Testicular Cancer Types, Symptoms, Diagnosis, and Treatment

Abstract

Testicular cancer is a condition where abnormal cells grow uncontrollably in one or both testicles, the organs responsible for producing sperm and testosterone. It is a relatively rare cancer, but it is the most common type in young men aged between 15 and 40 years. The condition is highly treatable, especially when detected early. This article explains everything about testicular cancer in a clear, easy-to-understand way, including its types, causes, symptoms, diagnosis, treatment options, and what to expect during recovery. It also addresses metastatic cases and provides insight into survival rates and supportive care options. This is part of the 'Public Education Series' initiative by Exon Publications.

Cite as: Testicular Cancer: Types, Symptoms, Diagnosis, and Treatment. Brisbane (AU): Exon Publications; 2025. Published on  10 May. DOI: https://doi.org/10.36255/testicular-cancer-types-symptoms-diagnosis-treatment

Introduction

Testicular cancer starts in the tissues of a man’s testicles, which are part of the reproductive system and located in the scrotum beneath the penis. Although it is not a common cancer overall, it is one of the most frequently diagnosed cancers in younger men. With timely treatment, most cases can be cured, making awareness and early detection crucial. Learning about the symptoms, risk factors, and treatment options can help men seek medical advice quickly and make informed decisions about their health (1-5).

Testicular cancer occurs when abnormal cells in the testicle begin to divide and grow uncontrollably. It typically starts in the germ cells, which are the cells that produce sperm. Image: Microscopic image of testicular cancer. Image Credit: Małgorzata Figura - Own work, CC BY 4.0, https://commons.wikimedia.org/w/index.php?curid=84417424

What is Testicular Cancer?

Testicular cancer occurs when abnormal cells in the testicle begin to divide and grow uncontrollably. It typically starts in the germ cells, which are the cells that produce sperm. The condition usually affects just one testicle, but in rare cases, both may be involved. Testicular cancer is categorized based on the type of cell it starts in, and each type has its own growth pattern and response to treatment.

What are the Types of Testicular Cancer?

Most testicular cancers fall into two main categories. Seminomas are cancers that grow slowly and respond well to treatment, often appearing in men in their 30s and 40s. Non-seminomas tend to grow faster and appear in younger men, usually in their late teens to early 30s. Non-seminomas include several subtypes such as embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma. Some testicular cancers are a mix of both seminoma and non-seminoma. There are also rare types like stromal tumors, which begin in the hormone-producing cells, but these make up a small percentage of cases.

What are the Causes and Risk Factors for Testicular Cancer?

The exact cause of testicular cancer is unknown, but several risk factors have been identified. Having an undescended testicle at birth increases the risk, even if surgery is done later to correct it. A family history of testicular cancer or personal history of the disease raises the likelihood of developing it again. Other risk factors include abnormal testicle development, infertility, and certain genetic conditions such as Klinefelter syndrome. Although testicular cancer can affect any man, white men are more likely to be diagnosed than men of other ethnic backgrounds. Regular testicular self-examination may help with early detection, but it is not a replacement for medical evaluation.

What are the Signs and Symptoms of Testicular Cancer?

The most common sign of testicular cancer is a painless lump or swelling in one of the testicles. Some men notice a feeling of heaviness in the scrotum or discomfort in the lower abdomen or groin. One testicle may appear larger or firmer than the other. In some cases, there is a sudden buildup of fluid in the scrotum. Pain, although less common, can occur in the affected testicle or nearby area. If the cancer has spread, symptoms like back pain, shortness of breath, or breast tenderness may develop. It is important to see a doctor if any unusual changes in the testicles are noticed.

How is Testicular Cancer Diagnosed?

Diagnosis usually begins with a physical examination of the testicles. An ultrasound is often the first imaging test used, as it helps distinguish solid lumps from fluid-filled ones. Blood tests are done to check for tumor markers, which are substances released into the bloodstream by some types of testicular cancer. These include alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (β-hCG), and lactate dehydrogenase (LDH). If cancer is suspected, the affected testicle may be surgically removed and examined to confirm the diagnosis and determine the exact type of cancer. Additional imaging tests such as CT scans or chest X-rays are used to find out if the cancer has spread.

What are the Stages and Grades of Testicular Cancer?

Staging describes how far the cancer has spread. Stage I means the cancer is limited to the testicle. Stage II indicates it has spread to nearby lymph nodes, often in the abdomen. Stage III means the cancer has reached distant parts of the body, such as the lungs or liver. The grade of the tumor reflects how aggressive the cells look under a microscope, which helps predict how fast the cancer may grow. Lower-grade tumors tend to grow slowly, while higher-grade tumors are more likely to spread. Both stage and grade guide the treatment plan and help estimate outcomes.

