Movember, more than a month to celebrate mustaches, is really about raising awareness for men’s health issues, including testicular cancer.
Testicular cancer is the most common cancer affecting young men between the ages of 15 and 44, and its incidence has been gradually increasing over recent decades, according to the National Cancer Institute.
The good news is that it’s also one of the most curable forms of cancer, especially when detected early. About 1 in 250 men will develop testicular cancer in their lifetime. But with prompt diagnosis and treatment, the survival rate exceeds 95 percent.
Men who recognize the warning signs of testicular cancer and know when to get checked have a much greater chance of successful treatment, faster recovery and better long-term health.
What Is Testicular Cancer?
Testicular cancer begins when abnormal cells develop in the testicles (testes), which are the glands inside the scrotum that produce sperm and testosterone.
In most cases, testicular cancer starts in the germ cells (the cells responsible for making sperm). These tumors are called germ cell tumors (or GCTs) and are divided into two main types:
- Seminomas: They grow more slowly and are often easier to treat. This is the type that is becoming more common.
- Non-seminomas: They grow more quickly but still usually respond well to treatment.
What Are the Early Warning Signs of Testicular Cancer?
Does testicular cancer start with a lump? It can. The most common early sign is a painless lump or swelling in one testicle. Some men describe it as feeling like a small marble or a heaviness in the scrotum.
Aside from a noticeable lump or swelling, other testicular cancer symptoms can include:
- A dull ache in the lower abdomen or groin
- A sudden buildup of fluid in the scrotum
- A feeling of heaviness or pressure in one testicle
- Pain or discomfort in a testicle or the scrotum (less common)
- Back pain, chest pain or shortness of breath (possible signs the cancer has spread)
Testicular cancer symptoms can be similar to those caused by other conditions, so it’s important to see your doctor right away if you notice any change in your testicles, even if it’s not painful.
Where Does Testicular Cancer Usually Start?
Most cases start in one testicle, often without spreading elsewhere at first. However, like other cancers, it can spread (or metastasize) if left untreated. When testicular cancer does spread, it’s typically to nearby lymph nodes, the abdomen or the chest.
Does Testicular Cancer Spread Fast?
Non-seminomas tend to grow and spread faster than seminomas. But both types can spread relatively quickly if undetected.
This is why early detection is key. When it’s caught early, the five-year survival rate for testicular cancer is over 95 percent, according to the American Cancer Society.
What Causes Testicular Cancer?
The exact cause of testicular cancer isn’t always known, but there are certain risk factors that can increase a man’s risk.
Risk factors for testicular cancer can include:
- Undescended testicle (cryptorchidism): Men born with one or both testicles not descending properly have a higher risk.
- Family history: Like other types of cancer, having a father or brother with testicular cancer increases risk.
- Previous testicular cancer: Having it once raises the risk in the other testicle.
- HIV infection: Slightly increases risk.
- Age and race: It’s most common in white men between 15-44 years old; the average age at first diagnosis is about 33 years old.
How Is Testicular Cancer Diagnosed?
Doctors use several tools to check for testicular cancer:
- Physical exam: Checking for lumps, swelling or changes in size.
- Ultrasound: The primary imaging test used to visualize the testicles and detect tumors.
- Blood tests: To measure tumor markers like AFP (alpha-fetoprotein) and HCG (human chorionic gonadotropin).
- CT scan: Used to determine if the cancer has spread.
If cancer is suspected, the affected testicle may be surgically removed (called an orchiectomy).
Is Testicular Cancer Curable?
Yes, testicular cancer is highly curable, even in later stages. The five-year survival rate is over 95 percent for localized cancer (when it hasn’t spread outside the testicle) and around 73 percent for advanced-stage cases. This makes it one of the most treatable cancers when addressed early.
Treatment for testicular cancer can include:
- Surgery: To remove the affected testicle and possibly nearby lymph nodes, if needed.
- Chemotherapy or radiation: Used if the cancer has spread beyond the testicle.
- Surveillance: For early-stage cases, doctors may monitor patients with regular imaging and blood tests instead of immediate treatment.
Can Testicular Cancer Come Back After Treatment?
It can, but recurrence is rare, which is why surveillance is a critical part of recovery. After treatment, doctors closely monitor patients for several years, looking for any signs that the cancer has returned. Doctors will be detecting any rise in tumor markers, which happens before symptoms appear.
A typical follow-up schedule is every 3-6 months for the first year. Most recurrences are caught early, and when they are, they’re usually highly treatable.
When Should You Check Yourself?
Doctors recommend monthly self-exams, ideally after a warm shower when the scrotal skin is relaxed. Gently roll each testicle between your fingers, feeling for any lumps, swelling, or changes in size or consistency.
If you notice anything unusual, schedule an appointment with your primary care doctor or a urologist right away.
Remember that testicular cancer doesn’t always cause pain—in fact, most cases are painless. If you feel a lump that doesn’t hurt, you should still be checked immediately.At Stony Brook Medicine, our Urologic Oncology team specializes in diagnosing and treating testicular cancer using state-of-the-art imaging, surgery, and supportive care. We also provide survivorship resources and personalized follow-up for long-term health. To learn more or schedule an appointment, visit the Stony Brook Cancer Center’s Urologic Oncology page.
