Testicular Cancer: Symptoms, Risk Factors, Diagnosis, and Treatment

Introduction

Testicular cancer is one of the least common cancers in the general population, yet it is the most common solid tumor in young men, particularly between the ages of 15 and 40. The good news is that when detected early, it has one of the highest cure rates of any type of cancer, even if it has spread beyond the testicle.

Knowing the symptoms, performing regular testicular self-examinations, and consulting a urologist if you notice any changes can make a significant difference in the outcome.

What Is Testicular Cancer?

Testicular cancer occurs when cells within the testicle begin to grow uncontrollably, forming a tumor. In most cases, it develops from germ cells, which are responsible for producing sperm.

There are two main types:

• Seminomas: These tumors tend to grow more slowly and respond very well to treatment.
• Non-seminomas: These tumors generally grow more rapidly and may require more intensive treatment.

Both types have excellent cure rates when diagnosed early.

What Are the Symptoms?

In many cases, testicular cancer does not cause pain during its early stages, making it important to pay attention to any physical changes.

The most common symptoms include:

• A lump or mass in one testicle.
• Enlargement of one testicle.
• A feeling of heaviness in the scrotum.
• Swelling or hardening of a testicle.
• Mild discomfort or pain in the testicle or groin.
• A sudden buildup of fluid around the testicle.

If the disease has spread, symptoms may also include:

• Lower back pain.
• Persistent cough or shortness of breath.
• Swollen lymph nodes.
• Unexplained weight loss.

It is important to remember that not every testicular lump is cancer, but every abnormality should be evaluated by a urologist.

Risk Factors

Although any man can develop testicular cancer, certain factors increase the risk:

• An undescended testicle (cryptorchidism).
• A family history of testicular cancer.
• Previous testicular cancer in the opposite testicle.
• Certain genetic conditions.
• Being between 15 and 40 years of age.

Having one or more risk factors does not mean you will develop testicular cancer, but it does make regular medical follow-up especially important.

How Is It Diagnosed?

Diagnosis begins with a physical examination performed by a urologist.

Additional tests may include:

Testicular Ultrasound

A scrotal ultrasound is the most important imaging study used to distinguish between benign conditions and tumors that may be cancerous.

Tumor Markers

Blood tests can detect substances produced by certain testicular tumors, including:

• Alpha-fetoprotein (AFP)
• Beta-human chorionic gonadotropin (β-hCG)
• Lactate dehydrogenase (LDH)

These markers also help monitor the effectiveness of treatment.

Imaging Studies

If there is concern that the cancer has spread, additional imaging may be recommended, including:

• Computed tomography (CT) scan.
• Magnetic resonance imaging (MRI) in selected cases.
• Chest X-ray or chest CT scan.

Treatment Options

Treatment depends on the type of tumor and the stage of the disease.

Available treatments include:

Surgery

The initial treatment is usually a procedure called a radical inguinal orchiectomy, in which the affected testicle is removed.

It is important to know that this surgery usually does not affect sexual function or the ability to achieve erections. Most men continue to enjoy a normal sex life with one healthy testicle.

Active Surveillance

For certain patients with low-risk tumors, careful monitoring after surgery may be all that is required.

Chemotherapy

Chemotherapy may be recommended if there is a risk that the cancer has spread beyond the testicle or if metastatic disease is present.

Radiation Therapy

Radiation therapy is primarily used in selected cases of seminoma.

Retroperitoneal Lymph Node Surgery

Some patients may require surgery to remove affected lymph nodes.

Can Testicular Cancer Affect Fertility?

Yes. Some treatments may temporarily or permanently reduce sperm production.

For this reason, many specialists recommend sperm banking before treatment begins for patients who wish to have children in the future.

Testicular Self-Examination

Performing a monthly self-examination can help detect abnormalities at an early stage.

The best time to perform the examination is after a warm shower, when the scrotal skin is relaxed.

Basic steps include:

1. Examine one testicle at a time.
2. Gently hold it between your thumb and fingers.
3. Roll it carefully, feeling for lumps or areas of firmness.
4. Compare both testicles, remembering that it is normal for one to be slightly larger or hang lower than the other.

If you notice any changes, schedule an appointment with a urologist as soon as possible.

Can Testicular Cancer Be Prevented?

There is currently no proven way to prevent testicular cancer.

However, early detection can be encouraged by:

• Performing monthly self-examinations.
• Consulting a urologist if you notice any changes.
• Never ignoring a lump, even if it is painless.
• Attending regular medical checkups if you have risk factors.

Prognosis

Testicular cancer is considered one of the most treatable forms of cancer.

When diagnosed in its early stages, the cure rate exceeds 95%, allowing most patients to make a full recovery and return to normal life after treatment.

Even in more advanced stages, modern therapies provide excellent chances of successful treatment.