What is testicular cancer?

Each year in the UK, around 2,300 men are diagnosed with testicular cancer. It is more common in white men and younger to middle-aged men. Testicular cancer is usually curable.

Testicular cancer starts in one of the testicles (sometimes called the testes).

The testicles produce sperm. Sperm can fertilise a female egg to make a baby. Testicles also make the hormone testosterone. Testosterone helps control different functions in our bodies including, sex drive and facial and body hair.

We have more information about the testicles and male reproductive system.

Testicular cancer and the lymph nodes

Sometimes testicular cancer can spread to lymph nodes (glands) at the back of the tummy. These are called the retroperitoneal lymph nodes.

We have more information about testicular cancer and the lymph nodes.

Testicular cancer types

Testicular cancer is a general term for all types of testicular cancer. Most of these cancers develop from germ cells in the testicles. So they are also sometimes called germ cell tumours (GCTs).

There are 2 main types of testicular germ cell tumours:

  • seminomas – they usually affect men aged 15 to 55
  • non-seminomas – they usually affect men aged 15 to 35.

There are also some rarer types of testicular cancer. We have more information about testicular cancer types.

Symptoms of testicular cancer

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.

How to check for testicular cancer

It is important to check your testicles regularly from puberty onwards. Testicular cancer is usually curable, and it is easier to treat when it is diagnosed early.

Causes and risk factors of testicular cancer

The cause of testicular cancer is not known. But there are certain risk factors that may increase the chance of developing it. These include having an undescended testicle as a child. Or having a brother or father who had testicular cancer can slightly increase the risk.

Having a risk factor does not mean you will get cancer. And if you do not have any risk factors, you may still develop it.

We have more information about the causes and risk factors of testicular cancer.

Testicular cancer diagnosis

Your GP will examine you and may arrange for you to have the following:

  • An ultrasound scan of the scrotum and testicles – this scan uses sound waves to produce a picture of inside your testicles. It can tell your doctor if the lump is harmless cyst (fluid filled lump) or if it is likely to be a cancer. It is a painless test and only takes a few minutes.
  • Blood tests – you may also have blood tests to check for levels of certain chemicals in your blood, called tumour markers. These can help to diagnose some testicular cancers. You will also have other blood tests to check your general health.

Or they may refer you directly to see a specialist doctor called a urologist.

Orchidectomy

If the ultrasound shows the lump is highly likely to be cancer you will need surgery to remove a testicle (orchidectomy). This is the only way to make a definite diagnosis.

It is natural to worry about this operation. If the other testicle is healthy, an orchidectomy will not affect your sex life or fertility. Fertility is being able to make someone pregnant.

During the operation the surgeon can put in an implant int so it looks the same as your other testicle.

You may see a specialist nurse who can give you information and support. Some men may be advised to store (bank) sperm before surgery rather than after it. This might be because they have fertility problems, or the other testicle is small.

Further tests

After testicular cancer is diagnosed you my have further tests:

  • General blood tests – to check how well your kidneys and liver are working.
  • Tumour marker blood tests – you usually have these checked a week after the orchidectomy.
  • CT scan or MRI scan – to find out if the cancer has spread to other parts of the body.
  • Chest x-ray – to check that you lungs are not affected and are healthy.

Waiting for test results can be a difficult time. We have more information that can help.

Stages of testicular cancer

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 4. 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.

Testicular cancer treatment

There are different treatments for testicular cancer. A team of specialists meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).

They can talk to you about things to think about when making treatment decisions.

Testicular cancer is diagnosed by having a testicle removed (orchidectomy). But this operation also treats the cancer by removing it. For some men it may be the only treatment they need.

Further treatment after orchidectomy depends on:

Treatment for testicular cancer includes:

  • Surveillance

    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

    Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It is given to reduce the risk of testicular cancer coming back or to treat cancer that has already spread, or comes back after treatment.

  • High-dose chemotherapy with stem cell support

    Occasionally, much higher doses of chemotherapy are given. The drugs destroy young blood cells (stem cells) in your bone marrow, as well as, cancer cells. Before having chemotherapy, you have your own stem cells taken and stored. They are then given back to you after having high dose chemotherapy, to start making new blood cells. It may be given if the cancer has not responded completely to treatment or has come back after treatment. It is also called an autologous stem cell transplant.

  • Radiotherapy

    Radiotherapy uses high-energy rays to destroy cancer cells. It is more often used to treat seminoma. You may have radiotherapy to reduce the risk of the cancer coming back in the lymph nodes at the back of the tummy (abdomen). These are called the retroperitoneal lymph nodes

  • Removing the retroperitoneal lymph nodes

    Some men may need an operation called a retroperitoneal lymph node dissection (RPLND) to removes these nodes (glands). This is usually after chemotherapy when a CT scan shows they are still enlarged. Rarely, they are removed in men with early-stage non-seminoma, who cannot have surveillance or adjuvant chemotherapy.

We have more information about testicular cancer treatment. You may be offered some treatments as part of a clinical trial.

Late effects of testicular cancer treatment

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.

They 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.

Effects on sex and fertility

Fertility

Most men are still able to make someone pregnant after testicular cancer treatment. But even if your chances of becoming infertile are low your doctor usually advises you to store (bank) some sperm. You usually do this after orchidectomy. It is important to have it done before you have any further treatment.

Sex drive

A diagnosis of testicular cancer can bring up a lot of different feelings. Sometimes this may affect your sex drive (libido).

Treatment side effects may also mean you are less interested in sex. This will usually improve as your feelings get easier to cope with and you recover from treatment.

We have more information about testicular cancer, sex and fertility.

After testicular cancer treatment

Follow-up

You will have regular check-ups at the hospital after treatment finishes. These may every month to begin with. Your doctor will examine you. They also check your remaining testicle.

You may have regular tumour marker tests. Other tests may include:

It is important to attend all your appointments. Make another appointment straightaway if you cannot go. In between appointments contact your hospital doctor, nurse, or GP if you have new symptoms.

It is important to check your remaining testicle every month. Getting a new primary cancer in the other testicle is rare. But men who have already had testicular cancer have a higher risk.

Well being and recovery

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.

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 and keeping physically active.

Complementary therapies can help you feel better, reduce stress and anxiety, and improve some treatment side effects

Your feelings

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.

Treating testicular cancer that comes back

If testicular cancer comes back it can usually still be cured even if the cancer has spread to other parts of the body. Cancer that comes back is sometimes called a recurrence. You usually have further chemotherapy. Some men may have an high-dose chemotherapy with stem cell support.

Occasionally after chemotherapy, some men develop signs of cancer in areas such as the lungs, brain or liver. They may need surgery. Experienced surgeons do these operations in specialist units. If you need this type of operation, your doctor will talk to you about it.

How we can help

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