This information is provided by SSCHRC to help you understand testicular cancer and its management. It is written in a patient-friendly and medically accurate style.
Testicular cancer develops when cells within the testicles grow and multiply uncontrollably. These abnormal cells can damage the surrounding testicular tissue and interfere with the organ's normal function. If the disease spreads to other parts of the body, it is still classified as testicular cancer.
The testicles (also known as testes) are a pair of male sex glands located in a sac-like pouch, the scrotum, beneath the penis. Their primary roles are to produce and store sperm and to serve as the body's main source of male hormones, which are essential for the development of reproductive organs and male characteristics.
This cancer is most frequently diagnosed in younger men, being the most common cancer among men aged 20 to 34. Despite this, it only accounts for approximately 1% of all cancers in men. When detected early, the chances for successful treatment are exceptionally high, nearly 99%. Annually, around 9,300 new cases of testicular cancer are diagnosed, and the disease boasts a five-year survival rate of over 95%.
There are two primary categories of testicular cancer, each with distinct subtypes:
These tumours originate in the cells that produce sperm. Types include:
These tumours develop in the testicular tissue responsible for hormone production. Types include:
A risk factor is anything that increases your likelihood of developing testicular cancer. These factors include:
Important Note: It is important to remember that not everyone with risk factors will develop testicular cancer. If you have any concerns regarding your risk factors, you should discuss them with your doctor.
The signs and symptoms of testicular cancer can vary from one man to another. Potential signs of testicular cancer may include:
Important Note: These symptoms can also indicate other health problems, so it is vital to consult your doctor immediately if you notice any changes.
Obtaining an accurate diagnosis is crucial to ensure the highest chances of successful treatment. At SSCHRC, our specialised experts utilise the most advanced and precise technology to diagnose testicular cancer and determine the extent (stage) of the disease.
If an ultrasound reveals a mass in the testicle, your doctor will likely proceed with a surgical removal of the testicle (orchiectomy). The incision is made in the groin rather than the scrotum to minimise the possibility of spreading cancer cells. A tissue sample from the removed testicle is then examined under a microscope to confirm the presence of testicular cancer cells and determine the stage of the disease.
Specific blood tests are used to detect certain protein "markers" to help diagnose and determine the extent of the cancer both before and after an orchiectomy. These markers include:
If you present with symptoms that might indicate testicular cancer, your doctor will perform a physical examination and take a detailed history of your health, lifestyle, and family background.
Following a diagnosis, your doctor will determine the stage of the disease. Staging is a system used to determine how much cancer is present in the body and where it has spread. This information is essential for your doctor to recommend the most appropriate treatment plan for you. Once the staging classification is determined, it remains the same, regardless of whether treatment is successful or the cancer progresses.
(Staging information is based on National Cancer Institute standards.)
Abnormal cells are found in the tiny tubules where sperm development begins. These cells have the potential to become cancerous and spread into nearby normal tissue. All tumour marker levels are normal.
Cancer is confined to the testicle and epididymis (the tube connecting the ducts in the rear of the testicle to the vas deferens) and may have spread to the inner layer of the membrane surrounding the testicle. All tumour marker levels are normal.
Cancer is in the testicle and epididymis and has spread to the blood or lymph vessels in the testicle, OR it has spread to the outer layer of the membrane surrounding the testicle, OR it is in the spermatic cord or scrotum and may be in the blood or lymph vessels of the testicle. All tumour marker levels are normal.
Cancer is found anywhere within the testicle, spermatic cord, or scrotum, and either: all tumour marker levels are slightly above normal, OR one or more tumour marker levels are moderately above normal or high.
Cancer is anywhere within the testicle, spermatic cord, or scrotum, AND has spread to up to five lymph nodes in the abdomen, none of which are larger than 2 centimetres. All tumour marker levels are normal or slightly above normal.
Cancer is anywhere within the testicle, spermatic cord, or scrotum, AND has spread to either: up to five abdominal lymph nodes (with at least one node larger than 2 centimetres but none larger than 5 centimetres), OR more than five lymph nodes that are all 5 centimetres or smaller. All tumour marker levels are normal or slightly above normal.
