Testicular cancer is cancer that originates in one or both testicles, or testes.

Testes are the male reproductive glands located inside the scrotum, which is the pouch of skin located underneath the penis. Testes are responsible for producing sperm and the hormone testosterone.

Testicular cancer can affect anyone who has testicles, including transgender and nonbinary people.

Testicular cancer most often begins with changes in germ cells. These are the cells in your testicles that produce sperm. Germ cell tumors account for about 95 percent of testicular cancers.

There are two main types of germ cell tumors:

  • Seminomas. These are testicular cancers that grow slowly. They’re usually confined to your testes, but your lymph nodes may also be involved.
  • Nonseminomas. These are the more common form of testicular cancer. This type grows faster 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 or sex-cord stromal tumors.

Testicular cancer is the most commonly diagnosed cancer in males 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.

The overall 5-year survival rate for testicular cancer is 95 percent, according to the American Cancer Society.

Some people show no symptoms when receiving the diagnosis of testicular cancer. When symptoms do appear, they can include:

  • a lump in the testicle
  • testicular pain or discomfort
  • testicular swelling
  • lower abdominal or back pain
  • heaviness or aching in lower belly
  • enlargement of breast tissue
  • voice changes and facial and body hair growth in pre-pubescent people with testicles

Late-stage symptoms

Symptoms of advanced testicular cancer may include:

  • low back pain from cancer spreading to lymph nodes in the back of the abdomen
  • shortness of breath
  • chest pain
  • cough
  • belly pain
  • headaches
  • confusion

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

A testicular self-exam is an easy way to check for cancer. It’s recommended that people with testicles do a self-exam every month. The best time to examine your testicles is during or after a bath or shower because the skin of your scrotum will be relaxed.

To perform a self-check for testicular cancer:

  1. Hold your penis out of the way and examine each testicle separately.
  2. Gently hold your testicle between your thumb and fingers with both hands.
  3. Roll it gently between your fingers.
  4. Look and feel for lumps, which may be as small as a grain of rice or a pea, or any change in the size, shape, or consistency of your testicles.

The tests your doctor uses 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 you have testicular cancer based on ultrasound and blood tumor marker test results, they will likely recommend surgery. The procedure, called a radical inguinal orchiectomy, aims to remove the tumor as soon as possible in order to take a tissue sample via a biopsy.

Biopsies are used to diagnose cancer. Performing a biopsy on a testicular tumor can cause cancer to spread. So, your doctor will very likely take the entire testicle out of the scrotum to take a sample from the tumor.

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:

  • 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 can spread to 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.

Testicular cancer can spread, or metastasize, to other parts of the body, including the lungs, lymph nodes, liver, and brain. How fast cancer spreads depends on what type of cancerous tumor you have, and what “grade” your cancer cells are in.

The two most common types of testicular cancer are:

  • Seminoma tumors, which tend to develop more slowly than nonseminoma tumors. Seminoma tumors are usually found only in the testicles and is less likely to spread to other parts of the body.
  • Nonseminoma tumors, which are more aggressive and more likely to spread relative to seminoma cancers. Nonseminoma tumors tend to spread lymphatically, which means they can spread to the lymph nodes.

When a healthcare professional takes a biopsy, they will look at the cancer cells and “grade” them on a scale of 1 to 3 based on how much they look like normal cells. Grade 3 cells look very different from normal cells and tend to grow and spread faster than grade 1 or 2 cells.

You can ask your healthcare professional to explain your cancer’s grade in order to understand how quickly the cancer is likely to spread.

Factors that can increase your risk of developing testicular cancer include:

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

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

The survival rate for testicular cancer depends on how much cancer has spread.

  • The 5-year survival rate for testicular cancer that is localized, or has not spread outside of the testicles, is 99 percent.
  • The 5-year survival rate for regional cancer that has spread outside the testicle to nearby lymph nodes or body parts is 96 percent.
  • The 5-year survival rate for distant cancer, or cancer that has spread to the lungs, liver, or distant lymph nodes, is 73 percent.

Surgery

Surgery is used to remove one or both of your testicles and some surrounding lymph nodes to determine the stage of the cancer. This helps guide the treatment plan.

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 highly treatable, testicular cancer 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.

Testicular cancer is cancer that originates in the testicles. It can spread or metastasize outside of the testicle and into other parts of the body. Testicular cancer is not common and will affect about 1 of every 250 males in the United States at some point during their lifetime.

Testicular cancer commonly affects young and middle-aged people and is often treated successfully with a combination of surgery, chemotherapy, and radiation therapy.

The survival rate for testicular cancer is very high, with an overall 5-year survival rate of 95 percent.

How fast does it spread?

How fast cancer spreads depends on what type of cancerous tumor you have, and what “grade” your cancer cells are. When your healthcare professional biopsies your tumor, the cancer cells will be “graded” on a scale of 1 to 3 based on how much they look like normal cells. Grade 3 cells look very different from normal cells and tend to grow and spread faster than grade 1 or 2 cells. You can ask your healthcare professional to explain your cancer’s grade in order to understand how quickly the cancer is likely to spread.

Is testicular cancer fatal?

Testicular cancer can be fatal but is generally known as one of the most curable types of cancer. The American Cancer Society estimates that about 460 people will die from testicular cancer in the United States in 2022. The lifetime risk of dying from testicular cancer is approximately 1 in 5,000.

Where does testicular cancer spread?

Testicular cancer can spread through tissue, your lymph nodes, and your blood. It may spread to parts of the body including the lungs, lymph nodes, liver, and brain.

How do you get testicular cancer?

The exact causes of testicular cancer are unknown. Factors that may increase your risk of developing testicular cancer include:

  • having undescended testicles
  • having a close relative with a history of testicular cancer
  • being white
  • have contracted HIV
  • having had testicular cancer in the past.

What are the chances of surviving testicular cancer?

The survival rate for testicular cancer is very high. Overall, 95 percent of people diagnosed with testicular cancer will survive.