Testicular Cancer

Testicular cancer is a cancer that starts in one of the testicles, the two organs inside the scrotum that produce sperm and male hormones. It is uncommon compared with many other cancers, but it is the most common cancer in younger men.

It is also one of the most treatable and curable cancers. Even when it has spread beyond the testicle, the outlook is generally very good with modern treatment, which is why noticing changes early and getting them checked matters.

Testicular cancer mainly affects younger and middle-aged men, most often between about 15 and 45 years of age. It can occur at other ages too, but it is much less common in older men.

Certain factors can increase the risk, including having had an undescended testicle in childhood, a family history of testicular cancer, or a previous testicular cancer in the other testicle.

The most common symptom is a painless lump or swelling in one testicle. It may be small — around the size of a pea — or larger. Other changes to look for include a testicle that becomes firmer, larger, or smaller, a heavy or aching feeling in the scrotum, or a dull ache in the lower abdomen.

Most lumps in the testicle are not cancer, but any new lump, swelling, or change should always be checked by a doctor so the cause can be found.

The exact cause of testicular cancer is not known. It develops when cells in the testicle begin to grow abnormally, but why this happens is not fully understood.

Because a cause cannot usually be identified, there is no reliable way to prevent it. Being aware of what is normal for you and getting changes checked early is the most useful step.

A doctor will examine the testicle and usually arrange an ultrasound scan of the scrotum, which is a simple, painless test that helps show whether a lump is likely to be cancer. Blood tests for substances called tumor markers can also support the diagnosis and help monitor treatment.

If cancer is suspected, further scans such as a CT may be done to check whether it has spread. In testicular cancer, the diagnosis is often confirmed by removing the affected testicle, because taking a biopsy from the testicle itself is generally avoided.

The main treatment is an operation to remove the affected testicle, called an orchidectomy (or orchiectomy). Removing one testicle does not usually affect the ability to have an erection or to father children, because the other testicle continues to work.

Depending on the type of cancer and whether it has spread, surgery may be followed by chemotherapy or radiotherapy, or by careful monitoring (surveillance). A multidisciplinary team plans treatment for each person. Because some treatments can affect fertility, storing sperm beforehand is often discussed.

With one testicle removed, the remaining testicle usually maintains hormone levels and fertility, so many men go on to have children naturally. Some men choose a testicular prosthesis for appearance, which can be discussed with the surgeon.

As chemotherapy or radiotherapy can temporarily or sometimes permanently affect fertility, your team may recommend sperm banking before treatment starts, so that options are preserved.

The outlook for testicular cancer is very good. It is one of the most curable cancers, and most men are successfully treated — including many whose cancer has spread by the time it is found. Finding and treating it early gives the best and simplest path to cure.

After treatment, follow-up appointments and scans check that the cancer has not returned. Being aware of changes and attending follow-up are the most helpful things you can do; there is no proven way to prevent testicular cancer.