Testicular cancer is a cancer that originates in one or both testicles, or testes. Your testes are the male reproductive glands located inside your scrotum, which is the pouch of skin located underneath your penis. Your testes are responsible for producing sperm and the hormone testosterone.

Testicular cancer most often begins with changes in the germ cells. These are the cells in your testicles that produce sperm. These germ cell tumors account for more than 90 percent of testicular cancers.

There are two main types of germ cell tumors:

  • Seminomas are testicular cancers that grow slowly. They’re usually confined to your testes, but your lymph nodes may also be involved.
  • Nonseminomas are the more common form of testicular cancer. This type is faster growing and may spread to other parts of your body.

Testicular cancer can also occur in the tissues that produce hormones. These tumors are called gonadal stromal tumors.

Testicular cancer is the most commonly diagnosed cancer in men ages 15 to 35, but it can occur at any age. It’s also one of the most treatable cancers, even if it’s spread to other areas.

According to the American Cancer Society, for those with testicular cancer in early stages, the five-year survival rate is greater than 95 percent.

Risk factors that can increase your risk of developing testicular cancer include:

  • having a family history of the disease
  • having abnormal testicular development
  • being of Caucasian descent
  • having an undescended testicle, which is called cryptorchidism

Some men show no symptoms when diagnosed with testicular cancer. When symptoms do appear, they can include:

  • testicular pain or discomfort
  • testicular swelling
  • lower abdominal or back pain
  • enlargement of breast tissue

Make an appointment with your doctor if you have any of these symptoms.

The tests your doctor may use to diagnose testicular cancer may include:

  • a physical exam, which can reveal any testicular abnormalities, such as lumps or swelling
  • an ultrasound to examine the internal structure of the testicles
  • blood tests called tumor marker tests, which may show elevated levels of substances related to testicular cancer, like alpha-fetoprotein or beta-human chorionic gonadotropin

If your doctor suspects cancer, your entire testicle may need to be removed to obtain a tissue sample. This can’t be done when your testicle is still in the scrotum because doing so can cause cancer to spread through the scrotum.

Once the diagnosis has been made, tests such as pelvic and abdominal CT scans will be done to see if the cancer has spread anywhere else. This is called staging.

The stages of testicular cancer are as follows:

  • Stage 1 is limited to the testicle.
  • Stage 2 has spread to lymph nodes in the abdomen.
  • Stage 3 has spread to other parts of the body. This type of cancer commonly spreads to the lungs, liver, brains, and bone.

The cancer is also categorized based on the expected response to treatment. The outlook can be good, intermediate, or poor.

There are three general categories of treatments used for testicular cancer. Depending on the stage of your cancer, you may be treated with one or more options.

Surgery

Surgery is used to remove one or both of your testicles and some surrounding lymph nodes to both stage and treat cancer.

Radiation therapy

Radiation therapy uses high-energy rays to kill cancer cells. It may be administered externally or internally.

External radiation uses a machine that aims the radiation at the cancerous area. Internal radiation involves the use of radioactive seeds or wires placed into the affected area. This form is often successful in treating seminomas.

Chemotherapy

Chemotherapy uses medication to kill cancer cells. It’s a systemic treatment, which means it can kill cancer cells that have traveled to other parts of your body. When it’s taken orally or through the veins, it can travel through your bloodstream to kill cancer cells.

In very advanced cases of testicular cancer, high-dose chemotherapy may be followed by a stem cell transplant. Once the chemotherapy has destroyed the cancer cells, the stem cells are administered and develop into healthy blood cells.

Though testicular cancer is a highly treatable cancer, it can still spread to other parts of your body. If one or both testicles are removed, your fertility may also be affected. Before treatment begins, ask your doctor about your options for preserving your fertility.