Testicular cancer

Testicular cancer is the second most common type of cancer in young men (aged 20-39). If you or someone you care about is facing this diagnosis, Cancer Council Queensland can help, so you don’t have to go through testicular cancer alone.

The terms “men,” “man,” and “male” used on this page reflect the language used in the research studies and data sources referenced. Unfortunately, these terms do not encompass all individuals with these reproductive organs. At Cancer Council Queensland, we remain committed to providing information that is both accurate and accessible to everyone. We acknowledge and stand in solidarity with the LGBTIQA+ community.

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About testicular cancer

Testicular cancer begins when abnormal cells grow in one or, in rare cases, both testicles. It is not a common cancer, but it is the second most diagnosed cancer in men aged 20-39 in Australia, behind non-melanoma skin cancer.

Most testicular cancers are germ cell tumours. There are two main types:

  • Seminoma, which generally develops more slowly and usually affects men aged 25-45
  • Non-seminoma, which grows more quickly and is most common in men in their late teens and early 20s.

Some cancers can be a mix of seminoma and non-seminoma cells, or a combination of different subtypes of non-seminoma cells. A small number of testicular tumours develop in the supportive and hormone-producing cells of the testicles. These are known as stromal tumours.

Over 1000 Australians are diagnosed with testicular cancer each year.

Risk Factors

While the exact cause of testicular cancer is not known, certain factors may increase the likelihood of developing it, including:

  • Undescended testicle (cryptorchidism): If the testicles don’t descend into the scrotum before or shortly after birth, the chance of testicular cancer is higher.
  • Family history: Having a father or brother with testicular cancer can slightly increase your likelihood of developing it.
  • Personal history: Men who have experienced cancer in one testicle may be more prone to having it occur in the other.
  • Infertility: Challenges in conceiving have been associated with testicular cancer.
  • HIV/AIDS: There’s evidence linking an increased risk among people with HIV/AIDS
  • Physical features: Conditions such as hypospadias, where the urethra opens on the underside of the penis, are connected to a higher likelihood of testicular cancer.
  • Cannabis use: Some evidence suggests regular use may be a contributing factor.
  • Intersex variations: Certain intersex traits, like partial androgen insensitivity syndrome, have been associated with an increased risk.

Importantly, there’s no known link between testicular cancer and injury, hot baths, tight clothing, or sports strains.

Testicular cancer symptoms

There are often no obvious symptoms of testicular cancer, which is why regular self-checks are especially important.

The most common sign is a painless swelling or lump in a testicle, or a change in its size, shape, or firmness.

Other signs of testicular cancer can include:

  • A feeling of heaviness in the scrotum
  • Unevenness between the testicles
  • Pain or discomfort in the testicle, scrotum, or lower abdomen
  • Back pain
  • Tenderness or enlargement of the breast tissue, caused by hormones produced by the cancer.

It’s important to understand these are not always signs of a testicular tumour – many conditions, like harmless cysts, can cause similar symptoms. But any unusual changes in your testicles should be checked by a doctor to rule out serious conditions.

The good news is that when caught early, testicular cancer is highly treatable.

Diagnosis

If you notice any unusual changes in your testicles, it’s important to make an appointment with your GP as soon as possible. They will perform a physical examination and may recommend further testing such as an ultrasound or blood test.

If these tests suggest cancer, you’ll most likely be referred to a urologist.

The only way to confirm a testicular cancer diagnosis is through surgery to remove the affected testicle (orchidectomy) for examination in a laboratory. Unlike other cancers, testicular tumours cannot be biopsied because doing so can spread cancer cells. Thankfully, in most cases only one testicle needs to be removed.

If testicular cancer is confirmed, it’s natural to feel a mix of emotions, including shock, confusion, or worry. Taking time to understand your condition, treatment options, and their potential side effects can help you to make informed decisions. You may also want to discuss with your doctor how treatment may impact your fertility and explore options to preserve it beforehand.

Treatment

A team of specialists will tailor your treatment plan based on factors including your overall health, the type and stage of cancer, and whether it has spread to other parts of your body.

In almost all cases, treatment begins with an orchidectomy: surgery to remove the affected testicle.

If the cancer is confined to the testicle (stage 1), this may be the only treatment needed. If it has spread to nearby lymph nodes (stage 2) or further (stage 3), additional treatments like chemotherapy, radiation therapy or both, may be recommended.

To determine the extent of the cancer, tests such as chest X-rays and CT scans of the chest, abdomen, and pelvis are used. Gain a deeper understanding of different tests.

If your cancer is more advanced, your medical team may discuss palliative care, which focuses on relieving symptoms and improving quality of life. This care may involve therapies like radiation, chemotherapy, or medications to manage pain and other symptoms.

Your treatment team may include:

  • Your GP, who will oversee your overall health and coordinate your care
  • A urologist, who is a specialist in surgery and reproductive health
  • Oncologists, who manage chemotherapy or radiation therapy
  • Cancer nurses and allied health professionals who will offer support, information, and care throughout your journey.

Prognosis

If you or someone close to you has been diagnosed with testicular cancer, it’s natural to want to understand the chances of overcoming it.

While no doctor can predict the exact course of anyone’s cancer experience, most testicular cancers are successfully treated, especially when caught early, and it has one of the highest survival rates of any cancer.

To assess your prognosis, your doctor will consider:

  • Your test results
  • The type and stage of your cancer
  • Your age, overall health, and medical history.

Regular follow-up care, including monitoring and surveillance, is a key factor in ensuring the best outcomes. Attending all your scheduled appointments helps your medical team track your progress and address any concerns quickly.

Questions you may have

What does testicular cancer look like?

There are often no physical testicular cancer symptoms, however in some cases the testicle may appear swollen, or a small lump may be noticed or felt. These signs do not mean you have cancer but should be immediately checked by your doctor.

How can I check for testicular cancer?

There is no specific screening test for testicular cancer. Investigation usually starts with a visit to your doctor, who will examine your testicles for lumps or swelling. Your doctor may also recommend an ultrasound and/or a blood test. Depending on your results, you may be referred to a urologist who may recommend the removal of the affected testicle to confirm your diagnosis.

What causes testicular cancer?

There is no known specific cause of testicular cancer, however some factors may increase your risk. These include family history, personal history, an undescended testicle from when you were an infant, infertility, and some lifestyle choices such as cannabis use.

Does testicular cancer kill you?

Survival for testicular cancer in Australia is very high. The estimated five-year survival rate is 97%.

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