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Testicular cancer

Key points

  • Testicular cancer affects around 2,280 men in the UK each year and is most common in young and middle-aged men.
  • Most men make a full recovery from testicular cancer.
  • The most common symptom of testicular cancer is swelling or a hard lump on one of your testicles.

Testicular cancer is an abnormal and uncontrolled growth of cells that starts in your testicle. It mostly affects men aged 20 to 40.

Animation - how cancer develops

About testicular cancer

In testicular cancer, cells in one of your testicles start to grow abnormally and out of control. The testicles are located inside your scrotum, the loose bag of skin that hangs below your penis. Your testicles produce sperm and the hormone testosterone from the start of puberty.

Illustration showing the position of the testicles and surrounding structures

Testicular cancer most often affects just one testicle, but rarely, it can affect both. Also after treatment for cancer in one testicle, you can develop it later in the other.

Testicular cancer can sometimes spread to your lymph nodes in your abdomen (tummy) or more rarely, to other organs, through your bloodstream or lymph system. The lymphatic system consists of the tissues and organs in your body that produce and store cells that fight infection and disease. These include your bone marrow, spleen, thymus and lymph nodes. The channels that carry lymph are also part of this system. If testicular cancer spreads to other parts of your body, it can form secondary tumours. The spread of cancer through your body is called metastasis.

Testicular cancer affects around 2,280 men in the UK each year, and mostly affects men aged 20 to 40, although you can get it if you’re younger or older than this. Testicular cancer isn’t common – one out of every 100 men diagnosed with cancer have testicular cancer. However, the number of men who develop it is increasing, particularly white men.

The outlook for men diagnosed with testicular cancer is one of the best for all cancers and most make a full recovery, particularly if it's diagnosed early.

Types of testicular cancer

There are two main types of testicular cancer:

  • seminoma
  • non-seminoma

The names refer to the type of cell that makes up the tumour.

Very rarely, another type of cancer called a lymphoma can develop in your testicles, which is cancer of the lymphatic tissue. This is the most common cancer found in the testicles in men over 50.

Symptoms of testicular cancer

The most common symptom of testicular cancer is swelling or a hard, pea-sized (or larger) lump on your testicle, which isn’t usually painful. Other symptoms can include:

  • a pulling sensation or heavy feeling in your scrotum
  • a dull ache in your groin or lower abdomen
  • pain or discomfort in your testicle or scrotum (which may come and go)
  • a collection of fluid in your scrotum (called a hydrocele)
  • feeling unwell and tired

If the cancer is at a later stage, you can get symptoms including:

  • enlarged breasts
  • back pain
  • shortness of breath
  • coughing
  • feeling sick

If you have any of these symptoms, see your GP.

It’s important to regularly check your testicles for any changes. The earlier testicular cancer is diagnosed, the easier and quicker it is to treat and the better your chances of recovery.

Causes of testicular cancer

The exact reasons why you may develop testicular cancer aren't fully understood at present. However, there are some things that can make it more likely. For example, if you were born with an undescended testicle (one that remains in your abdomen rather than descending into your scrotum) you’re three times more likely to develop testicular cancer than men who didn’t have this problem. And if you don't have this corrected by the age of 13, you may be up to five times more likely to develop testicular cancer later in life.

Other factors that may increase your risk of getting testicular cancer include:

  • having a brother or father who has had testicular cancer
  • having fertility problems and low quality sperm
  • being white
  • having other medical conditions, such as hypospadias, an inguinal hernia, or HIV/AIDS
  • having a rare complication of mumps called orchitis (painful swelling of the testicles)

Having a vasectomy or an injury to your testicles doesn’t increase your risk of getting testicular cancer.

Diagnosis of testicular cancer

Your GP will ask you about your symptoms and examine you. He or she may also ask you about your medical history, and whether anyone else in your family has had testicular cancer. Your GP may refer you to a urologist (a doctor who specialises in identifying and treating conditions that affect the urinary system) or a testicular cancer specialist.

You may have a blood test to check the levels of certain hormones and proteins that can be high if you have testicular cancer. You may also be asked to have an ultrasound scan. An ultrasound scan uses sound waves to produce an image of the inside of your scrotum and your testicle. It can help to show whether the lump is caused by a condition other than cancer.

The only way to confirm testicular cancer is with a biopsy. In other types of cancer this would involve removing a small sample of tissue. However for testicular cancer, your entire affected testicle is usually removed in an operation called an orchidectomy. This is because the risk of the cancer spreading is too high with a normal biopsy. However, very occasionally if you have a very small tumour, your surgeon will remove only part of your testicle, which is called a partial orchidectomy.

If you’re found to have cancer, you may need to have other tests to assess if the cancer has spread. This process of finding out whether the cancer has spread is called staging. These further tests may include a CT or MRI scan or a chest X-ray.

Treatment of testicular cancer

Treatment for testicular cancer is usually very successful. The type of treatment you have will depend on the type of cancer you have and how far it has spread. Your doctor will describe your treatment to you and also describe any effects your treatment may have, such as on your sex life and fertility. See out FAQs for more information on how treatment may affect your fertility.

Surgery

The main treatment for testicular cancer is surgery to remove your affected testicle (if it hasn’t already been removed during your diagnosis). If you’re diagnosed early, surgery may be the only treatment that you need.

Your doctor will talk to you about the operation and your options. You may be able to have an artificial testicle inserted into your scrotum to give it a normal appearance.

After surgery, you will be referred to a team of specialists including an oncologist (a doctor who specialises in cancer care) to decide on further treatment. If your cancer is more advanced, you may need to have the lymph nodes in your abdomen removed for example. Your doctor will explain what treatment you need.

Non-surgical treatments

Chemotherapy

Chemotherapy uses medicines to destroy cancer cells. The type of chemotherapy treatment you have will vary depending on your type of testicular cancer. Usually you have a course of treatment, which you will have as several doses over a period of weeks. Your doctor will give you information on the type and course that’s best for you.

If the cancer has spread beyond your testicle or come back after surgery to remove your testicle, you will need to have chemotherapy. You may also have chemotherapy after surgery to reduce the chance of the cancer returning in the future. This is known as adjuvant chemotherapy.

Radiotherapy

Radiotherapy uses radiation to kill cancer cells. You may have radiotherapy after surgery to prevent the cancer coming back or to treat any cancer cells that have spread out of your testicle. You can have radiotherapy as an alternative to or in addition to chemotherapy.

After your treatment

You will need to attend hospital appointments and have regular check-ups after your treatment to see if any of the cancer remains. If further cancer is found, you may be able to have more treatment to remove it.

Help and support

Being diagnosed with cancer can be distressing for you and your family. An important part of cancer treatment is support to deal with the emotional aspects as well as the physical symptoms. Specialist cancer doctors and nurses are experts in providing the support you need.

 

Reviewed by Rachael Mayfield-Blake, Bupa Health Information Team, June 2013.

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For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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