Testicular cancer typically affects men between their teens and mid-30s. Common signs include a painless lump, scrotal swelling, or a dull ache in the groin. Diagnosis involves exam, ultrasound, and tumor markers; surgical removal of the affected testicle is the initial treatment. Additional therapy (radiation, chemotherapy, or lymph node surgery) depends on type and stage. Early detection leads to high cure rates and fertility-preservation options should be discussed before treatment.
Overview
Testicular cancer occurs in the testicles (testes) and most commonly affects younger men. It is the most common cancer in males aged about 15 to 35. Early detection greatly improves outcomes, so knowing the usual symptoms and getting prompt evaluation matters.
Who is at risk
Risk is highest in younger adult men, but testicular cancer can occur at other ages. A prior history of an undescended testicle (cryptorchidism), a family history of testicular cancer, and some genetic conditions raise risk. Regular self-awareness is important because many cases are first found by the patient.
Common symptoms to watch for
- A painless lump or hard area on a testicle (the most common sign).
- Swelling of part or all of a testicle.
- A feeling of heaviness in the scrotum.
- A dull ache in the lower abdomen, groin, or scrotum.
- Sudden collection of fluid in the scrotum or a painful testicle (less common).
Staging (simplified)
Clinicians describe spread in broad groups:
- Localized: cancer confined to the testicle.
- Regional: spread to nearby lymph nodes (often in the abdomen).
- Distant: spread to other organs, such as the lungs or liver.
Diagnosis and treatment
Diagnosis usually begins with a physical exam, ultrasound of the scrotum, and blood tests for tumor markers. The first-line treatment for a suspected testicular tumor is surgical removal of the affected testicle (radical inguinal orchiectomy). Additional treatments depend on tumor type and stage. Options include active surveillance, radiation (used mainly for seminomas), chemotherapy regimens such as bleomycin/etoposide/cisplatin (BEP), and in some cases retroperitoneal lymph node dissection (RPLND). High-dose chemotherapy and stem cell transplant are reserved for select recurrent or resistant cases.
Most testicular cancers are highly curable, particularly when found early.
Follow-up and fertility
Treatment can affect fertility. Sperm banking before treatment is commonly offered when fertility preservation is a concern. Follow-up care includes physical exams, tumor marker monitoring, and imaging as recommended by the treating team.
When to see a doctor
See a healthcare provider promptly for any new lump, persistent swelling, or other testicular changes. Monthly self-checks can help men notice changes earlier and get timely care.
- Confirm current annual number of new testicular cancer cases in the United States (American Cancer Society or CDC). [[CHECK]]
- Verify the most recent overall 5-year survival rate for testicular cancer (ACS or SEER). [[CHECK]]
- Confirm typical age range used by current guidelines for highest incidence (ACS or CDC). [[CHECK]]