Testicular cancer is a rare type of malignant tumor that affects the testicles and often develops without noticeable symptoms. However, some men may detect hard, painless lumps in one of the testicles, experience pain when touching the area, or notice an increase in size.

This form of cancer most commonly affects men between the ages of 20 and 34 and is more frequent among those who have had an injury to the testicular area, such as athletes.

When testicular cancer is suspected, it’s important to see a urologist for proper diagnosis and treatment. In most cases, treatment involves surgery.

male doctor talking to male patient, both are smiling

Testicular cancer symptoms

The main symptoms of testicular cancer include:

Hard, painless lumps about the size of a pea;
Enlargement or increased heaviness of the testicle;
Breast swelling or tenderness;
One testicle feeling firmer than the other;
Testicle pain when touched or after sexual intercourse.

In many cases, testicular cancer develops silently and can be difficult to detect early. For this reason, performing regular testicular self-exams may be recommended, especially for men with a family history of the condition.

Early detection can help identify changes that may lead to cancer, therefore it is important to talk to your primary care provider or a urologist about screening recommendations.

Other testicular conditions can cause similar symptoms, particularly lumps, but are usually less serious, such as epididymitis, cysts, or varicocele. It’s important to consult a urologist to determine the exact cause.

Symptoms of advanced testicular cancer

When testicular cancer advances, it may spread to other parts of the body and cause additional symptoms, such as:

Persistent pain in the lower back;
Shortness of breath or frequent coughing;
Ongoing abdominal pain;
Frequent headaches or confusion.

These symptoms are uncommon and generally indicate that the cancer has spread to other organs, such as the lymph nodes, lungs, liver, or brain.

At this stage, testicular cancer is more difficult to treat, but therapy focuses on reducing the size of the tumor and relieving symptoms.

Confirming a diagnosis

If any changes are noticed during a self-exam, it’s important to see a urologist for diagnostic tests, which may include a physical exam, testicular ultrasound, blood tests for tumor markers, and a CT scan (computed tomography).

In some cases, a biopsy of the testicular tissue may be recommended to confirm the diagnosis and determine the cancer stage.

If there is a high suspicion for testicular cancer, the entire testicle is typically removed in a procedure called a radical inguinal orchiectomy. The diagnosis is then confirmed by examining the removed tissue.

Main stages

There are four main stages in the development of testicular cancer:

Stage	What it means
Stage 0	Cancer is confined to the seminiferous tubules inside the testicle and has not spread to lymph nodes or other tissues.
Stage I	Cancer cells have grown outside the seminiferous tubules and may affect nearby structures, but have not yet reached the lymph nodes.
Stage II	The cancer may have extended beyond the testicle and spread to one or more lymph nodes.
Stage III	The cancer has spread beyond the testicle and lymph nodes, possibly forming metastases in nearby or distant organs.

The more advanced the stage, the more challenging treatment becomes.

Possible causes

The main causes and risk factors for testicular cancer include:

Undescended testicle (cryptorchidism);
Testicular injury or trauma;
Family history of testicular cancer;
Personal history of cancer in one testicle;
Infections caused by viruses such as HIV, HPV, Epstein-Barr virus, cytomegalovirus, or parvovirus B19;
Age, with the highest risk between 20 and 34 years.

Additionally, being of Caucasian ethnicity appears to increase the risk of developing testicular cancer by up to five times compared to Black men.

Treatment options

Treatment for testicular cancer depends on the stage of the disease. It typically starts with surgery (orchiectomy) to remove the affected testicle and all cancerous cells, which is often sufficient in early-stage cases.

For more advanced stages, radiation therapy or chemotherapy may be recommended after surgery to destroy any remaining tumor cells.

After treatment, the urologist will schedule regular follow-up appointments, including blood tests and imaging exams, to monitor recovery and ensure that the cancer has been completely eliminated.

Does treatment cause infertility?

Infertility generally occurs only when both testicles must be removed, which is rare.

However, in such cases, sperm can be stored in specialized labs before surgery and later used in assisted reproduction technology (ART) techniques, such as artificial insemination, allowing the man to have children in the future.

Is testicular cancer curable?

Testicular cancer has a high cure rate, even when it has spread to other parts of the body, as long as it’s detected and treated early.

Testicular Cancer: Symptoms, Causes & Treatment