Testicular Cancer: Your GoodRx Guide

Definition

Testicular cancer is an abnormal growth that forms from the cells within the testicles. The testicles are part of the male reproductive system. They make sperm and testosterone — the male sex hormone.

Testicular cancer is rare and can occur at any age. But it most commonly affects young people between the ages of 20 and 45 years old. 

Most testicular cancers start in the cells that make sperm. These are called germ cell tumors. The two types of germ cell testicular cancers are seminoma and nonseminoma germ cell tumors. 

Testicular cancers can also start in the cells that make testosterone. These are Leydig cell tumors or Sertoli cell tumors.

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Causes

Scientists don’t completely understand what causes testicular cancer. It’s likely a combination of genetic and environmental factors a person is exposed to.  

Experts think there are some risk factors that may make it more likely to develop. Risk factors for testicular cancer include:

• An undescended testicle at birth

• A family history of testicular cancer

• Previous testicular cancer

• HIV infection

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Symptoms

The most common symptom of testicular cancer is a lump in the testicle. Usually there’s no pain or tenderness. 

As many as 3 in 4 people with a lump in their testicle have testicular cancer. So visit your healthcare provider as soon as possible if you have a lump.

But not all testicular lumps are a sign of cancer. Other symptoms that may suggest testicular cancer include:

• Swelling in the testicle

• An achy pain in the scrotum or groin

• Heaviness in the testicles

• Breast pain or growth

If you have any of these symptoms, see a healthcare provider right away.

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Diagnosis

Testicular cancer is usually diagnosed after you first notice a lump or swelling in the testicle. Your provider can then use different tests to figure out what’s causing the symptoms. 

Here are some of the tests providers use to diagnose testicular cancer:

• Blood tests: Common blood tests include human chorionic gonadotropin (HCG), alpha feto-protein (AFP), and lactate dehydrogenase (LDH).

• Ultrasound: This is an imaging scan that lets your provider look at the testicle and surrounding structures. 

• Surgery: This lets the healthcare team look at a sample of tissue from the testicles to see if there’s cancer. If they suspect cancer, they’ll often remove the entire testicle as a precaution.

After getting a diagnosis of testicular cancer, your healthcare providers will see what stage of cancer you have. The “TNMS system” describes this process as follows:

• Tumor size (T)

• Lymph nodes with cancer (N)

• Metastases, or spread to other organs and tissues (M)

• Serum (blood) tests (S)

Testicular cancer stages range from stage 0 (least advanced) to stage 3 (most advanced). In early stages, the tumor is small, there is no spread to other tissues, and serum blood tests are not very high.  

Staging for testicular cancer helps your healthcare team design the best treatment plan for your specific situation. 

Treatments

With proper treatment and early diagnosis, testicular cancer has over a 90% cure rate. This makes it one of the most curable cancers. 

There are several different treatments for testicular cancer depending on the stage. Let’s take a closer look at each treatment option.

Surgery

Surgery is an important part of treating testicular cancer. In the earliest stages of testicular cancer, surgery may be the only treatment needed. For advanced stages of testicular cancer, you may need other treatment as well.

Testicular cancer surgery typically includes removing the testicle and spermatic cord, which helps to hold the testicle in place in the scrotum. 

Radiation therapy

Radiation therapy is often used with surgery or chemotherapy for more advanced stages of testicular cancer. Radiation helps to kill cancer cells in the testicle and tissues surrounding it. It also helps to shrink tumors that have spread to other organs. 

But not all testicular cancers respond in the same way to radiation therapy. Radiation is more effective for seminomas, but it’s less effective for nonseminoma cancers.  

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Medications

Depending on your stage of testicular cancer, your cancer specialist may suggest chemotherapy instead of — or in addition to — other treatments. Chemotherapy medications can help to stop the growth and spread of cancer cells.

Common chemotherapy treatments for testicular cancer include:

• Bleomycin

• Etoposide

• Dactinomycin

• Ifosfamide

• Vinblastine

• Cisplatin

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Surviving testicular cancer

After getting treatment for testicular cancer, you’ll still need close follow-up for a while to make sure you stay cancer free. 

Although testicular cancer has a high rate of cure, there’s a small chance of it returning. There’s also a very small risk of it showing up in the other unaffected testicle. So you’ll need to do regular testicular self-exams.

Treatment for testicular cancer may affect your future fertility. So it’s a good idea to talk with your healthcare team about this — even if you’re not ready to think about having children just yet.  There are options to bank your sperm, which can help you keep your options open in the future. 

Here are some more resources to help you along your experience with testicular cancer:

• Testicular Cancer Society

• American Cancer Society

• Testicular Cancer Awareness Foundation

• CancerCare

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