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occurs when cells that aren't normal grow out of control in the
testicles (testes). It is highly curable, especially
when it is found early.
The testes are the two male sex organs
that make and store
sperm. They are located in a pouch below the penis
scrotum. The testes also make the hormone
Testicular cancer isn't very common. It affects mostly young, white males between the ages of 15 and 35.1
Most testicular cancers start in cells that make sperm. These cells are called germ cells. The two main types of testicular germ cell cancers are seminomas and nonseminomas. Seminomas grow and spread slowly
and respond to radiation therapy. Nonseminomas grow and spread more quickly than seminomas.
There are several different types of nonseminomas.
This topic covers seminoma and nonseminoma cancer. It does not cover non-germ cell testicular cancers, such as Leydig cell tumors.
Experts don't know
what causes testicular cancer. But some problems, such as having an undescended testicle or Klinefelter syndrome, may increase a man's risk for this cancer. Most men who get testicular cancer don't have any risk
The most common symptoms of
testicular cancer include:
Most men find
testicular cancer themselves during a
self-exam. Or your doctor may find it during a
routine physical exam.
Because other problems can cause symptoms
like those of testicular cancer, your doctor may order tests to find out if you
have another problem. These tests may include blood tests and imaging tests of
the testicles such as an
ultrasound or a
CT scan. These tests can also help find out if
cancer has spread to other parts of your body.
Nearly all men with testicular
cancer begin treatment with surgery to remove the testicle that has cancer.
Removing the testicle
allows your doctor to find out the type of cancer cells you have. It also helps
him or her plan any other treatment you may need.
Treatment after surgery may include watchful waiting, chemotherapy, or radiation therapy. Chemotherapy is often used for cancer that has spread to
other parts of the body. In some cases, surgery is used to remove that kind of
most cases, removing a testicle doesn't cause long-term sexual problems or
make you unable to father children. But if you had these problems before
treatment, surgery may make them worse. And other treatments for cancer may
cause you to become infertile. You may want to think about saving sperm in a
sperm bank. Talk to your doctor if you have any questions or concerns about
sexual problems or whether you can father children.
choose to get an artificial, or prosthetic, testicle. A surgeon places the
artificial testicle in the scrotum to keep the natural look of the
Finding out that you have cancer can change your life. You may feel like your world has turned upside down and you have lost all control. Talking with family, friends, or a counselor can really help. Ask your doctor about support groups. Or call the American Cancer Society (1-800-227-2345) or visit its website at www.cancer.org.
Learning about testicular cancer:
Living with testicular cancer:
Health Tools help you make wise health decisions or take action to improve your health.
The exact causes of
testicular cancer are unknown.
Infertility from sperm problems has
been linked to testicular cancer. Men with sperm problems have a higher rate of
testicular cancer than men who do not. Experts don't yet know if the two
problems share the same cause or if one causes the other.2
Common symptoms of
testicular cancer include:
Sometimes these symptoms can be caused by other problems, such as a hydrocele or epididymitis.
Testicular cancer that has spread (metastasized)
beyond the testicles and regional
lymph nodes to other organs may cause other symptoms
depending on the area of the body affected. Symptoms of late-stage testicular
cancer may include:
In most cases, the first sign of
testicular cancer is a change in the size or shape of
one or both testicles (testes). Often this change doesn't cause pain, though
pain may be present. If unnoticed or untreated, testicular cancer may spread
(metastasize) to other areas of the body.
After you are diagnosed with testicular cancer, you and your doctor will begin planning your treatment. Nearly all men with testicular cancer have surgery. After surgery, you may have other treatments, if they are needed. This depends on your choices, the type of cells involved, and the stage of your cancer.
Testicular cancer is one of the most curable forms of cancer, especially
during its early stages. If you have symptoms of testicular cancer, see a
doctor as soon as possible.
Some things may
increase your chances of getting
testicular cancer. These risk factors include:
Most men who get testicular cancer don't have
any known risk factors.
Call your doctor as soon as
possible if you have any symptoms of testicular cancer, including:
Some early-stage testicular cancers are successfully managed
a "wait-and-see" approach after surgery. This option involves frequent exams as well as blood tests and
imaging tests to watch your condition. Watchful waiting may let you avoid the side effects from other follow-up treatments, such as chemotherapy and radiation therapy.
If you are
concerned about your symptoms, talk to your doctor right away. Watchful waiting
isn't appropriate unless it is prescribed by a doctor.
