What is testicular cancer?
Cancer of the testes is the most common cancer among young men aged 20 to 39 years and accounts for 1–2% of all male cancers. Almost 50% of testicular cancers occur in men under the age of 35. There are around 8,500 new cases of testicular cancer and 350 related deaths in the U.S. each year. The prognosis has improved greatly, and most men can be totally cured of the disease.
Treatment is very successful and can be rapid; it is only when there is a long delay in diagnosis that the cancer may spread and become more difficult to treat. The risks of developing testicular cancer are increased if you have a close family member (i.e., brother or father) with testicular cancer. Having an undescended testicle at birth can also increase the risk.
What are the symptoms of testicular cancer?
Swellings of the scrotum are fairly common and may be accompanied by pain. All swellings should always be checked by a doctor as soon as possible. There are many causes of scrotal swelling, most of which are not cancer. A sudden onset of swelling and pain could suggest torsion of the testis, which requires urgent surgical treatment. Testicular cancer does not usually cause severe pain but may cause discomfort and a hardening of the testis.
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It is important that you know your own anatomy and what is normal for you so that any changes can be detected quickly. There are leaflets available on self-examination which explain the normal physiology of the scrotum. All young men should be aware of the need for self-examination.
How is testicular cancer diagnosed?
A physical examination by a doctor is the first step if a swelling or change in the testes is noticed. An ultrasound will then be performed to diagnose the cause of the swelling. Blood tests will also be performed. Your doctor will refer you to a surgeon if the tests indicate that cancer is present.
The affected testicle is usually removed surgically. A biopsy may also be needed to confirm diagnosis. Scans and x-rays will then be used to check that the cancer has not spread elsewhere.
How is testicular cancer treated?
Treatment is usually surgery, and the affected testicle is removed. This procedure is called an orchidectomy. This should not affect your sex life or fertility, which should return when treatment has been completed.
If fertility problems have been experienced or if a family has not been completed, sperm can be stored until it is proved that normal production of sperm has returned. If the cancer has been detected early, then surgery alone may be required. However, many men need additional treatment in the form of chemotherapy.
Chemotherapy does have side effects, which may be severe but are usually temporary. These may include severe nausea and vomiting, hair loss, and suppression of the bone marrow. However, the cure rates for this type of cancer are very high and the recurrence rate is very low.
Further information
National Cancer Institute
www.cancer.gov
Last reviewed: August 2011
