Testicular cancer is fairly rare – there are just under 8,000 new cases a year in the United States – but it is one of the most common cancers in young men. Testicular cancer is a highly treatable and usually curable form of cancer.
A primary risk factor for developing testicular cancer is having undescended testicles (cryptorchidism) or partially descended testicles. (In normal development, the testicles descend into the scrotum as the fetus develops.) Other risk factors include having a family history of testicular cancer (but this link is tenuous, about three percent of cases) or multiple irregular dark spots ("atypical nevi") on one's skin. It is possible that being infected with HIV, or more so having AIDS may be a predisposition to testicular cancer. Sometimes having testicular germ cell cancers (carcinoma in situ, intratubular germ cell neoplasia) may progress to testicular cancer. About 90 percent of testicular cancer cases occur in men age 20 - 54 so young age can be considered a factor. Race can be a factor too with Caucasian men being at higher risk than men of other races.
Symptoms of testicular cancer may include: a painless lump or swelling in a testicle; pain or discomfort in a testicle or the scrotum; an enlarged testicle or change in the way it feels; feeling of heaviness in the scrotum; dull ache in the lower abdomen, back, or groin; and a sudden swelling of the scrotum. Conditions other than testicular cancer can cause these symptoms too, and men should see a doctor to determine the cause.
To determine if a patient has testicular cancer doctors may conduct a blood test to look for certain markers of a testicular tumor, and/or visually examine the testicle with ultrasound. If evidence of a tumor is found, they will next take a biopsy of the tumor and have it examined by a pathologist. Biopsy is the standard test to confirm a diagnosis of testicular cancer.
Doctors usually treat men who have testicular cancer with surgery to remove the tumor. Most often the entire testicle is removed, though removing only the tumor and some surrounding tissue and sparing the remaining normal testicular tissue and sperm-producing regions is a possibility being investigated.
After surgery some men diagnosed with testicular cancer may not need additional treatment, but will be followed closely by their doctors; this approach is called "active surveillance." Others with more advanced disease may be treated with chemotherapy, additional surgery (lymph node dissection), and/or radiation therapy to destroy any remaining cancer. Even testicular cancer which has spread throughout the body has a good chance of being cured.
Testicular cancer and treatment for it can affect a man's fertility so men with testicular cancer who wish to have families in the future should talk with their doctor about options to preserve fertility.