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What is testicular cancer?
Testicular cancer types
Symptoms of testicular cancer
How to check for testicular cancer
Causes and risk factors of testicular cancer
Testicular cancer diagnosis
Stages of testicular cancer
Testicular cancer treatment
Late effects of testicular cancer treatment
Effects on sex and fertility
After testicular cancer treatment
About our information
How we can help
Testicular cancer starts in one of the testicles. The testicles are the main part of the male reproductive system.
This type of cancer can affect anyone who has testicles, including men, transgender (trans) women and people assigned male at birth. It is most likely to happen between the ages of 25 and 40.
Each year in the UK, around 2,300 men are diagnosed with testicular cancer. Testicular cancer is usually curable. Like other cancers, it is not infectious, and you cannot pass it on to other people.
We have more information about the testicles and male reproductive system.
Testicular cancer and the lymph nodes
Testicular cancer is usually only found in the testicle, but sometimes cancer cells from the testicles can spread to nearby lymph nodes. Lymph nodes are part of the lymphatic system.
Sometimes testicular cancer can spread to lymph nodes at the back of the tummy (abdomen). These are called the retroperitoneal lymph nodes.
We have more information about testicular cancer and the lymph nodes.
Booklets and resources
Testicular cancer is the general term used for all types of testicular cancer. Most testicular cancers develop from cells in the testicles called germ cells. They are also called germ cell tumours (GCTs).
There are 2 main types of testicular germ cell tumours:
- seminomas – they usually affect those aged 15 to 50
- non-seminomas – they usually affect those aged 15 to 35.
There are also some rarer types of testicular cancer. We have more information about testicular cancer types.
The most common symptom is a lump or swelling in a testicle, or a dull ache, pain, or heaviness in the scrotum.
If the cancer has spread to lymph nodes or other parts of the body it may cause other symptoms.
We have more information about testicular cancer symptoms.
Doctors do not yet know what causes testicular cancer. But we know some of the risk factors that may increase the chances of developing it.
Having one or more risk factors does not mean you will get testicular cancer. And if you do not have any risk factors, it does not mean you will not get testicular cancer.
We have more information about the causes and risk factors of testicular cancer.
Usually, you begin by seeing your GP, who will examine you. If your GP thinks your symptoms may be linked to testicular cancer, they will refer you to a hospital to be seen within 2 weeks. Sometimes, your GP will arrange for an ultrasound scan of the testicle before you visit the hospital.
At the hospital, you will see a urologist. This is a doctor who specialises in treating problems with the testicles, penis, prostate, bladder and kidneys. They will examine you and ask about your general health and any previous health problems you may have had.
They will arrange an ultrasound scan of the scrotum and testicles. They will also arrange blood tests.
Some hospitals have testicular one-stop clinics. This means as well as seeing a urology doctor, you may have an ultrasound on the same day. You will also be seen by a specialist nurse.
An ultrasound scan uses sound waves to produce a picture of the inside of your testicles. This is done by putting gel onto the scrotum and then passing a device like a microphone over the area. It is a painless test, and only takes a few minutes. An ultrasound is the quickest and most accurate test for diagnosing testicular cancer. It can tell your doctor whether the lump is a harmless cyst (fluid-filled lump) or likely to be a cancer.
Some testicular cancers make certain chemicals called tumour markers that are released into the blood. You may have blood tests to see if you have raised levels of these chemicals. Even if these chemicals are not raised in the blood, you may still have testicular cancer. You will also have other blood tests to check your general health, including your iron (haemoglobin) levels and how your liver and kidneys are working.
Sometimes doctors diagnose testicular cancer during tests for symptoms in other areas of the body. For example, if a testicular cancer has spread, it may be diagnosed after having had a CT or MRI scan.
Waiting for test results can be a difficult time. We have more information that can help.
After the ultrasound scan
If the ultrasound shows the lump is highly likely to be testicular cancer, the whole testicle needs to be closely examined. The only way to get a definite diagnosis is to have surgery to remove the whole of the affected testicle. This operation is called an orchidectomy. This is because taking just a small piece of tissue (biopsy) may miss a cancer.
On rare occasions, the surgeon will remove only part of the testicle. For example, this may happen when someone has only one testicle. Or it may happen if the scan does not show clearly how likely it is to be cancer.
A doctor called a pathologist will examine the removed tissue using a microscope. This is to see if there are any cancer cells. If there are, the sample will show which type of testicular cancer you have.
Removing the testicle (orchidectomy)
As well as confirming a diagnosis, removing the testicle removes the cancer. It is the main treatment for testicular cancer that has not spread.
If the other testicle is healthy, an orchidectomy will not affect your ability to get an erection or your fertility. Fertility is being able to make someone pregnant.
If you are gay, bisexual or transgender
There may be times when members of your healthcare team ask about your sexual orientation or gender identity. This information can help your team give the right care and support to you and the people close to you. You may find it makes things easier or less stressful for you.
If the questions they ask do not fit who you are or how you identify, tell your team. If you are unsure or uncomfortable answering a question, it is okay to check why the person is asking. You can ask them why they need this information and why they think it is relevant to your care.
The stage of a cancer describes its size and if it has spread from where it started. Testicular cancer is divided into stages 1 to 3. Staging also includes the level of tumour marker tests.
