What is testicular cancer?

Cancer that develops in a testicle is called testicular cancer or cancer of the testis (plural: testes). Usually only one testicle is affected, but in some cases both are affected.

Types of Testicular Cancer

The most common testicular cancers are called germ cell tumours. There are 2 main types:

• Seminoma – tends to develop more slowly, usually occurs between the ages of 25 and 45.
• Non-seminoma – tends to develop more quickly, more common in late teens and early 20s.

Sometimes a testicular cancer can be a mix of seminoma and non-seminoma cells, or a combination of the different subtypes of non-seminoma cells.

A small number of testicular tumours start in cells that make up the supportive (structural) and hormone-producing tissue of the testicles. These are called stromal tumours.

Risk factors

The causes of testicular cancer are unknown, but certain factors may increase your risk of developing it.

• Personal history – if you have previously had cancer in one testicle, you are more likely to develop cancer in the other testicle.
• Undescended testicles – before birth, testicles develop inside the abdomen. By birth, or within 6 months, the testicles should move down into the scrotum. If they don’t descend by themselves, doctors perform an operation to bring them down. Although this reduces the risk of developing testicular cancer, people born with undescended testicles are more likely to develop testicular cancer.
• Family history – sometimes gene mutations are passed on in families. If your father or brother has had testicular cancer, you are slightly more (2%) at risk.
• Infertility – having difficulty conceiving a baby can be associated with testicular cancer.
• HIV and AIDS – there is some evidence that people with HIV and AIDS have an increased risk of testicular cancer.
• Some congenital defects – some people are born with an abnormality of the penis called hypospadias which leads to an increased risk of developing testicular cancer.

Symptoms

In some people, testicular cancer does not cause any noticeable symptoms and it may be found during tests for other conditions.

When there are symptoms, the most common ones are:

• swelling or a lump (usually painless)
• a change in a testicles size or shape (hardness or swelling)

These symptoms don’t necessarily mean you have testicular cancer. They can be caused by other conditions, such as cysts, which are harmless lumps in the scrotum. If you find any lump, however, it’s important to see your doctor for a check-up.

Diagnosis

You will usually begin by seeing your GP, who will examine your testicles and scrotum for a lump or swelling. If the GP feels a lump that might be cancer, you will have an ultrasound. If the lump looks like a tumour on the ultrasound, you will have a blood test and are likely to be referred to a specialist called a urologist.

After doing a physical examination, ultrasound and blood tests, your urologist may strongly suspect testicular cancer. However, none of these tests can give a definitive diagnosis. The only way to be sure of the diagnosis is to surgically remove the affected testicle (orchidectomy) and examine it in a laboratory. In most cases only one testicle needs to be removed.

Treatment

Your treatment team will advise you on the best treatment for you. They will consider:

• your general health
• the type of testicular cancer you have
• the size of the tumour
• the number and size of any lymph nodes involved
• whether the cancer has spread to other parts of your body.

In almost all cases, an orchidectomy is done to remove the affected testicle. If the cancer hasn’t spread, this may be the only treatment you need. If additional treatments are needed, they may include chemotherapy, radiation therapy or a combination of treatment.

Prognosis

Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis with your doctor, but it is not possible for anyone to predict the exact course of the disease. To assess your prognosis, your doctor will consider:

• your test results
• the type of testicular cancer you have
• the stage of the cancer
• other factors such as your age, fitness and medical history.

Testicular cancer has one of the highest survival rates of any cancer. Regular monitoring and review (surveillance) is a major factor in ensuring good outcomes, so it’s vital you attend all your follow-up appointments.

Support for Queenslanders

Whether you have been diagnosed with testicular cancer, or have a family member or friend who is affected by cancer, there are times when you may need support. Our professional services and support programs are here to help you.

Resources

For more information about Testicular cancer, please see these resources

If you are a patient, family or friend and would like to order a copy of the Understanding Testicular Cancer booklet, please call Cancer Council 13 11 20 Information and Support Line.