Testicular cancer is relatively uncommon and accounts for < 1% of all male tumors. But, it represents the most common solid tumor in men between the ages of 20 and 34. The incidence of testicular cancer has been increasing over the last six decades.

Testicular germ cell tumors comprise 95% of all malignant tumors arising from the testicles.

Testicular germ cell tumors are categorized into two main types: seminomas and nonseminomas. Seminomas are more common. Nonseminomatous tumors tend to grow faster and include multiple subtypes (embryonal carcinoma, choriocarcinoma, yolk sac tumor, and teratoma).

Testicular cancers are most commonly found incidentally during testicular self examinations as a painless hard mass within the testicle. Some men describe a dull ache or heaviness in the abdomen, groin or scrotum.

Causes and Risk Factors

Risk factors for the development of testicular cancer include:

  • History of undescended testicle (cryptorchidism)
  • Family history of testicular cancer
  • Personal history of testicular cancer
  • Caucasion race

When to Speak with a Urologist about Testicular Cancer

You should talk to a Urologist about testicular cancer if you notice a hard mass in your testicles.

What to Expect when Seeking Treatment

In addition to a history and physical examination, initial assessment includes ultrasound imaging of the scrotum to better characterize the area. If testicular cancer is suspected, further evaluation typically includes CT imaging of the chest, abdomen, and pelvis in addition to blood work to check tumor marker levels. If initial evaluation is suspicious for testicular cancer, the testicle requires surgical removal for definitive diagnosis.

Treatment Options

Testicular cancer is one of the most treatable and curable cancers with cure rates above 90% even for men with very advanced metastatic disease and cure rates approaching 100% for men with more confined disease.

Additional treatments may be required after removal of the cancerous testicle, depending on the staging studies and tumor type. These additional treatments may include additional surgery (retroperitoneal lymph node dissection), chemotherapy, radiation therapy, or careful radiographic and blood test monitoring.

If additional treatments are required that can potentially affect future fertility, sperm cryopreservation will be recommended to aide future fertility options.