Knowing the stage helps your doctor decide on the best treatment for you.
We have more information about the stages of testicular cancer.
You usually have surgery to diagnose and also remove the cancer (orchidectomy). After surgery, your doctors and team of specialists meet to talk about the best treatment for you. They are called a multidisciplinary team. They will talk to you about possible further treatment options and explain what might be best for your situation. They can talk to you about things to think about when making treatment decisions.
Treatment options depend on:
- the stage of testicular cancer you have
- whether it is non-seminoma or seminoma
- the risk of the testicular cancer coming back.
After surgery, treatment options for testicular cancer include:
If the risk of the cancer coming back after surgery is low, your doctor may recommend surveillance (monitoring). They check you regularly for signs of the cancer coming back. It is very important to go to all your appointments.
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It may be given to reduce the risk of testicular cancer coming back. It may also be used to treat testicular cancer that has already spread or come back after treatment.
High-dose chemotherapy with stem cell support
Radiotherapy uses high-energy rays to destroy cancer cells. It may be used to treat seminoma. It may be used to reduce the risk of the cancer coming back in the lymph nodes at the back of the tummy (abdomen) or if a seminoma comes back. These nodes are called the retroperitoneal lymph nodes.
More rarely, radiotherapy may be to treat non-seminomas.
Removing the retroperitoneal lymph nodes
Surgery to other parts of the body
Occasionally, testicular cancer may spread to other parts of the body such as the lungs, brain or liver. If further surgery is needed, it is done in a specialist unit. If you need this type of operation, your doctor will explain more about it.
Treating testicular cancer that comes back
If testicular cancer comes back, treatment can still usually cure it. This is even if the cancer has spread to other parts of the body. Treatment will depend on the type of testicular cancer, the areas affected and previous treatment.
We have more information about testicular cancer treatment. You may be offered some treatments as part of a clinical trial.
Sometimes side effects of treatment may take a long time to improve. Or some may not completely go away and may become permanent. These are called long-term effects. Other side effects may develop years after treatment finishes. These are called late effects. You may not have any of these effects at all. Or they may range from mild to severe.
Possible late effects include hearing problems, changes in sensation in your hands and feet and heart or lung problems. There are different ways to manage these.
We have more information on testicular cancer treatment late effects.
Treatments used for testicular cancer do not usually affect your ability to have sex or make someone pregnant (your fertility). But it is common to worry about this.
We have more information about how treatment may affect your sex life and fertility. This includes information on contraception during treatment, having children in the future, testosterone replacement and storing sperm (sperm banking).
You will have regular check-ups at the hospital after treatment finishes. Your doctor will examine you and check your remaining testicle. These may be every month to begin with. But how often you go to the hospital will depend on the type and stage of testicular cancer.
You may have regular tumour marker tests. Other tests may include:
It is important to go to these appointments. If you cannot go to an appointment, make another one straight away.
Having to attend follow-up appointments can feel stressful. Your healthcare team can help you to cope with any problems you might have after treatment and help you find support. This can make you feel more confident and give you back a feeling of control.
If you have new symptoms between your appointments, contact your hospital doctor, nurse or GP. It is important that you check your remaining testicle every month. It is rare to develop a new cancer in the other testicle, but having already had testicular cancer increases the risk of this happening.
Well being and recovery
Recovering from cancer and its treatment can take time. You may still have side effects, such as tiredness, and be coping with the emotional effects for a while after treatment. In time, you may find you slowly start to focus more on the day-to-day things you did before your diagnosis. Going back to work and getting back to your usual interests can be positive steps.
You may choose to make some positive lifestyle changes after treatment, even if you already have a healthy lifestyle. Changes to the way you live can improve your health and well-being and help your body recover. They may also help to reduce the risk of late effects. These include not smoking, keeping physically active and having a well-balanced diet.
Complementary therapies can help you feel better, reduce stress and anxiety, and improve some treatment side effects.
Everyone has their own way of dealing with illness and the different emotions they experience. There are lots of different ways to communicate and these can help you feel less alone. They include support groups and online support. You may find it helpful to talk things over with family and friends or your doctor or nurse.
Macmillan is also here to support you. If you would like to talk, you can:
Below is a sample of the sources used in our testicular cancer information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
The British Association of Urological Surgeons (BAUS) Guidelines on Testicular Cancer. March 2015. Available from: https://www.baus.org.uk/professionals/sections/testicular_cancer.aspx (accessed April 2022).
European Association of Urology (EAU) Guidelines on Testicular Cancer 2022. Available from: https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-Guidelines-on-Testicular-Cancer-2022.pdf (accessed April 2022).
European Society for Medical Oncology (ESMO). Testicular seminoma and non-seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Last updated 2022.
European Society for Medical Oncology (ESMO). Testicular seminoma and non-seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Last updated 2022. Available from: https://www.annalsofoncology.org/article/S0923-7534(22)00007-2/fulltext (accessed April 2022).
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Ursula McGovern, Consultant Medical Oncologist.
Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.
The language we use
We want everyone affected by cancer to feel our information is written for them.
We want our information to be as clear as possible. To do this, we try to:
- use plain English
- explain medical words
- use short sentences
- use illustrations to explain text
- structure the information clearly
- make sure important points are clear.
We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.
You can read more about how we produce our information here.