Health professionals who can evaluate your symptoms
and your risk for
testicular cancer include:
Health professionals who can manage your cancer
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Most abnormalities of the
testes are found during a
self-exam or routine physical exam by a doctor.
testicular cancer is suspected, your doctor may want
to do other tests. Tests include:
If the ultrasound and blood tests suggest testicular cancer, a doctor will surgically remove your affected testicle. It will be checked for cancer. If cancer is found, you may have other tests, such as X-rays, CT scans, or MRIs, to find out the stage of your cancer.
treatment for testicular cancer, your doctor will schedule a thorough follow-up
program to monitor your recovery, especially if you are doing
watchful waiting. These exams and tests may continue for several years. In addition to physical exams, your follow-up program may include:
A genital exam is an important part of a
routine physical exam for every adolescent boy and man.
may also detect testicular cancer at an early stage. Many of these cancers are
first found as a painless lump or an enlarged
testicle during a self-exam.
Some doctors recommend that men ages 15 to 40 perform monthly testicular self-exams (TSE). But many doctors don't believe that monthly TSE is needed for men who are at average
risk for testicular cancer. Monthly TSE may be recommended for men who are at
high risk for this kind of cancer. This includes men with a history of an
undescended testicle or a family or personal history of testicular
Most testicular cancers are either seminomas or nonseminomas. The main difference between the two is that seminomas grow and spread slowly and respond to radiation therapy. Nonseminomas grow and spread more quickly than seminomas. They don't respond to radiation.
If you are diagnosed with
testicular cancer, your doctor will explain what type
of cancer you have, whether it has spread beyond the testicle (metastasized),
and the potential for curing it. You and your doctor will discuss your
treatment options and possible outcomes of those treatments. Testicular cancer
is highly curable, especially when it's diagnosed at an early
If the cancer isn't treated during its early stages, it may spread (metastasize) to the lymph nodes and to the lungs, liver, brain, and bones. But often testicular cancer that has spread can still be treated successfully.
Some cancer treatments raise your risk of
infertility. Unless you are sure you won't want to father a child in the
future, talk to your doctor about sperm banking before any treatment for
Treatment begins with a
radical inguinal orchiectomy (say "IN-gwuh-nul or-kee-EK-tuh-mee"), which is surgery to
remove the affected testicle(s).
After surgery, depending on which type of cancer cells are
present and whether your cancer has spread to other areas of your body (stage), you may need only watchful waiting. Or you may need further treatment with chemotherapy, radiation therapy, or surgery to remove lymph nodes.
If your cancer was found early, you may have a choice about further treatment. Talk with your doctor about the risks and possible side effects of each treatment option.
After treatment, it is important to receive
follow-up care. This care may lead to early identification and management of
cancer that comes back. Your regular follow-up program may
A diagnosis of testicular cancer means that you will be
seeing your doctor regularly for years to come. It's a good idea to build
a relationship based on trust and the sharing of information. Your doctor may
give you some advice on changes to make in your life to help treatment succeed.
Testicular cancer that has come back (recurred) may be
found during a physical exam, through an imaging test, or as a result of
increasing tumor marker levels. In some cases, recurrent cancer can be successfully treated. This is especially true if the cancer has spread only to
the lymph nodes in the pelvis, belly, or lower back and pelvis.
Recurrent testicular cancer may be treated with chemotherapy, surgery to remove lymph nodes, or radiation. Sometimes high doses of chemotherapy are needed. If these treatments don't work, then high-dose chemotherapy with stem cell transplant may be tried.
In many cases of recurrent testicular cancer,
chemotherapy is followed by surgery. The surgery can remove any remaining cancer as
well as tissue damaged by chemotherapy.
Cancer treatment has two main goals: curing cancer and making your quality of life as good as possible. Palliative care can improve your quality of life by helping you manage your symptoms. It can also help you with other concerns that you may have when you are living with a serious illness.
Testicular cancer has a very good cure rate. But for some people, a time comes when treatment to cure cancer no longer seems like a good choice. This can be because the side effects, time, and costs of treatment are greater than the promise of cure or relief. But this isn't the end of treatment. You and your doctor can decide when you may be ready for hospice care.
It can be hard to decide when to stop treatment aimed at prolonging your life and shift the focus to end-of-life care.
For more information about types of care, see:
Additional information about testicular cancer is provided by the National Cancer Institute at www.cancer.gov/cancertopics/types/testicular.
There are no proven ways to prevent
Home treatment can help you manage the side effects that may occur from your treatment. Some treatments for testicular cancer, such as chemotherapy or radiation, can have serious side effects. Be sure to follow any instructions and take medicines given to you by your doctor.
