Patient education: Testicular cancer (The Basics)

What is testicular cancer? — Testicular cancer happens when normal cells in 1 or both testicles change into abnormal cells and grow out of control. The testicles are found inside a skin sac called the "scrotum" (figure 1). The testicles make sperm and male hormones.

Testicular cancer occurs most often between the ages of 15 and 35. There are different types of testicular cancer. But most cases of testicular cancer, whatever the type, can be cured with treatment.

What are the symptoms of testicular cancer? — The first symptom of testicular cancer is often a lump or swelling in the scrotum that is not painful. Other symptoms can include:

●A dull ache or heavy feeling in the low belly, or around the anus or scrotum

●Pain in the testicles or scrotum

These symptoms can be caused by conditions that are not cancer. But if you feel a lump in your testicle, you should see your doctor or nurse as soon as possible.

Is there a test for testicular cancer? — Yes. If your doctor or nurse thinks you might have testicular cancer, they might order a testicular ultrasound. This is an imaging test that creates pictures of the inside of the testicles and can show abnormal growths. A mass or lump seen on ultrasound can be a sign of testicular cancer.

The only way to know for sure if you have testicular cancer is for a doctor to remove the abnormal testicle and send it to a lab to be checked for cancer. Surgery to remove a testicle is called an "orchiectomy."

What is cancer staging? — Cancer staging is a way for doctors to find out if the cancer has spread beyond the testicles to other parts of the body. Staging usually involves blood tests, CT scans, or other imaging tests. Based on the test results, the cancer is then given a "stage," for example, "stage 1." The stage of your cancer helps your doctor to figure out your options for treatment.

How is testicular cancer treated? — Removing the testicle is the first part of treatment. Further treatment depends on:

●The type of cancer that is found

●Whether or not there is any risk it could return – This risk is based on the type of cancer, but also on whether it has spread outside of the testicle. In some cases, doctors will also do blood tests to check "tumor markers." These are substances in the blood produced by the cancer. Measuring the levels of these markers can help guide treatment.

In general, the treatment options for testicular cancer could include any of the following:

●Chemotherapy – Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing.

●Radiation therapy – Radiation kills cancer cells.

●Surgery – Testicular cancer is sometimes treated with surgery to remove nearby lymph nodes, which are bean-shaped internal organs. This surgery can help prevent the spread of testicular cancer in the body. A doctor might also do surgery to remove a mass in another part of the body if the cancer has spread.

●A rigorous follow-up schedule (also called active surveillance) – If you have early testicular cancer, treatment beyond removal of the testicle is not always needed. In these cases, doctors sometimes recommend simply monitoring the body for changes that could indicate the return of cancer.

What if I want to father a child one day? — If you want to father a child one day, talk with your doctor. Some treatments for testicular cancer can reduce or stop sperm production. You might choose to store your sperm before treatment so you can use it in the future to have a child.

What happens after treatment? — After treatment, you will be checked every so often to see if the cancer comes back. Follow-up tests usually include exams, blood tests, and imaging tests such as X-rays and CT scans.

What happens if the cancer comes back or spreads? — If the cancer comes back or spreads, you might have more chemotherapy, radiation therapy, or surgery.

What else should I do? — It is important to follow all your doctors' instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.

Getting treated for testicular cancer involves making many choices, such as what treatment to have.

Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:

●What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?

●What are the downsides to this treatment?

●Are there other options besides this treatment?

●What happens if I do not have this treatment?

More on this topic

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Patient education: Testicular cancer (Beyond the Basics)
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