Testicular cancer is the second most common cancer in young men (aged 18 to 39).1
The most common type is seminoma, which usually occurs in men aged between 25 and 50 years. The other main type is non-seminoma, which is more common in younger men, usually in their 20s.
In 2013, 721 new cases of testicular cancer were diagnosed in Australia. For Australian men, the risk of being diagnosed with testicular cancer by age 85 is 1 in 218. The rate of men diagnosed with testicular cancer has grown by more than 50% over the past 30 years, however the reason for this is not known.
The five-year survival rate for men diagnosed with testicular cancer is close to 98%.
In 2014, there were 23 deaths from testicular cancer.
Testicular cancer may cause no symptoms. The most common symptom is a painless swelling or a lump in a testicle.
Less common symptoms include:
- feeling of heaviness in the scrotum
- swelling or lump in the testicle
- change in the size or shape of the testicle
- feeling of unevenness
- pain or ache in the lower abdomen, the testicle or scrotum
- back pain
- enlargement or tenderness of the breast tissue (due to hormones created by cancer cells).
Some factors that may increase a man’s risk of testicular cancer include:
- undescended testicle (when an infant)
- family history (having a father or brother who has had testicular cancer).
There is no known link between testicular cancer and injury to the testicles, sporting strains, hot baths or wearing tight clothes.
Tests used to diagnose testicular cancer include:
- ultrasound (to confirm the presence of a mass) and
- blood tests for the tumour markers alpha-fetoprotein, beta human chorionic gonadotrophin and lactate dehydrogenase.
However, the only way to definitely diagnose testicular cancer is by surgical removal of the affected testicle. While many other types of cancers are diagnosed by biopsy (removing a small piece of tissue from the tumour), cutting into a testicle could spread the cancer to other parts of the body. Hence the whole testicle needs to be removed if cancer is strongly suspected.
In addition to the results of the diagnostic tests above, a chest X-ray and CT scans of the chest, abdomen and pelvis are done to determine whether and how far the cancer has spread.
Stage 1 means the cancer is found only in the testicle, stage 2 means it has spread to the lymph nodes in the abdomen or pelvis, and stage 3 means the cancer has spread beyond the lymph nodes to other areas of the body such as the lungs and liver.
If the cancer is found only in the testicle (stage 1), removal of the testicle (orchidectomy) may be the only treatment needed. If the cancer has spread beyond the testicle, chemotherapy and/or radiotherapy may be used as well.
Depending on your treatment, your treatment team may include a number of the following professionals:
- GP who looks after your general health and coordinates specialist treatment
- urologist who specialises in the treatment of diseases of the urinary system and male reproductive system
- medical oncologist who prescribes chemotherapy treatment
- radiation oncologist who prescribes radiation therapy
- cancer nurses
- endocrinologist who specialises in diagnoses and treatment of disorders of the endocrine system. For men who have had both testicles removed, this will include testosterone replacement
- other health professionals such as dietitians, social workers and physiotherapists.
In some cases of testicular cancer, your medical team may talk to you about palliative care. Palliative care aims to improve your quality of life by alleviating symptoms of cancer.
As well as slowing the spread of testicular cancer, palliative treatment can relieve pain and help manage other symptoms. Treatment may include radiotherapy, chemotherapy or other drug therapies.
There is no routine screening test for testicular cancer. While it is important to get to know the regular look and feel of your testicles and let your doctor know if you notice anything unusual, there is little evidence to suggest that testicular self-examination detects cancer earlier or improves outcomes.
Prognosis for testicular cancer
Prognosis means the expected outcome of a disease. An individual’s prognosis depends on the type and stage of cancer as well as their age and general health at the time of diagnosis. You may wish to discuss your prognosis and treatment options with your doctor, but it is not possible for any doctor to predict the exact course of your disease.
All testicular cancers can be treated and most testicular cancers are successfully treated.
There are no proven measures to prevent testicular cancer.
Understanding Testicular Cancer, Cancer Council Australia © 2016. Last medical review of source booklet: September 2016.
Australian Institute of Health and Welfare (AIHW) 2017. Cancer in Australia 2017. Cancer series no. 101. Cat. no. CAN 100. Canberra: AIHW.
Australian Institute of Health and Welfare. ACIM (Australian Cancer Incidence and Mortality) Books. Canberra: AIHW.