Testicular Cancer

LP - UCI Urology - Testicular Cancer


Considered rare when compared to other forms of cancer, testicular cancer is often curable when detected and treated early.

More likely to affect men in the 15- to 35-year-old age group, testicle or testicular cancer refers to abnormal growths that develop in one or both testicles in the scrotum. These male sex hormones are responsible for producing sperm.

  • Testicular pain and swelling are among common symptoms associated with this type of cancer.
  • These symptoms often result in a referral to a doctor specializing in urology for further evaluation.

Causes and Risk Factors

There are different types of testicular cancer, including forms that do not normally develop in the germ cells that produce sperm. While there is no clear cause of testicular cancer, it has been associated with risk factors that include testicles that fail to fully descend (cryptorchidism) and having a family history of testicular cancer.

Types of Testicular Cancer

Seminomas and non-seminomas are the two main forms of testicular cancer that develop in sperm-producing germ cells. Non-seminomas tend to grow at a slower pace than seminomas. Men 25 to 45 years of age are more likely to have classical seminoma. Testicular cancer of this nature sometimes causes a spike in HCG levels that can be detected with a blood test. Stromal tumors form in hormone-producing tissues. Non-germ cell Leydig cell tumors are often benign. Some men have secondary testicular cancer that develops elsewhere, such as lymphoma.



Signs and Symptoms

When the testicles are affected by cancer or a tumor, the scrotum may feel unusually heavy. Discomfort or recurring pain may also be noticeable in the groin or lower abdomen. Other possible symptoms include:

  • A visible lump in the scrotum
  • Lower back pain
  • Swelling extending to one or both legs
  • One testicle that’s significantly different from the other one in size and shape

Diagnosis and Treatment

Some men discover possible signs of testicular cancer themselves. If testicular cancer is suspected following a physical exam, a testicular ultrasound may be performed with a handheld probe to get a better view of the tissues inside of the scrotum and testicles. Blood tests may reveal certain tumor markers that can help make a better diagnosis, although simply having certain markers doesn’t always mean a patient has cancer.

If cancer is detected, surgery will be necessary to remove the affected testicle. This is the only way to positively identify what type of testicular cancer is affecting tissues. Testicle removal is a procedure referred to as a radical inguinal orchiectomy. In some instances, testicle removal may be all that’s necessary. A prosthetic testicle can be inserted to restore the appearance of the scrotum when a testicle has to be removed. Treatment may also involve:

  • Removal of nearby lymph nodes
  • Chemotherapy
  • Radiation therapy
  • Ongoing observation and testing

Chemotherapy may contribute to issues with infertility. For men planning on having children, sperm can sometimes be collected and preserved prior to starting this type of treatment.

Having regular urological exams is one way to increase the likelihood that abnormalities that may be testicular cancer will be detected as early as possible. A standard exam normally involves a physical evaluation of the appearance and health of the penis, testicles, and urinary tract, blood and testosterone tests, a urinalysis, a semen analysis, and image tests. Patients can also be proactive by doing self-exams following a shower or warm bath.

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