Testicular Cancer

Overview

Testicular cancer is a type of cancer that starts in the testicles, the two small organs inside the scrotum that produce sperm and male hormones. It can occur at different ages, but it is more often seen in younger and middle-aged adult men. Most testicular cancers begin in the cells that make sperm, called germ cells.

Although hearing the word “cancer” can be frightening, testicular cancer is often highly responsive to modern treatment, especially when found early. Even when it has spread, there are several established treatment options. The most important step is to seek medical evaluation promptly if there is any unusual change in the testicle or scrotum.

Symptoms

Testicular cancer may cause noticeable changes, but some people have only mild symptoms or no pain. Common signs and symptoms include:

• A lump, swelling, or firmness in one testicle
• A change in the size, shape, or weight of a testicle
• A feeling of heaviness in the scrotum
• A dull ache or discomfort in the lower abdomen, groin, testicle, or scrotum
• Sudden fluid buildup or swelling in the scrotum
• Pain or tenderness in a testicle, although many lumps are painless
• Breast tenderness or enlargement in some cases
• Back pain, cough, or unexplained tiredness if the disease has spread

Not every lump or swelling is cancer. Infections, cysts, injury, and other benign conditions can also affect the testicles. However, any new or persistent change should be assessed by a healthcare professional.

Causes and Risk Factors

The exact cause of testicular cancer is not always known. It develops when cells in the testicle grow and divide in an abnormal, uncontrolled way. Certain factors may increase risk, although having a risk factor does not mean a person will develop cancer.

• An undescended testicle, even if corrected earlier in life
• A personal history of testicular cancer in the other testicle
• A family history of testicular cancer
• Abnormal development of the testicles
• Some genetic or congenital conditions that affect testicular development
• Infertility or certain testicular function problems

Injury, exercise, or sexual activity do not cause testicular cancer. Regular awareness of what is normal for one’s own body can help a person notice changes early.

Diagnosis

Diagnosis begins with a medical consultation and physical examination. The doctor may ask about symptoms, personal medical history, and any family history of testicular cancer. If a suspicious change is found, further tests are usually recommended.

A scrotal ultrasound is commonly used to look at the inside of the testicle and help distinguish solid masses from fluid-filled cysts. Blood tests may be done to measure tumor markers, which are substances that can be higher in some types of testicular cancer. These tests can support diagnosis, help guide treatment planning, and be used later for follow-up.

If testicular cancer is suspected, the affected testicle is often removed through surgery and examined by a pathology specialist. A biopsy through the scrotal skin is generally avoided because it may affect the usual pathways of cancer spread. Imaging tests, such as scans of the chest, abdomen, or pelvis, may be used to check whether the cancer has spread and to determine its stage.

Treatment Options

Treatment depends on the type of testicular cancer, its stage, tumor marker results, overall health, and personal preferences. Care is usually planned by a multidisciplinary team, which may include specialists in urology, medical oncology, radiation oncology, radiology, pathology, and fertility care.

Surgery to remove the affected testicle is usually the first treatment. Many men can live normally with one remaining testicle, which often continues to produce testosterone and sperm. A testicular implant may be discussed for cosmetic reasons if the patient wishes.

After surgery, some patients may be monitored closely with regular examinations, blood tests, and imaging. This approach is called active surveillance and is used only when the medical team considers it appropriate. Other patients may need additional treatment, such as chemotherapy, radiation therapy, or surgery to remove lymph nodes, depending on cancer type and stage.

Before treatment, it is important to discuss fertility. Some treatments can affect sperm production. Sperm banking may be offered before treatment begins for patients who may want children in the future.

Follow-up care is an important part of treatment. Regular visits help monitor recovery, check tumor markers, detect possible recurrence, and manage any long-term effects of treatment.

When to See a Doctor

A doctor should be consulted if there is any lump, swelling, firmness, pain, or change in the size or shape of a testicle, especially if it lasts more than a short time or is getting worse. Sudden severe testicular pain requires urgent medical attention, as it may be caused by conditions that need immediate care.

It is understandable to feel embarrassed or anxious about discussing testicular symptoms, but healthcare professionals are experienced in evaluating these concerns. Early medical assessment can help identify the cause and, if needed, allow treatment to begin as soon as possible.