A Brief Guide to Testicular Cancer

Doctor in discussion with patient in exam room
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Testicular cancer is the most common solid cancer in men ages 15 to 35 but places only 25th among all cancer in the United States, accounting for 0.5% of all new cancer cases. 8,430 new cases were projected to occur in 2015. It most frequently affects men between 20 and 40 with 33 being the median age at diagnosis. It is very rare in anyone above 50.

There is about a 0.4% risk of developing testicular cancer over one’s lifetime. 

Although the rate of testicular cancer has nearly doubled since the 1970s, the death rate has been reduced by more than half due to better treatment. It typically carries an excellent prognosis with cure rates exceeding 95% in the majority of cases.

How Testicular Cancer Begins

Normal cells adhere to certain rules. They divide and grow within certain perimeters, die off when they are supposed to and do not invade surrounding structures or other organs. Cancer cells have lost this regulation and grow out of control forming tumors. These cells can invade surrounding tissues and spread to other parts of the body through blood and lymphatic vessels.

Testicular cancer originates in the testicles, also referred to as testes. The testicles have both reproductive and endocrine functions. They produce testosterone, the hormone responsible for the secondary sex characteristics of men, as well as sperm, which plays an essential role in reproduction.


Testicular cancer is a varied cancer with many subtypes. The vast majority, around 95%, of testicular cancers can be divided into two main groups: seminoma and nonseminoma. Both types are known as germ cell tumors. Germ cells give rise to the reproductive cells in humans, which include egg cells in females and sperm in males.

Signs and Symptoms

Testicular cancer typically presents as a painless lump on one of the testicles oftentimes accompanied by scrotal swelling. Other signs and symptoms may be present if the cancer has spread (metastasized) to other locations. When testicular cancer spreads, it typically involves the lymph nodes in a space behind the bowel known as the retroperitoneum. Other sites, which can be involved, include the lungs, liver, brain, and bones. Testicular cancer is unique from most other cancers in that if it has spread it still carries the potential of cure with the right treatment.


Treatment depends largely on tumor type and stage. The first step in a vast majority of cases is surgery to remove the cancerous testicle in a procedure known as a radical orchiectomy. This may be followed by chemotherapy, radiation or surgery to remove the retroperitoneal lymph nodes.

Prior to any treatment, sperm banking should be considered due to a risk for infertility.

Following treatment, CT scans are typically done at defined intervals looking for any recurrent cancer in other locations including the retroperitoneal lymph nodes and the lungs. There are also several blood tests consisting of certain enzymes, proteins, and hormones known as tumor markers, which can be increased if cancer has returned.

If recurrence does happen, it usually does so within the first year or two. Recurrences beyond 5 years are rare and most people are considered cured after this point.

If the cancer recurs, the primary treatment is typically chemotherapy. Sometimes surgery is done if it has only spread to a single site. Novel approaches and new treatments can be used under what are known as clinical trials, which oftentimes are based in academic centers and other large institutions.

This is a very brief guide and is intended to provide a basic understanding over just a few paragraphs. Every cancer is unique and needs to be managed by specialists with expertise in diagnosing and treating testicular cancer.

The most common specialties include urology, medical oncology, and radiation oncology.


National Cancer Institute. "Cancer Stat Facts: Testiscular Cancer."