The testicles are part of the male reproductive system. Normally, there are 2 testicles, and they are located under the penis in a sac-like pouch called the scrotum. The testicles produce sperm and testosterone. Testosterone is a hormone that plays a role in the development of male reproductive organs and other masculine characteristics.

 Most types of testicular cancer develop in the sperm-producing cells known as germ cells and are referred to as germ cell tumors. Testicular cancer is highly treatable, even when cancer has spread beyond the testicle. Depending on the type and stage of testicular cancer, you may receive one of several treatments, or a combination

Causes and Risk Factors

The exact cause is unknown. Risk factors can be,

Age. More than half of the people who are diagnosed with testicular cancer are between age 20 and 45. However, people of any age can develop this disease, including those in their teens and in their 60s

Cryptorchidism. Cryptorchidism is an undescended testicle, meaning that 1 or both testicles do not move down into the scrotum before birth. This condition increases the risk of developing testicular cancer

Family history. A person who has a close relative, particularly a sibling, who has had testicular cancer has an increased risk of developing testicular cancer

Personal history. People who have had cancer in 1 testicle have an increased risk of developing cancer in the other testicle.

Race. Although people of any race can develop testicular cancer, white people are more likely than those of other races to be diagnosed with testicular cancer

Human immunodeficiency virus (HIV). People with HIV or acquired immune deficiency syndrome (AIDS) caused by HIV have a slightly higher risk of developing seminoma.

Signs and Symptoms of Testicular Cancer

Many of the symptoms are more likely to be caused by something other than testicular cancer. A number of non-cancerous conditions, such as testicle injury or inflammation, can cause symptoms a lot like those of testicular cancer. 

But if you have any of these signs or symptoms, see your doctor right away,

  • A painless lump or swelling on either testicle.  Testicle becomes swollen or larger.
  • Pain, discomfort, or numbness in a testicle or the scrotum, with or without swelling.
  • Change in the way a testicle feels or a feeling of heaviness in the scrotum. For example, 1 testicle may become firmer than the other testicle. 
  • Dull ache in the lower abdomen or groin
  • Sudden buildup of fluid in the scrotum
  • Breast tenderness or growth. Although rare, some testicular tumors make hormones that cause breast tenderness or growth of breast tissue, a condition called gynecomastia.
  • Swelling of 1 or both legs or shortness of breath from a blood clot can be symptoms of testicular cancer. For some young or middle-aged people, developing a blood clot may be the first sign of testicular cancer.

Symptoms of metastatic testicular cancer can include:


Testicular Self-Exam

The best time to do a testicular self-exam is after a warm bath or shower, while standing, when the scrotum is relaxed. It only takes a few minutes. To start:

  1. Check each testicle: Gently but firmly roll each testicle between the thumb and forefingers. Feel the whole surface. The firmness of the testis should be the same all around. It’s normal for one testis to be slightly larger than the other.
  2. Find the epididymis and vas deferens: These are soft, tube-like structures above and behind the testicle. These tubes collect and carry sperm. Just become familiar with how these cords feel.
  3. Look for lumps, swelling or things that don’t seem right: Lumps or bumps are not normal (even if they cause no pain). Pain is not normal.
  4. Check yourself at least once per month: Always look for any changes in size, shape, or texture.

Medical Exam

  • Health record and physical exam: Urologist will examine the scrotum, belly (abdomen), lymph nodes, and other parts to look for signs of cancer. And a detailed health history.
  • Testicular ultrasound: This imaging test is used to see inside the scrotum and to check a suspicious lump. 
  • Blood test:  Many testicular cancers make high levels of certain proteins called tumor markers, such as alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG).
  • Biopsy: Most types of cancer are diagnosed by removing a small piece of the tumor and looking at it under a microscope for cancer cells. 
  • Chest x-ray: to see if cancer has spread to lungs.
  • Computed tomography (CT) scan: CT scans can be used to help determine the stage (extent) of the cancer by showing if it has spread to the lymph nodes, lungs, liver, or other organs.
  • Positron emission tomography (PET) scan: A PET scan can help spot small collections of cancer cells in the body.
  • Bone scan: A bone scan can help to show if a cancer has spread to the bones

Stages of testicular cancer

Stage 1: testicular cancer is when the cancer is contained within the testicle.

