Men who have been diagnosed with testicular cancer may have important questions about their futures: Will I be healthy again? Will I be able to have a normal sex life? Will I be able to have children? The answer to each of these questions—especially if the cancer is caught early—is most often a resounding yes.
Testicular cancer is highly treatable, and an estimated 99% percent of men with localized testicular cancer survive five years or longer. So, knowing what to look for is important to detecting this cancer
"Usually it's not pain that causes someone to notice they have testicular cancer," says Preston Sprenkle, MD, a Yale Medicine urologist and expert in urologic cancers. "Very often it's a new lump on the testicle, so one thing we encourage is self-examination on a regular basis."
What is testicular cancer?
Testicular cancer is a disease in which cells in the male testes—the sperm-producing glands inside the scrotum—become malignant. It is a relatively rare disease with only 8,000 new cases diagnosed in the U.S. annually.
It is, however, the most common cancer among 15- to 34-year-old men in the United States. More than half of the testicular cancer cases in the United States affect young men in this age group.
What are the risk factors for testicular cancer?
While there is no single factor known to cause testicular cancer, there are a few conditions that have been known to increase the risk. These include:
- An undescended testicle (cryptorchidism): Normally, the testicles descend from inside the abdomen into the scrotum before birth. Males born with an undescended testes have a greater risk of developing testicular cancer even if they have corrective surgery.
- Family history: Having a close relative with testicular cancer increases a patient’s chance of also developing the condition.
- Cancer in the other testicle: A history of cancer, particularly other cancers of the reproductive organs, can lead to a higher risk for developing testicular cancer.
- Age: About half of testicular cancers occur in men between the ages of 15 and 34.
- Race/ethnicity: In the US, Caucasian men are more likely to get testicular cancer than other groups.
What are the symptoms of testicular cancer?
Men typically start to worry about cancer when they notice an unusual lump or growth in their testicles. This is a common sign of cancer, but there are a few other signs that should also be noted which include:
- A dull ache in the lower abdomen or the groin.
- A sudden build-up of fluid in the scrotum.
- Pain or discomfort in a testicle or in the scrotum.
- Regular self-examinations are very important as they can help identify problems early on, increasing the likelihood of successful treatment.
How is testicular cancer diagnosed?
Patients will share their health history and symptoms with the doctor who will perform a physical exam, checking the testicles for lumps, swelling or pain. Other tests may include:
- Ultrasound: Using a small handheld device called a transducer, doctors are able to receive images from inside the testicle and identify any abnormal growths.
- A serum tumor marker test: A blood sample may be taken to test the presence of certain “serum tumor markers” or “biomarkers.” These are substances that are only released into the body when tumors are present.
How is testicular cancer treated?
There are a number of options for treating testicular cancer. The most common treatments include:
- Surveillance: This consists of closely following a patient's condition without giving any treatment, unless there are changes in test results. Exams and tests are scheduled regularly to make sure there are no new developments.
- High-dose chemotherapy with stem cell transplant: This treatment involves high doses of chemotherapy. The doctor will then replace red blood cells destroyed by the chemotherapy. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stem cells are thawed and the patient receives an infusion. These new stem cells grow into and restore the body’s red blood cells.
- Surgery: Surgical removal of a malignant testicle is the most common treatment. Having one testicle should have no impact on sexual performance or the ability to father children.
However, because certain treatments for testicular cancer can cause permanent infertility, patients who may wish to have children should talk to their doctor about sperm banking, which involves freezing and storing sperm for later use if desired.
What makes Yale Medicine's approach to testicular cancer unique?
Our physicians provide compassionate care while offering the most advanced diagnostic, medical and surgical treatments available. The most common treatment—surgical removal of the malignant testicle—typically has no impact on sexual performance or the ability to have children, says Dr. Sprenkle.
Yale Medicine Urology is committed to offering our patients with early and late-stage testicular cancer the most advanced diagnostic technologies and treatment strategies available. We take this journey with our patients as they move toward recovery.