or by unintentionally noticing something abnormal. Otherwise, lumps may be found during an annual physical when your doctor does a regular check. But, just because there’s a lump may not mean it’s cancer. Your doctor may recommend a testicular ultrasound or blood tests (these check for tumor markers). If the results hint at the possibility of cancer, the testicle may need to be surgically removed to make the final diagnosis.5
The signs of testicular cancer are pretty straightforward. While most lumps are likely caused by something other than cancer, it’s always best to be aware and check in if there's anything new. Things like:6, 7
- Lump(s) in either testicle (most common and usually hard, but painless)
- Swollen testicle
- Dull ache in the groin
- Heaviness, pain or discomfort in the scrotum
- Sudden collection of fluid in the scrotum
- Enlarged or tender breasts (rare)
If you have any of these symptoms listed and they last for more than two weeks, visit your doctor.
The causes of testicular cancer are unknown. It seems to be a mystery what makes those germ cells (the most common place where tumors grow) become abnormal. There’s still quite a bit of research going on. However, some known risk factors include:7, 8
- An undescended testicle: This is when one or both testes don’t make it down from the abdomen (where they develop) into the scrotum. It happens in just 3% of boys, but it greatly increases the chance of getting testicular cancer.
- Family history: If your dad or brother have been diagnosed, your chances increase — but not by much.
- Age: Around half of cases happen in men between 20 and 34. But men all ages can be diagnosed, from infants to seniors.
- Race: White men are more likely to get testicular cancer.
Testicular cancer can be treated in a few ways, and the best option may depend on its type and severity. Talk with your provider about your specific situation. Here’s the breakdown of what you might expect:9, 10
- Surgery: Usually, surgery may be all that’s needed to get rid of the cancer. The testis is removed and might be replaced with a prosthetic. Your urologist might also want to take out nearby lymph nodes to prevent cancer from using those nodes as a highway to maybe spread to other parts of your body. After surgery, you’ll likely have ongoing follow-up visits with your doctor to make sure the cancer hasn’t returned.
- Radiation: This is often used for men who may have seminomas or as an added treatment after surgery. Radiation is typically used to kill cancer cells that may have spread to the lymph nodes.
- Chemotherapy: These medicines work to kill any cancer cells that may have traveled outside the testicle. It also helps reduce the risk of the cancer coming back. Chemo may be used on its own or in addition to surgery.
Talk with your doctor about your options and weigh the pros and cons. You’ll want to understand the potential side effects, effectiveness and recovery time of each treatment.
How can I get checked for testicular cancer?
If you think you may have symptoms of testicular cancer, schedule a visit with your primary provider (the doctor or provider you might see for your yearly exam). Your doctor may likely check for lumps at your annual physical. (You should check yourself regularly as well.) If there’s a lump that needs attention, you may end up having an ultrasound or blood test to help identify what it might be. Depending on those results, you may be referred to a specialist, like a urologist or oncologist.11