Stage 2: testicular cancer is when the cancer has spread into nearby lymph nodes (small glands that fight infection) in the pelvis or tummy.

Stage 3 cancer is split into 3 sub-stages.

  • Stage 3A: testicular cancer is when the cancer has spread into distant lymph nodes, such as the nodes near collarbone or to lungs. Tumor marker levels are normal or only slightly raised.
  • Stage 3B: The cancer has spread to nearby lymph nodes and higher marker levels, or

The cancer has spread to distant lymph nodes or lungs and have higher tumor

  • stage 3C: The cancer spread is the same as stage 3B, but very high marker levels or the cancer has now spread body organs, such as the liver or the brain.



Surveillance is a way to look for changes with normal check-ups. These include a physical exam, tumor marker tests, and imaging tests. Imaging tests start with an ultrasound of the scrotum


  • Orchiectomy: It is used to diagnose and treat both early-stage and later-stage testicular cancer. This surgery removes the entire testicle and mass through a small cut in the groin. The spermatic cord is also removed.
  • Testis-sparing surgery (TSS): It is only recommended in select cases. This surgery removes just the tumor tissue, not the entire testis. For this, the mass must be very small and tumor markers must be negative.
  • Retroperitoneal lymph node dissection (RPLND): It is a complex surgery used to limit the side effects of removing the lymph nodes in the back of the abdomen.

Radiation Therapy 

Radiation therapy uses a beam of high-energy rays (such as gamma rays or x-rays) or particles (such as electrons, protons, or neutrons) to destroy cancer cells or slow their growth. In treating testicular cancer, radiation is used mainly to kill cancer cells that have spread to lymph nodes.

Side effects of radiotherapy can include:

  • Reddening and soreness of the skin, which is similar to sunburn
  • Feeling sick
  • Diarrhea 
  • Fatigue


Chemotherapy (chemo) is the use of drugs to treat cancer. The drugs can be swallowed in pill form, or they can be injected by needle into a vein or muscle. The drug travels throughout the body to reach and destroy the cancer cells.

Side effects of chemotherapy can include:

  • feeling sick, loss of appetite, fatigue
  • hair loss, sore mouth and mouth ulcers 
  • breathlessness and lung damage 
  • infertility
  • ringing in ears (tinnitus)
  • skin that bleeds or bruises easily 
  • low blood count, increased vulnerability to infection 
  • numbness and tingling (pins and needles) in  hands and feet


  • It can take two weeks to two months to fully recover from an orchiectomy. Should not lift anything over 10 pounds for the first two weeks or have sex until healed. Things like exercise, sports and running should be avoided for about four weeks after surgery.
  • It is important to learn how to do a testicular self-exam. Also, regular follow-up visits with urologist will be important.
  • The removal of one testicle should not change sexual energy or fertility (chances of having a child). Most men can have a normal erection after surgery. Still, men diagnosed with testicular cancer have a higher risk of infertility and low testosterone than the others. there are drugs that can help with ejaculation. And there is option for sperm banking before starting the treatment
  • Because of the risk of recurrence, need regular tests to check if the cancer has returned.

      These include:

Physical examination

Blood tests to check for tumor markers

Chest X-ray

CT scan

Disclaimer: All contents on this site are for general information and in no circumstances, information be substituted for professional advice from the relevant healthcare professional, Writer does not take responsibility for any damage done by the misuse or use of the information.

References         urology care foundation                            NHS                      Cancer net ASCO                       American cancer society                 Myoclinic