(Cancer of the Testicle; Cancer, Testicular; Seminoma; Germinoma)
Testicular cancer is a disease in which cancer cells grow in one or both testicles. The testicles are a pair of male sex glands that make and store sperm. The testicles also make male hormones. They are located under the penis in a sac-like pouch called the scrotum.
There are three main types of testicular cancer:
- Nonseminomas (yolk sac, embryonal cell carcinoma, teratomas, and choriocarcinoma)
- Stromal cell tumors
Treatment will vary depending on the cell type.
Cancer occurs when cells in the body divide without control or order. Eventually these uncontrolled cells form a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues including the lymph nodes. Cancer that has invaded the lymph nodes can then spread to other parts of the body..
It is not clear exactly what causes these problems in the cells, but is probably a combination of genetics and environment.
Testicular cancer is more common in men aged 25-35 years. It is also more common in Caucasians. Other factors that may increase your risk of testicular cancer include:
- Personal or family history of testicular cancer
- Abnormal testicular development, such as that seen in Klinefelter syndrome
- Undescended testicle that did not move down into the scrotum before birth
Testicular cancer may cause:
- A painless lump or swelling in either testicle
- Enlargement or swelling of a testicle or change in the way it feels
- Feeling of heaviness in the scrotum
- A dull ache in the lower abdomen or groin
- Fluid in the scrotum that appears suddenly
- Pain or discomfort in a testicle or in the scrotum
- Lower back pain (in later stages of the cancer)
- Enlarged breasts
The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:
- Blood tests
- Ultrasound—a test that uses sound waves to find or examine tumors
- Excisional biopsy—removal of testicular tissue to test for cancer cells
Once testicular cancer is found, tests may be done to find out if the cancer has spread and, if so, to what extent. These imaging tests of the body may include:
The physical exam, combined with all test results, will help to determine the type and stage of cancer. Staging is used to guide a treatment plan. Testicular cancer is staged from I-III. Stage I is a very localized cancer, while stage III indicates a spread to other parts of the body.
Cancer treatment varies depending on the stage and type of cancer. Options include:
Surgery requires removing the cancerous testicle. This is done through an incision in the groin. The surgeon may also remove nearby lymph nodes to check for metastasis.
Radiation therapy is the use of radiation to kill cancer cells and shrink tumors. Radiation therapy for testicular cancer directs radiation at the abdomen from outside of the body.
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms including: pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells.
If you were born with undescended testicles, having surgery to correct this condition may reduce your risk of getting testicular cancer.
There are no specific guidelines for regular screening by a doctor or for self-screening in men who do not have any symptoms. However, the American Cancer Society recommends that your doctor at your routine cancer-related check-ups should do a testicular exam. No studies have been done that look at the benefit or harm of screening for testicular cancer. Discuss screening with your doctor, especially if you are at high risk for testicular cancer.
Keep in mind that if you notice any symptoms of testicular cancer, such as a lump or swelling in the testicles, it is important that you see your doctor for an evaluation.
Canadian Cancer Society
Cancer Care Ontario
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Testicular cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003142-pdf.pdf. Accessed September 30, 2014.
Walsh TJ, Dall'Era MA, Croughan MS, Carroll PR, Turek PJ. Prepubertal orchiopexy for cryptorchidism may be associated with lower risk of testicular cancer. J Urol. 2007 Oct;178(4 Pt 1):1440-6; discussion 1446.
3/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Ilic D, Misso M. Screening for testicular cancer. Cochrane Database Syst Rev. 2011;(2):CD007853.
2/1/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American College of Radiology. ACR Appropriateness Criteria. 2012; Jun 16. Available at http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/StagingTesticularMalignancy.pdf. Updated June, 2012. Accessed September 30, 2014.
Last reviewed August 2014 by Mohei Abouzied, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.