What are the Differences Between Benign and Malignant Testicular Cancer?

Benign tumors in the testicles are non-cancerous and do not spread to other parts of the body. These are rare and are usually removed surgically. Malignant tumors are cancerous and can grow and spread beyond the testicle. Most testicular tumors are malignant and require prompt treatment. Benign conditions such as epididymal cysts or hydroceles may mimic testicular cancer but are harmless. Medical imaging and blood tests help distinguish between benign and malignant conditions, but surgery is often necessary to confirm the diagnosis.

What is Metastatic Testicular Cancer?

Metastatic testicular cancer refers to cancer that has spread beyond the testicle to other parts of the body. It often moves to the lymph nodes in the abdomen and chest, and in more advanced cases, it may reach the lungs, liver, or brain. Metastatic cancer requires a more aggressive treatment approach, which may include a combination of chemotherapy, surgery, and sometimes radiation. Despite spreading, testicular cancer remains one of the most curable solid tumors, even in its advanced stages.

How does Testicular Cancer Spread?

Testicular cancer typically spreads through the lymphatic system or the bloodstream. It usually begins in the testicle and moves to the lymph nodes in the lower back or abdomen. From there, cancer cells can enter the bloodstream and travel to other organs, especially the lungs and, less commonly, the brain or liver. The spread is tracked using imaging tests and blood markers, which also help monitor the effectiveness of treatment. Understanding how the cancer spreads is crucial in developing the right treatment plan.

What are the Treatment Options for Testicular Cancer?

Treatment depends on the type, stage, and grade of the cancer. Surgery is almost always the first step and involves removing the affected testicle. Further treatment may not be necessary for early-stage cancer. If the cancer has spread, chemotherapy is often used to kill cancer cells throughout the body. Radiation therapy may be used in certain cases, especially for seminoma types. Newer treatments like targeted therapy or immunotherapy are being explored in clinical trials, especially for resistant or recurrent cases. Treatment plans are tailored to the individual and often involve a team of specialists, including urologists, oncologists, and fertility experts.

Surgery for Testicular Cancer

The standard surgical procedure is called a radical inguinal orchiectomy, where the entire testicle is removed through an incision in the groin. The operation is typically quick and has a short recovery time. If the cancer is advanced, additional surgery called retroperitoneal lymph node dissection may be needed to remove lymph nodes in the abdomen. Surgery may also be used to remove residual tumors after chemotherapy. The removal of one testicle does not usually affect hormone levels or fertility, although sperm banking is often recommended before treatment begins.

Chemotherapy for Testicular Cancer

Chemotherapy uses drugs to destroy cancer cells and is commonly used when the cancer has spread or is at high risk of recurrence. It is usually given in cycles over several weeks. The most common drugs include cisplatin, etoposide, and bleomycin. While highly effective, chemotherapy can cause temporary side effects like fatigue, hair loss, nausea, and increased infection risk. Most of these side effects go away after treatment ends, but long-term effects such as reduced fertility or nerve damage may occur in some men.

Hormone Therapy for Testicular Cancer

Hormone therapy is not commonly used in testicular cancer because most cases do not rely on hormones to grow. However, if both testicles are removed, testosterone replacement therapy may be needed. This helps maintain muscle mass, bone strength, sex drive, and general well-being. Testosterone can be given as injections, gels, or patches. Hormone levels are closely monitored after treatment to ensure they remain within a healthy range.

Radiation Therapy for Testicular Cancer

Radiation therapy uses high-energy beams to destroy cancer cells and is mainly used for seminomas. It may be given after surgery to lower the risk of recurrence or to treat cancer that has spread to nearby lymph nodes. Radiation is typically delivered externally in short sessions over a few weeks. Side effects can include skin irritation, fatigue, and nausea, but most resolve after the treatment ends. Long-term risks are minimal but may include infertility or secondary cancers in rare cases.

Immunotherapy for Testicular Cancer

Immunotherapy uses the body’s own immune system to fight cancer and is still being studied for testicular cancer. While it is not currently a standard treatment, clinical trials are exploring its use in cases that do not respond to traditional treatments. These therapies aim to improve the body’s ability to recognize and attack cancer cells without harming healthy tissues. Research in this area is ongoing and offers hope for future advancements.

