Testicular cancer is not common, affecting about 1 of every 250 males in their lifetime, but it is one of the most treatable cancers with high long-term survival rates. It most commonly presents in men ages 20 to 40.
- undescended testicle
- personal history of testicular cancer
- family history of testicular cancer
- HIV infection
Screening and Diagnosis
Starting in teenage and young adult males, testicular self-examination is recommended to check for any lumps or abnormal swelling of the testicle. Most often, there is no pain associated with these findings. A pediatrician or primary care physician should also examine the testicles during yearly well visits. In rare cases, certain testicular tumors can secrete high levels of hormones that can lead to breast growth or breast tenderness.
A consultation with a urologist is important if any of the above are identified and a testicular ultrasound will be performed to determine if this is a benign condition or a solid tumor which could be a testicular cancer. If a solid mass is found on ultrasound, blood tests will be ordered to check certain tumor markers that may suggest the presence of testicular cancer.
Biopsy is rarely done to diagnose testicular cancer due to the risk of cancer spread from the procedure. The final step in making a definitive diagnosis of testicular cancer is radical inguinal orchiectomy (removal of the entire testicle through a groin incision). A pathologist will determine the type of cancer and what parts of the testicle are involved.
If testicular cancer is diagnosed after radical orchiectomy, your urologist may check the blood tumor markers to see how they respond after surgery. The doctor will also order imaging studies of your chest, abdomen, and pelvis to look for any spread of cancer to lymph nodes or other organs.
Your urologist will develop a treatment plan with you depending on the results of the pathology, imaging studies and blood tumor markers. Treatments can vary from regular surveillance imaging to chemotherapy or radiation therapy. Patients who do not have any evidence of enlarged lymph nodes (lymphadenopathy) or spread to other organs (metastasis) may be candidates for surveillance.