Cancer is anywhere within the testicle, spermatic cord, or scrotum, AND has spread to an abdominal lymph node that is larger than 5 centimetres. All tumour marker levels are normal or slightly above normal.
Cancer is anywhere within the testicle, spermatic cord, or scrotum, AND has spread to one or more lymph nodes in the abdomen, AND has spread to distant lymph nodes or to the lungs. The level of one or more tumour markers may range from normal to slightly above normal.
Cancer is anywhere within the testicle, spermatic cord, or scrotum, AND may have spread to one or more nearby or distant lymph nodes or to the lungs. The level of one or more tumour markers may range from normal to high.
Cancer is anywhere within the testicle, spermatic cord, or scrotum, AND may have spread to one or more nearby or distant lymph nodes, to the lungs, or anywhere else in the body. The level of one or more tumour markers may range from normal to very high.
Our Treatment Approach at SSCHRC: Treatment for testicular cancer at SSCHRC is centred on the latest techniques in chemotherapy, surgery, and other therapies. We tailor your treatment plan to include the most advanced procedures while aiming for the least possible impact on your body.
Our dedicated team of experts carefully evaluates all possible options to determine the best, most customised course of action specifically for you. Your personalised testicular cancer treatment may include:
Experience Matters: As one of the nation's largest cancer centres, SSCHRC treats a significantly higher number of testicular cancer patients than most oncologists. This vast experience is particularly important in testicular cancer surgery, which is a delicate and challenging procedure requiring extensive expertise. Studies have consistently shown that the effectiveness of surgical treatment for testicular cancer is greatly dependent on the surgeon's procedural volume. The skilled surgeons at SSCHRC are among the most experienced in the country, which translates to optimal recovery prospects for you.
Furthermore, as a major cancer research centre, SSCHRC is able to offer clinical trials for new and emerging treatments for certain types of testicular cancer.
If you are diagnosed with testicular cancer, your doctor will discuss the most suitable treatment options with you. This selection depends on several factors, including the cancer's stage and type, as well as your overall health.
Surgical procedures include:
Possible Side Effects of Surgery: If only one testicle is removed, most men can still achieve erections and have sexual intercourse, provided they maintain adequate testosterone levels. If both testicles are removed, a man will be unable to father a child or produce enough natural testosterone for sexual function. In this instance, testosterone replacement therapy (via gel, patch, or injection) will be necessary. Since both surgical procedures can affect fertility, patients who wish to start a family in the future may want to discuss sperm banking with their doctor. Sperm cells can be collected and frozen before cancer treatment begins for later use.
Seminomas, the most common form of testicular cancer, are highly sensitive to radiation therapy. The treatment dosage is typically lower than that required for prostate cancer, and the treatment cycle is usually only two weeks long. Radiation is administered after the surgical removal of the testicle (orchiectomy). If the tumour was a seminoma, the oncologist may recommend 'watchful waiting' to monitor for recurrence, or use radiation to treat the lymph nodes along the spine, where most recurrences are found. Even if testicular cancer recurs, it is still treatable with chemotherapy or radiation. Radiation treatment has an average recurrence rate of about 5% and can also be employed after chemotherapy if any residual cancer remains. Other types of testicular cancer (nonseminoma) are generally more resistant to radiation and are typically treated with orchiectomy, chemotherapy, and surgery to remove affected lymph nodes.
Chemotherapy is sometimes used alongside the surgical removal of the testicle to ensure all cancer cells are destroyed. For men with advanced tumours that have spread beyond the testicle or metastasised to distant areas of the body, chemotherapy is typically administered for nine weeks or longer. The most common chemotherapy combinations used for testicular cancer are:
For men with poor-risk testicular cancer, SSCHRC employs a strategy known as dose-dense chemotherapy. This involves administering a higher concentration of chemotherapy drugs at more frequent intervals, allowing the cancer cells less time to recover between each treatment session.
A stem cell transplant is most often reserved for testicular cancers that have returned following successful initial treatment. SSCHRC is home to one of the most advanced stem cell transplant centres in the country.