Targeted Therapy for Testicular Cancer

Targeted therapy involves drugs that specifically attack cancer cells without affecting normal cells. This approach is still experimental for testicular cancer but may become more common in the future as genetic and molecular research improves. Targeted treatments could potentially offer effective alternatives with fewer side effects than chemotherapy or radiation.

Managing Side Effects of Testicular Cancer Treatments

Most treatments come with side effects, but many are manageable with supportive care. Fatigue, nausea, and temporary hair loss are common during chemotherapy. After surgery, mild pain and swelling are expected. Hormone therapy can affect mood or libido if not properly adjusted. Regular follow-up visits help monitor for complications and ensure recovery stays on track. Mental health support, physical rehabilitation, and nutritional counseling can all play a role in managing the side effects of treatment.

Supportive Care for Testicular Cancer

Supportive care includes a wide range of services that help improve quality of life during and after treatment. These may involve counseling, pain management, physical therapy, and support groups. Nutritionists, social workers, and fertility specialists may also be part of the care team. Emotional and psychological support is vital, especially for younger men coping with a cancer diagnosis. Supportive care aims to treat the whole person, not just the disease.

Prognosis and Survival Rate for Testicular Cancer

The prognosis for testicular cancer is very good, especially when caught early. The five-year survival rate for localized testicular cancer is above 95 percent. Even when the cancer has spread, aggressive treatment often leads to complete remission. Factors that influence prognosis include the type of cancer, the stage at diagnosis, and how well the cancer responds to treatment. Regular follow-ups and blood marker monitoring help detect any recurrence early, further improving outcomes.

Living with Testicular Cancer

Living with and beyond testicular cancer can bring physical and emotional changes. Some men experience anxiety about recurrence, body image concerns after surgery, or issues with fertility. Open communication with healthcare providers, peer support groups, and mental health counseling can help manage these challenges. Many men return to normal life after treatment, including work, relationships, and physical activity. Long-term follow-up care ensures that any new symptoms or complications are caught early and managed appropriately.

Common FAQs and Answers
Can testicular cancer go away on its own without treatment?

No, testicular cancer does not resolve on its own. Without treatment, it can spread and become life-threatening, even if symptoms are mild at first.

Is testicular cancer painful?

Most cases are painless, but some men may experience discomfort or a dull ache. Pain is not always present, which is why any lump should be checked.

How fast does testicular cancer grow?

Non-seminomas tend to grow and spread faster than seminomas. The growth rate varies, but early detection is critical in all cases.

Can testicular cancer cause infertility?

Yes, especially if both testicles are affected or if chemotherapy or radiation is needed. Sperm banking before treatment is often recommended.

Is it safe to have children after testicular cancer treatment?

Many men can father children after treatment, especially if only one testicle is removed. Fertility testing may be done before trying to conceive.

Does testicular cancer affect testosterone levels?

Removal of one testicle usually does not affect hormone levels. If both are removed, testosterone replacement is needed.

Is testicular cancer hereditary?

There may be a genetic link, especially if close relatives have had it. However, most men diagnosed have no family history.

Can exercise reduce the risk of testicular cancer?

There is no proven link between exercise and prevention, but maintaining overall health supports recovery and resilience.

What does testicular cancer feel like to touch?

It often feels like a hard or painless lump, different from normal soft tissue. Any change in size, shape, or consistency should be examined.

What age should men check for testicular cancer?

Self-examination is recommended monthly from the late teens through mid-forties, the most common age group for diagnosis.

Conclusion

Testicular cancer is a highly treatable disease, particularly when diagnosed early. Knowing the signs and seeking prompt medical attention can make a significant difference. With modern treatments including surgery, chemotherapy, and radiation, most men go on to live healthy lives after diagnosis. Staying informed, attending regular follow-up appointments, and receiving supportive care are key components of successful recovery and long-term well-being.

References

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3. Gilligan T, Lin DW, Aggarwal R, Chism D, Cost C, Derweesh IH, et al. Testicular cancer, version 2.2020, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2019;17(12):1529–1554. doi: https://doi.org/10.6004/jnccn.2020.0002


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This article is part of the 'Public Education Series' initiative by Exon Publications. It was written by professional medical writers for the general public in plain language, based on peer-reviewed articles indexed in PubMed, and further reviewed for scientific accuracy by experts. The views and opinions expressed in this article are believed to be accurate at the time of publication. However, the publisher, editors, and authors cannot be held responsible or liable for any errors, omissions, or consequences arising from the use of the information provided. The publisher makes no warranties, explicit or implicit, regarding the contents of this article or its use. The information in this article is intended solely for informational purposes and should not be considered medical advice.