Healthy habits such
as eating a balanced diet and getting enough sleep and exercise may help
control your symptoms.
To learn more, see the topic
Getting Support When You Have Cancer.
treatment uses medicines to kill the
cancer cells in your body.
Chemotherapy can cause nausea and vomiting. Your doctor may prescribe
medicines to control nausea and vomiting to take
before, during, or after your treatments.
You may be given a choice between
receiving chemotherapy or another treatment. When making your decision, talk to your doctor about the risks and possible side effects of
Some common medicines used to treat testicular cancer
Testicular cancer may be treated with:
Try to find an experienced
surgeon and a medical center where many surgeries are done for your kind of
cancer. Experience can make a big difference. You will likely have fewer side
effects, and you'll recover more quickly.
Radiation therapy for testicular cancer uses high-dose
X-rays or other types of radiation to kill cancer cells. This
therapy may be used after surgery to keep the cancer from coming back.
Sometimes radiation therapy is used to treat testicular cancer that has come
Radiation therapy may be used to treat seminoma cancer. Because the lymph nodes in
the pelvis and lower back are the most common areas for
testicular cancer to spread, radiation is often focused on
You may have a choice between
radiation therapy or another treatment. When making your decision, talk to your doctor about the risks and possible side effects of
Stem cell transplant may be used along with high-dose chemotherapy to treat testicular cancer that has spread into other parts of the body. This is done with stem cells from the person's own body.
People sometimes use complementary therapies along with medical treatment to help relieve symptoms and side effects of cancer treatments. Some of the complementary therapies that may be helpful include:
Mind-body treatments like the ones listed above may help you feel better. They can make it easier to cope with cancer treatments. They also may reduce chronic low back pain, joint pain, headaches, and pain from treatments.
Before you try a complementary therapy, talk to your doctor about its potential value and side effects. Let your doctor know if you are already using any such therapies. These therapies aren't meant to take the place of standard medical treatment. But they may improve your quality of life and help you deal with the stress and side effects of cancer treatment.
The American Cancer Society (ACS) conducts educational
programs and offers many services to people with cancer and to their families.
Staff at the toll-free number have information about services and activities
in local areas and can provide referrals to local ACS divisions.
UrologyHealth.org is a website written by urologists
for patients. Visitors can find specific topics by using the "search"
The website provides information about adult and
pediatric urologic topics, including kidney, bladder, and prostate conditions.
You can find a urologist, sign up for a free quarterly newsletter, or click on
the Urology A–Z page to find materials about urologic problems.
The National Cancer Institute (NCI) is a U.S. government
agency that provides up-to-date information about the prevention, detection,
and treatment of cancer. NCI also offers supportive care to people who have cancer
and to their families. NCI information is also available to doctors, nurses,
and other health professionals. NCI provides the latest information about
clinical trials. The Cancer Information Service, a service of NCI, has trained
staff members available to answer questions and send free publications.
Spanish-speaking staff members are also available.
Bosl GJ, et al. (2008). Cancer of the testis. In VT
DeVita et al., eds., DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology, 8th ed., vol. 1, pp. 1463–1485.
Philadelphia: Lippincott Williams and Wilkins.
Raman JD, et al. (2005). Increased incidence of
testicular cancer in men presenting with infertility and abnormal semen
analysis. Journal of Urology, 174:
Other Works Consulted
American Joint Committee on Cancer (2010). Testis. In AJCC Cancer Staging Manual, 7th ed., pp. 469–478. New York: Springer.
Cornett PA, Dea TO (2010). Primary tumors of the testis section of Cancer. In SJ McPhee, MA Papadakis, eds., Current Medical Diagnosis and Treatment, 49th ed., pp. 1492–1494. New York: McGraw-Hill.
Kollmannsberger C, et al. (2010). Evolution in management of testicular seminoma: Population-based outcomes with selective utilization of active therapies. Annals of Oncology. Published online October 6, 2010 (doi:10.1093/annonc/mdq466).
National Cancer Institute (2010). Testicular Cancer PDQ: Screening—Patient Version. Available online: http://www.cancer.gov/cancertopics/pdq/screening/testicular/patient.
Neal R, et al. (2008). Testicular cancer: seminoma,
search date April 2006. Online version of BMJ Clinical Evidence:
van As NJ, et al. (2008). Evidence-based pragmatic
guidelines for the follow-up of testicular cancer: Optimising the detection of
relapse. British Journal of Cancer,
October 22, 2012
E. Gregory Thompson, MD - Internal Medicine & Christopher G. Wood, MD, FACS - Urology, Oncology
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