Testicular Cancer 101: Symptoms, Treatment, and the Importance of Self-Exams

While talking openly about testicular cancer may feel taboo, it shouldn’t.

Roughly 1 in every 250 men will develop testicular cancer in their lifetime, according to the American Cancer Society.

Men of any age can develop testicular cancer. However it is primarily a disease of young men who are often hesitant to seek care, and this often results in a delay in diagnosis – allowing the cancer to grow and potentially spread. Testicular cancer is the leading type of cancer in men ages 20 to 40.

Fortunately, testicular cancer has a very high cure rate—greater than 95 percent. When caught early, less intensive treatment is required to achieve a cure.

Testicular Cancer Symptoms and Diagnosis

While men should be on the lookout for any changes to the appearance of their testicles or scrotum, testicular cancer is most often diagnosed when a man feels something abnormal in the testicle. Palpation or feeling of a painless noticeable lump, bump, or swelling in one or both testicles is usually the first sign of testicular cancer.

Occasionally, men also report feeling a dull ache or a sense of heaviness in their groin or lower stomach. These physical sensations could be an early warning sign of testicular cancer.

Men who notice physical changes in the feeling or appearance of their testicles, scrotum, or broader groin area should get checked by their physician.

Generally, physicians use a combination of a physical exam, blood tests, and an ultrasound screening to have a very high suspicion of testicular cancer, which is confirmed with surgical removal of the testicle to confirm the presence of testicular cancer. Providers may recommend a CT scan to determine the cancer’s staging. This scan determines if the cancer has spread from the testicle to the abdominal cavity.

Testicular Cancer Risk Factors

Testicular cancer is primarily a disease of young white men, and this is in striking contrast to most other cancers that tend to impact older people.

Additionally, men are more likely to develop testicular cancer if they have one or more known risk factors. These risk factors include:

• An undescended testicle or a history of an undescended testicle (cryptorchidism).
• White, American Indian, and Alaska Native men are several times more likely to get testicular cancer than Black, Asian American, and Pacific Islander men.
• Family history of testicular cancer.
• Previous testicular cancer diagnosis (roughly 3-4% of men develop testicular cancer in both testicles, though typically not at the same time).
• Precancerous, abnormal testicular lesions (intratubular germ cell neoplasia, or ITGCN).
• HIV diagnosis

Testicular Cancer Treatment

Treatment for testicular cancer usually involves an orchiectomy, the surgical removal of the affected testicle. Often, men are encouraged to bank sperm prior to that procedure to preserve fertility. At the time of orchiectomy, a testicular prosthesis can be placed to preserve the natural look and feel of the testicles and scrotum. Following surgery, some men undergo chemotherapy, radiation, or a combination of those therapies.

Treatment for testicular cancer can last weeks, months, or even years, depending on the type and spread of the cancer. Some treatments for testicular cancer could impact fertility. Men should discuss their goals for future parenthood with their providers when considering treatment options.

Testicular Cancer Self-Exams and the Power of Early Detection

All men should conduct testicular self-exams monthly. At-home exams support early cancer detection since they encourage men to note any changes to their testicles. Most men are already conducting testicular self-exams, whether they recognize it or not.

Formally, to conduct a testicular self-exam, men should stand in front of a mirror and check for visual signs of swelling in their scrotum. Then, they should use their thumb and fingers to gently roll each testicle. Watch for the presence of any unusual lumps or bumps or changes to testicular size and shape.

Less formally often when a man is touching or feeling his own testicles, he may notice an abnormality.

Most men perform some type (formal or informal) of testicular self-exams but often delay in reporting abnormal findings or irregularities to their physicians. This delay may be for a host of reasons, but it ultimately allows this rapidly growing type of cancer to continue to grow or even spread to other parts of the body. This can make treatment much more burdensome or even lead to life-threatening complications.

The good news is that most men recover fully from testicular cancer, especially when we catch the disease in its earliest stages. In fact, in more than 9 out of 10 cases, men diagnosed with testicular cancer recover from the disease and go on to live full, healthy lives.

Learn more about comprehensive testicular cancer care at Memorial Cancer Institute — including proven, precise and patient-focused testicular cancer treatments.