Testicular Cancer

Last Updated April 2022 | This article was created by editorial staff and reviewed by Robert "Chuck" Rich, Jr., MD, FAAFP

What is testicular cancer?

Testicular cancer occurs in one or both of a person’s testicles. The testicles are located in the scrotum (the skin sac that hangs beneath your penis). Testicles can vary in size and are round, smooth, and firm. They produce male hormones and sperm.

Testicular cancer is the most common type of cancer in young and middle-aged, white men. It can occur in older men, as well. In rare cases, it can occur in younger boys. Black and Asian men are less likely to develop it.

Symptoms of testicular cancer

The most common sign of testicular cancer is a hard, painless lump on the testicle. Other symptoms include:

  • Pain or a dull ache in your scrotum
  • Enlarged testicle
  • Swelling of your scrotum
  • Heavy feeling in your scrotum
  • Pain in your lower back or stomach
  • Tender or enlarged breasts

What causes testicular cancer?

Cancer is caused by abnormal cell growth. Most cases of testicular cancer are caused by germ cells. These are cells that make sperm. There is no evidence linking testicular cancer to a vasectomy.

How is testicular cancer diagnosed?

Early detection is important. Regular, self-examinations may be your first clue. Contact your doctor if you notice something unusual.

Your doctor will perform a physical exam. He or she will feel your scrotum and testicles for lumps. Your doctor may do a transillumination test. This is done by shining a light to your scrotum. If the light does not pass through a lump, it could be cancerous. Not all lumps or tumors are cancerous.

To confirm cancer, your doctor will do other tests. These may include a blood test, ultrasound, X-ray, or computed tomography (CT) scan. If you have cancer, your doctor will check to see what type and stage it is.

There are two types of testicular cancer. Seminoma cancer grows slowly. Nonseminoma cancer grows quickly. You may have a combination of the two.

Can testicular cancer be prevented or avoided?

You cannot prevent or avoid testicular cancer. Although this type of cancer is rare. Risk factors include:

  • A family history of testicular cancer
  • Caucasian (white) descent
  • Having an undescended testicle (This means the testicle did not drop down into your scrotum. The risk exists even if you had surgery to correct that.)
  • Small or misshaped testicles
  • Having an HIV infection
  • Klinefelter syndrome (a rare disorder in which a man has an extra X chromosome)

Testicular cancer treatment

Treatment depends on your type and stage of cancer. Your general health also is important. Most men who have testicular cancer will require surgery. This involves removing the cancerous testicle.

You may need other treatments. If your cancer is severe, has spread, or reoccurs, you may need radiation or chemotherapy. Radiation kills cancer cells using X-rays or radio waves. Chemotherapy kills cancer cells with powerful medicines.

Living with testicular cancer

Testicular cancer is treatable and curable. Early detection improves your outcome. You can still have children with one testicle. Removing both testicles means you will be infertile. You may be able to store your sperm before treatment.

Talk to your doctor about regular exams and concerns after treatment. They may suggest you join a support group or get counseling.

Questions to ask your doctor

  • How do I perform a testicular self-exam?
  • What are the side effects and risks of surgery?
  • Will surgery affect my ability to have sex?
  • If I have cancer in one testicle, what are my chances of having it in the other one?