What is testicular cancer?

Testicular cancer is a cancer that develops in your testicles, the two small, egg-shaped glands behind your penis that produce sperm. The cancer is usually just in one testicle, but it can appear in both.

It is possible for testicular cancer to spread to the lymph nodes in the stomach or to other parts of the body. With treatment, more than 9 out of 10 people with testicular cancer can be cured.

How common is testicular cancer?

About 1 in every 100 cancers in males is testicular cancer. Around 800 people are diagnosed with testicular cancer in Australia every year.

It’s the second most common cancer affecting young males aged between 20 and 39.

What are the risk factors for testicular cancer?

It is not known why some people develop testicular cancer. It is not caused by injuring your testicles, but there are some things that can increase your risk. You may be at greater risk of developing testicular cancer if:

• you have had cancer in the other testicle in the past
• you have undescended testicles (testicles that did not move down into the scrotum after you were born)
• you have a parent or sibling who had testicular cancer (although the risk is very small)
• you have fertility problems (trouble conceiving a baby)
• you have HIV or AIDS
• you were born with a defect of the penis known as hypospadias

What are the types of testicular cancer?

There are different types of testicular cancer. The most common type is known as seminoma. The other types are known as non-seminoma and include choriocarcinoma, embryonal carcinoma, teratoma and yolk sac tumours.

Another condition, called intratubular germ cell neoplasia (ITGCN or IGCN), is a pre-cancerous tumour. It has a 1 in 2 chance of developing into testicular cancer within 5 years. This condition can only be discovered with a biopsy.

What are the symptoms of testicular cancer?

The most common symptom of testicular cancer is a painless lump or swelling of one of your testicles.

Less common symptoms may include:

• a feeling of heaviness in the scrotum (the sac of skin that holds your testicles)
• a change in the size or shape of your testicle
• a feeling that your testicles are uneven
• aches and pains in your testicles, scrotum, stomach or back
• enlarged, tender nipples
• coughing or breathlessness

Sometimes testicular cancer doesn’t cause any symptoms.

How is testicular cancer diagnosed?

If you find a lump on your testicle or have any other symptoms of testicular cancer, see your doctor. They will ask about your symptoms and examine your testicles.

If they find a lump, they may send you for an an ultrasound and/or a blood test. You may also be referred for other tests such as a CT scan, an MRI scan or a biopsy (where a small sample of tissue is taken from the testicle).

How do I examine myself for testicular cancer?

Testicular cancer is almost always curable if it is found early. You should regularly check your testicles for any lumps or swelling.

Check yourself after a warm bath or shower, when the skin of your scrotum is relaxed. Examine both testicles by rolling them gently between your fingers and thumb. Also check the tube at the back of the testicle (the epididymis) for any swelling.

A healthy testicle feels firm and smooth. It is normal for one testicle to be slightly bigger or to hang lower than the other. If you notice any changes, lumps or swelling in your testicle, see your doctor.

How is testicular cancer treated?

Treatment for testicular cancer depends on the type of testicular cancer and how far it has spread.

You’ll usually need the affected testicle surgically removed in an operation called an orchidectomy. A laboratory will then examine the tissue to confirm the type of cancer and check how advanced it is.

After the surgery, you may not need any further treatment, apart from close monitoring. In some cases, you may need chemotherapy or radiotherapy to kill any cancer cells that may have spread to other parts of the body. You may also need further surgery.

What is it like to live with testicular cancer?

You may have a silicone implant (prosthesis) implanted to replace your lost testicle. This will look and feel like a normal testicle. If you would like to have a prosthesis, talk to your doctor. You may have the implant at the same time as the orchidectomy or later.

Having one testicle removed will not usually affect your fertility. However, testicular cancer, as well as treatments like chemotherapy and radiotherapy, can lower fertility.

Your remaining testicle should produce enough testosterone to keep up your muscle and bone strength, libido (sex drive) and energy levels.

After you have been treated for cancer, it is normal to feel afraid that the cancer will return. It can also take time to adjust to the physical and emotional changes involved in losing a testicle.

If you are struggling, it is important to seek support from your doctor, a therapist or others who have gone through testicular cancer.

Resources and support

Cancer Council Australia provides services and support to all people affected by cancer. Call them on 13 11 20.

Beyond Blue provides support for people experiencing anxiety and depression — read the factsheet, Testicular cancer, anxiety and depression. You can call Beyond Blue on 1300 22 4636.

CanTeen provides support for young people (aged 12 to 25) affected by cancer. Contact Canteen on 1800 835 932.

Cancer Australia provides information on the social and emotional impact of cancer in its resource, Cancer – how are you travelling?