Testicular Cancer

What Is Testicular Cancer?

Cancer is when cells in part of the body grow out of control. They crowd out normal, healthy cells, so the body can't work as it should.

Cancer that affects a testicle is called testicular (tes-TIK-yuh-lur) cancer. It's uncommon in boys. Most cases are in young and middle-aged men.

Testicular cancer responds well to treatment, especially when it's found early.

What Are the Testicles?

The testicles are part of the male reproductive system. They:

• are the pair of egg-shaped organs in the sac (the scrotum) that hangs behind the penis
• make male hormones, like , needed for changes during puberty
• make sperm, which fertilize a female's egg to start a pregnancy

Can Boys Get Testicular Cancer?

Testicular cancer usually affects men 20‒34 years old. But in can happen in boys and teens during puberty.

Things that can make a boy more likely to get testicular cancer include having:

• an undescended testicle (now or in the past)
• a hydrocele (when fluid fills the scrotum)
• a varicocele (enlargement of the veins in the scrotum)
• an inguinal hernia (now or in the past)
• a father or brother with testicular cancer
• HIV

What Happens in Testicular Cancer?

Testicular cancer can:

• spread to other parts of the body
• damage other body parts as it spreads
• begin in the testicle (primary testicle cancer), or start elsewhere and spread to the testicle (secondary testicle cancer)

What Are the Signs & Symptoms of Testicular Cancer?

Symptoms of testicular cancer include:

• a painless lump in the testicle
• a swollen testicle
• different-sized testicles
• heaviness in the scrotum
• pain in the testicle, scrotum, or groin (the area between the belly and thigh)

What Causes Testicular Cancer?

Doctors don't know what causes all testicular cancers, but they think:

• Some cells left from early pregnancy may grow into cancers.
• Something in the environment may cause changes that lead to testicular cancer.

How Is Testicular Cancer Diagnosed?

Testicular cancer is usually diagnosed after a lump is found in the testicle. To find out what is causing the lump, a urologist (doctor specializes in treating genital problems) will:

• do an exam
• order an ultrasound to get a closer look at the lump
• order blood tests that check for tumor markers (proteins made by cancer)
• do a biopsy (take a piece of tissue from the tumor to check under a microscope)

The urologist also might order other tests to see if the cancer has spread. These tests may include:

• a chest X-ray
• an MRI (magnetic resonance imaging)
• a CT (computerized tomography) scan

How Is Testicular Cancer Treated?

Boys with testicular cancer have a care team to help them get the best treatment. The care team usually includes:

• a urologist
• an oncologist (a doctor who specializes in cancer diagnosis and treatment)
• a surgeon

Depending on the type of cancer and whether it has spread, doctors may treat testicular cancer with:

• surgery:
  • that removes the cancer without removing the testicle
  • that removes the cancer and the testicle (a total inguinal orchiectomy)
  • that removes lymph nodes
• chemotherapy: treatment with medicines
• radiation therapy: treatment with high-energy radiation

Can People Who Have Had Testicular Cancer Still Have Children?

Most boys who had one testicle removed and still have one healthy testicle can father children later in life. Sometimes doctors recommend sperm banking before cancer treatment begins. Sperm banking freezes and stores sperm for future use.

For younger teens and boys, an experimental procedure called sperm aspiration might be possible. This process removes immature sperm cells for future use.

Talk to your son's doctor about these options and any other concerns.

What Happens After Treatment?

Depending on the type of tumor and its treatment, boys will need follow-up visits that might include:

• an exam
• blood tests
• a chest X-ray (if the cancer had spread)
• regular CT scans of the belly and pelvis for several years

Sometimes, survivors of testicular cancer can get a second cancer. This usually is another testicular tumor, but also can be other types such as rectal, bladder, kidney, or thyroid cancer. Regular follow-up visits will help find these tumors early so treatment can start right away.

What Else Should I Know?

Teens who had a total inguinal orchiectomy can get a prosthetic, or artificial, testicle a few months after surgery. This can help make some boys feel more comfortable about their appearance.

How Can Parents Help?

To help your son after cancer treatment:

• Go to all follow-up doctor visits.
• Remind your son to do monthly testicular self-exams and to tell you or his doctor if he finds anything unusual.
• If your son had a total orchiectomy and feels self-conscious, it may help to talk to a therapist.

A cancer diagnosis and treatment can be stressful for any family. The care team is there to support your son and the whole family. Be sure to reach out to them with any questions or concerns. You and your son also can find more information and support online at:

• Testicular Cancer Awareness Foundation
• Testicular Cancer Society