Often categorized as a growth or lump on the testicles, testicular cancer is the most common cancer in American males aged 15 to 35.

What is Testicular Cancer?

testicle with tumor mass
An ultrasound scan can reveal the presence of a mass in the testicle.

Testicles are part of the male reproductive system. The testicles are normally a little smaller than a golf ball in adult men and are contained within a sac of skin called the scrotum. Their main functions are to produce sperm and testosterone.

Testicular cancer occurs in the testicles (testes) and is rare compared with other types of cancer. Though it is more common in younger males, it can be treated effectively. Depending on the stage of testicular cancer, you may receive one of several treatments, or a combination.

Though the cause of testicular is not definitive in most cases, we do know that testicular cancer occurs when healthy cells in a testicle become altered, developing into small growths (tumors). Outcomes remain favorable for testicular cancer even when cancer has metastasized beyond the primary site.

Types of Testicular Cancer

More than 90 percent of cancers of the testicle develop in germ cells. These are the cells that are responsible for producing sperm. There are two main types of germ cell tumors:


These tumors tend to grow and spread more slowly than non-seminomas. More than 95 percent of seminomas occur in men between the ages of 25 and 45.


These types of germ cell tumors usually occur in men earlier in life from late teens to their early 30s.

What Are the Signs and Symptoms of Testicular Cancer?

Cancer usually affects one of the two testicles and is usually detected prior to medical diagnosis. Symptoms may include one or more of the following:

  • A lump or swelling of a testicle
  • Pain or discomfort in a testicle or the scrotum
  • A feeling of heaviness in the scrotum
  • A dull ache in the abdomen or groin
  • A sudden collection of fluid in the scrotum
  • Enlargement or tenderness of the breasts
  • Low or mid-back pain
  • Early puberty

What are the Risk Factors for Testicular Cancer:

Altered testicular cells in the testicles may develop for a variety of reasons, though there are many conditions that may present greater risk.

  • A family history of testicular cancer
  • Age – testicular cancer is the most common cancer in American males ages 15 to 35
  • Race – testicular cancer is more common in Caucasian men
  • An undescended testicle (cryptorchidism) during fetal development
    • Males with cryptorchidism are many times more likely to develop testicular cancer than those with normally descended testicles.


  • Abnormal testicle development
  • Obesity
  • HIV infection
  • Carcinoma in situ of the testicle
  • Having had testicular cancer before

Urologic and robotics surgeon, Dr. Jennifer Linehan, discusses testicular cancer prevalence and self-evaluation for men.


How is Testicular Cancer Diagnosed?

Testicular cancer is diagnosed by a urology oncologist using ultrasound and blood tests. An ultrasound is performed using a small hand-held scanning tool that is completely painless.  Using sound waves, the scanner generates an on-screen image, indicating the location of the lump relative to other structures.

Stages of Testicular Cancer

If you are diagnosed with testicular cancer, your urologic oncologist will determine the stage of the disease. Staging is a way to classify cancer by how much of the disease is in the body and whether it has spread. This helps doctors plan the best way to treat the cancer.

testicle diagram-cancer stages 1-4
Testicular cancer is diagnosed in stages, revealing progression from the testis into the scrotum.

This stage is testicular carcinoma in situ (CIS), often a precancerous condition in which there are germ cells that appear cancerous but are not yet behaving the way cancer cells do. CIS becomes cancer when the cells spread to areas of the testicle(s) where they do not normally belong.


The primary tumor is only in the testicle, which may include the rete testis. It has not grown into blood vessels or lymph vessels in the testicles. The tumor may have grown into the inner membrane layer surrounding the testicle, called the tunica albuginea. It has not spread to the outer membrane layer surrounding the testicle, called the tunica vaginalis.


The tumor is in the testicle, which may include the rete testis, and it has grown into blood vessels or lymphatic vessels. Or the tumor has grown into the fatty tissue next to the epididymis called the hilar soft tissue, the epididymis, or the tunica vaginalis, with or without growth to blood or lymph vessels.


The tumor has grown into the spermatic cord, without or without growth to blood or lymph vessels.


The tumor has grown into the scrotum, without or without growth to blood or lymph vessels.

How is Testicular Cancer Treated?

Multidisciplinary Urology Team - Surgery Medical Oncology and Radiation
The multidisciplinary urology team at Saint John’s Health Center is ready to support you.

Treatment options for testicular cancer include:


The urologists at Saint John’s Health Center specialize in robotic-assisted surgery for testicular cancer. This minimally invasive procedure is performed with the da Vinci Surgical System.

Laparoscopic surgery is a minimally invasive approach, which is done through small incisions using thin surgical tools guided by a tiny video camera. This surgery has several benefits, including less pain and a shorter recovery time.

Radical inguinal orchiectomy is surgery for removing the testicles.

Retroperitoneal lymph node dissection is surgery for removing lymph nodes at the back of the abdomen.

Radiation therapy

Radiation is used to kill cancer cells that have spread from the testicles to lymph nodes. Radiation therapy uses high-energy rays or particles to destroy cancer cells or slow their growth. This treatment is similar to getting an X-ray, but the radiation is more intense.


Either intravenously or orally taken, chemotherapy is a drug that travels throughout the body to destroy cancer that have spread. Chemotherapy also is used to decrease the risk of cancer returning after a cancerous testicle is removed.

You may receive more than one type of treatment, depending on several factors, including the grade of the tumor, where it is located and whether it has spread to other parts of your body.

If you have questions regarding treatments for testicular cancer, or possible symptoms, please call today. Click here to request an appointment on line.