Patient education: Testicular cancer (The Basics)

What is testicular cancer? — 

This is when normal cells in 1 or both testicles change into abnormal cells and grow out of control. The testicles are found inside a skin sac called the "scrotum" (figure 1). They make sperm and male hormones.

Testicular cancer occurs most often between the ages of 15 and 35. There are different types. But most cases, whatever the type, can be cured with treatment.

What are the symptoms of testicular cancer? — 

The first symptom is often a lump or swelling in the scrotum that is not painful.

Other symptoms can include:

●A dull ache or heavy feeling in the low belly, or around the anus or scrotum

●Pain in the testicles or scrotum

These symptoms can be caused by conditions that are not cancer. But if you feel a lump in your testicle, see your doctor or nurse as soon as possible.

Is there a test for testicular cancer? — 

Yes. If your doctor or nurse thinks you might have testicular cancer, they might order a testicular ultrasound. This is an imaging test that creates pictures of the inside of the testicles and can show abnormal growths. A mass or lump seen on ultrasound can be a sign of testicular cancer.

The only way to know for sure if you have testicular cancer is for a doctor to remove the abnormal testicle and send it to a lab to be checked for cancer. Surgery to remove a testicle is called an "orchiectomy."

What is cancer staging? — 

This is a way to find out if the cancer has spread beyond the testicles to other parts of the body. Staging usually involves blood tests, CT scans, or other imaging tests. Based on the test results, the cancer is then given a "stage," for example, "stage 1."

Your cancer stage helps your doctor figure out your treatment options.

How is testicular cancer treated? — 

Removing the testicle is the first part of treatment.

Further treatment depends on:

●The type of cancer

●If there is a risk the cancer could return – This risk is based on the type of cancer, but also on whether it spread outside the testicle. In some cases, doctors will also do blood tests to check "tumor markers." These are substances in the blood produced by the cancer. Measuring the levels of these markers can help guide treatment.

In general, the treatment options for testicular cancer could include any of the following:

●Chemotherapy – These are medicines that kill cancer cells or stop them from growing.

●Radiation therapy – This kills cancer cells.

●Surgery – Testicular cancer is sometimes treated with surgery to remove nearby lymph nodes, which are bean-shaped internal organs. This surgery can help prevent the spread of testicular cancer in the body. A doctor might also do surgery to remove a mass in another part of the body if the cancer has spread.

●Monitoring for changes, called "surveillance" – If you have early testicular cancer, you might not need more treatment after removing the testicle. In these cases, doctors sometimes recommend simply monitoring the body for changes that could mean the cancer has returned. This involves getting regular exams, blood tests, and imaging tests.

What if I want to have a baby? — 

If you want to be able to get a partner pregnant in the future, talk with your doctor. Some treatments for testicular cancer can reduce or stop sperm production. You might choose to store your sperm before treatment so you can use it in the future.

What happens after treatment? — 

You will be checked regularly to see if the cancer comes back. Follow-up tests usually include exams, blood tests, and imaging tests.

What happens if the cancer comes back or spreads? — 

You might have more chemotherapy, radiation therapy, or surgery.

What else should I do? — 

Follow all your doctors' instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.

Getting treated for testicular cancer involves making many choices, such as what treatment to have. Always tell your doctors and nurses how you feel about a treatment. Any time you are offered a treatment, ask:

●What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?

●What are the downsides of this treatment?

●Are there other options besides this treatment?

●What happens if I do not have this treatment?

More on this topic

Patient education: Alpha-fetoprotein tumor marker test (The Basics)
Patient education: Chemotherapy (The Basics)
Patient education: External beam radiation therapy (The Basics)
Patient education: Preserving fertility after cancer treatment in men (The Basics)
Patient education: What are clinical trials? (The Basics)

Patient education: Testicular cancer (Beyond the Basics)
Patient education: Treatment of male infertility (Beyond the Basics)
Patient education: Evaluation of infertility in couples (Beyond the Basics)