12183 Testicular Cancer

Overview

Testicular cancer is a type of cancer that starts in the testicles, which are the male sex organs that make sperm and the male hormone testosterone. It happens when healthy cells in the testicle grow out of control and form a lump (tumour).

Testicular cancer is relatively rare compared to other types of cancer. About 1 in 250 men will develop it at some point in their lives. The number of cases has risen over the years, but thanks to better treatment, the chance of survival is very high.

Testicular cancer mainly affects younger and middle-aged men, particularly between ages 15 and 49. It is more common in white men and in men who have had an undescended testicle at birth, a family history of the disease, or a previous cancer in the other testicle.

Symptoms

Common symptoms

• A painless lump or swelling in either testicle
• A feeling of heaviness in the scrotum
• A dull ache or pain in the lower belly, groin, or scrotum
• A sudden collection of fluid in the scrotum
• Enlargement or tenderness of the breast tissue (rare)

Symptoms in children

• Testicular cancer is very rare in children, but it can happen. Parents should look for a hard lump or swelling in a child's testicle, or any unusual difference between the two testicles. These signs should always be checked by a doctor.

Symptoms in older adults

• In older men, symptoms are similar: a painless lump, swelling, or heaviness in the scrotum. Sometimes these symptoms are mistakenly blamed on other conditions like a hernia or fluid collection, so it is important to see a doctor for any new change.

Causes

Main causes

• The exact cause of testicular cancer is not known.
• It begins when the DNA in a normal testicular cell changes, causing the cell to multiply without control and form a tumour.
• Certain conditions, like an undescended testicle, increase the risk.
• There is nothing a man can do to prevent most cases, and it is not caused by injury, sexual activity, or lifestyle.

Risk factors

• Having an undescended testicle (the testicle does not move down into the scrotum before birth)
• A family history of testicular cancer (for example, in a father or brother)
• Having had testicular cancer in the other testicle
• Being between the ages of 15 and 49
• Being of white ethnicity
• Having atypical germ cells in the testicle (a condition called carcinoma in situ)

When to see a doctor

See a doctor urgently if:

• If you notice any new lump or swelling in a testicle, contact a doctor the same day.
• If you have persistent discomfort, pain, or a heavy feeling in the scrotum, do not wait to get it checked.

Book a routine appointment if:

• If you have any concerns about changes in your testicles but no urgent symptoms, make a routine appointment with your GP.
• If you previously had testicular cancer, attend all follow-up appointments as advised by your specialist.

Diagnosis

A doctor will first examine your testicles and ask about your symptoms. If they suspect testicular cancer, they will usually refer you for an ultrasound scan of the scrotum and may do blood tests to check for substances called tumour markers. In most cases, the diagnosis can be confirmed by removing the affected testicle (a procedure called radical inguinal orchidectomy), which also serves as the first step in treatment.

Tests that may be done

• Physical examination of the testicles and scrotum
• Ultrasound scan of the scrotum
• Blood tests to check for tumour markers (such as alpha-fetoprotein and human chorionic gonadotropin)
• CT scan or chest X-ray to see if cancer has spread (staging)

What to expect at your appointment

If your GP suspects testicular cancer, you will usually be seen by a specialist within two weeks. The tests are painless and quick. You may feel anxious, but knowing exactly what is happening can help. Your healthcare team will explain each step and support you throughout.

Treatment

Treatment for testicular cancer depends on the type of cancer, its stage, and your overall health. The main treatments are surgery, chemotherapy, and radiotherapy. You will be cared for by a specialist team who will tailor the treatment to you.

Self-care at home

• Follow your specialist team's advice and attend all follow-up appointments.
• After surgery, keep the wound clean and dry, and report any signs of infection such as redness, swelling, or discharge.
• Be gently aware of changes in your remaining testicle, but avoid unnecessary frequent checking that causes anxiety.
• If you have questions about fertility, talk to your doctor before treatment starts.

Medical treatments

The most common treatment for testicular cancer is surgery to remove the affected testicle (radical inguinal orchidectomy). Depending on the type of cancer and whether it has spread, you may also need chemotherapy or radiotherapy. Some men with early-stage cancer may be offered active surveillance, which means regular monitoring without immediate treatment, so small changes can be caught early. You may also be given steroid tablets or other supportive medicines to manage side effects, but any specific medicines will be prescribed by your oncologist.

Living with this condition

Most men recover well and can return to normal activities within a few weeks after surgery. You may feel tired at times, especially if you have chemotherapy or radiotherapy. Give yourself time to heal and regain energy. After treatment, you will have regular check-ups for several years to make sure the cancer has not returned. You can still live a full and active life with one remaining testicle; it produces enough testosterone and sperm for most men.

Lifestyle tips

• Stay as active as you can, but listen to your body and rest when needed.
• If you smoke, consider quitting; it is good for your overall health.
• Limit alcohol and eat a balanced diet to help your body recover.
• Keep up with routine health check-ups and mental well-being.

Diet and exercise

Eating a healthy diet rich in fruit, vegetables, whole grains, and lean protein can support your recovery. Gentle exercise, like walking or light cycling, can help improve your energy and mood. Start slowly and build up gradually. Ask your doctor before starting any new exercise programme, especially after surgery.

Mental health and emotional wellbeing

A diagnosis of testicular cancer can bring up many emotions, including shock, fear, and sadness. It can also affect body image and intimate relationships. These feelings are normal and it is important to talk about them. You may find it helpful to speak with a counsellor, a psychologist, or a support group. If you are in distress and feel unable to cope, please reach out to a mental health professional or call a local crisis helpline.

Prevention

There is no known way to prevent testicular cancer. The best thing you can do is get to know what is normal for your testicles so you can notice changes early. If you notice a lump, swelling, or pain, see a doctor without delay. Early detection greatly improves the chance of successful treatment.

Complications

If left untreated

• Without treatment, testicular cancer can spread to other parts of the body, including the lymph nodes, lungs, liver, and brain.
• Once it spreads, it becomes harder to treat and can be life-threatening.
• It is very rare for testicular cancer to go away on its own.

Long-term outlook

The outlook for testicular cancer is very positive. It is one of the most curable cancers, even when it has spread to nearby lymph nodes. The treatment success rate is over 95%. Most men return to a normal, healthy life after treatment, and with regular check-ups, recurrences can be caught and treated early. You have every reason to be hopeful.

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