Testicular Cancer

Testicular cancer is most likely treatable and most often curable. It is the most common cancer in men 15 to 34 years old. 

The Testicles

The testicles are part of the male reproductive system and held in the scrotum below the penis. The testicles have a firm, slightly spongy feel.
The testicles are where sperm mature before being ejaculated. The testicles also make male hormones such as testosterone.

What are the Symptoms of Testicular Cancer?

Signs of a testicular tumor are:

  • a painless lump in the testicle (the most common sign)
  • a feeling of weight in the scrotum
  • swelling of the testicle (with or without pain)
  • pain or a dull ache in the testicle, scrotum or groin.

What Causes Testicular Cancer?

A History of Undescended Testes

The only risk factor linked to testicular tumors is a history of undescended testicles (cryptorchidism). This means that a testicle did not drop from the abdomen down into the scrotum by birth.

Other Risk Factors

Men whose father or brother had testicular cancer are also at greater risk. Testicular cancer is also more common in white men than in black men.

How is Testicular Cancer Diagnosed?

  • Health record and physical exam: Your urologist will look for lumps, firmness or signs of swelling, and ask about a history of undescended testicles.
  • Ultrasound: Your urologist may call for an ultrasound to check any suspicious lump.
  • Blood test: A blood sample can be checked for tumor markers that show up if cancer is present.

What are the Stages of Testicular Cancer?

  • Stage 1: Cancer is found only in the testicle.
  • Stage 2: Cancer has spread to the lymph nodes in the belly.
  • Stage 3: Cancer has spread beyond the lymph nodes in the belly. There may be cancer in parts of the body far away from the testicles such as the lungs and liver.

How are Testicular Tumors Treated?

Surgery

Suspicious tumors are first treated by removing the testicle through a small groin incision (orchiectomy).

Further Treatment 

  • Seminoma – The most common tumor type is seminoma. This type responds to radiation and chemotherapy.
  • Nonseminomatous Tumors – Treatment can involve observation, surgery or chemotherapy. 
  • Advanced Testicular Cancer or Aggressive Tumors – Some cases may call for surgical removal of lymph nodes in the abdomen from the area behind the peritoneum. If the disease is advanced, you may be put on chemotherapy. Sometimes residual tumors may need to be removed surgically after chemotherapy is completed.

What Can You Expect after Treatment?

Potency and Fertility

Removal of 1 testicle should not impair your sexual potency or fertility. Still, there is a chance of

  • a brief decrease in sperm production
  • a change in ability to ejaculate (after surgery to remove lymph nodes)

Because ejaculation can be impaired with surgery and because chemotherapy can lower sperm counts (usually only temporarily), you may wish to bank sperm before treatment.

Follow-up

Expect to be followed for at least 5 years.

Frequently Asked Questions

What is the cure rate for testicular tumors? 
The good news is that a strategy using surgery, chemotherapy or radiation (alone or combined) has resulted in cure rates of almost 100% for low stage or early disease, and more than 85% for more advanced tumors.

How do I perform a testicular self-exam?
Monthly testicular self-exams are the most important way to detect a tumor early. The best time to examine the testicles is right after a hot bath or shower. The exam should be done while standing.

  • Examine the testicles one at a time. Firmly and gently roll each testicle between the thumb and fingers of both hands to feel the whole surface.
  • Note that it is normal for one testicle to be slightly larger than the other. It is also normal to feel a cord-like structure (the epididymis) on the top and back of each testicle.
  • If you find a lump, swelling, pain or other change, get it checked out right away. Changes are not always cancer. If it is cancer and you catch it early, you have the best chance for a cure.

If you have questions regarding Testicular Cancer treatment options, please contact Potomac Urology at our office in Alexandria or Woodbridge, VA at (703) 680-2111.