Testicular cancer 

 

Cancer of the testicle is one of the less common cancers and tends to mostly affect men between 15 and 49 years of age.

The most common symptom is a painless lump or swelling in one of the testicles. It can be the size of a pea or it may be much larger.

Other symptoms can include:

• a dull ache in the scrotum
• a feeling of heaviness in the scrotum

It's important to be aware of what feels normal for you. Get to know your body and see your GP if you notice any changes.

Read more about the look and feel of normal testicles, the symptoms of testicular cancer and diagnosing testicular cancer.

The testicles

The testicles are the two oval-shaped male sex organs that sit inside the scrotum on either side of the penis.

The testicles are an important part of the male reproductive system because they produce sperm and the hormone testosterone, which plays a major role in male sexual development.

Types of testicular cancer

The different types of testicular cancer are classified by the type of cells the cancer begins in.

The most common type of testicular cancer is "germ cell testicular cancer", which accounts for around 95% of all cases. Germ cells are a type of cell that the body uses to create sperm.

There are two main subtypes of germ cell testicular cancer. They are:

• seminomas – which have become more common in the last 20 years and now account for 50-55% of testicular cancers
• non-seminomas – which account for most of the rest and include teratomas, embryonal carcinomas, choriocarcinomas and yolk sac tumours

Both types tend to respond well to chemotherapy.

Less common types of testicular cancer include:

• Leydig cell tumours – which account for around 1-3% of cases
• Sertoli cell tumours – which account for around 1% of cases
• lymphoma – which accounts for around 4% of cases

This topic focuses on germ cell testicular cancer. You can contact the cancer support specialists at Macmillan for more information about Leydig cell tumour and Sertoli cell tumours. Their helpline number is 0808 808 00 00 and it's open Monday to Friday, 9am to 8pm.

Read more about Hodgkin lymphoma and non-Hodgkin lymphoma.

How common is testicular cancer?

Testicular cancer is a relatively rare type of cancer, accounting for just 1% of all cancers that occur in men. Around 2,200 men are diagnosed with testicular cancer each year in the UK.

Testicular cancer is unusual compared to other cancers because it tends to affect younger men. Although it's relatively uncommon overall, testicular cancer is the most common type of cancer to affect men between the ages of 15 and 49.

For reasons that are unclear, white men have a higher risk of developing testicular cancer compared with men from other ethnic groups.

The number of cases of testicular cancer that are diagnosed each year in the UK has roughly doubled since the mid-1970s. Again, the reasons for this are unclear.

Causes of testicular cancer

The exact cause or causes of testicular cancer are unknown, but a number of factors have been identified that increase a man's risk of developing it. The three main risk factors are described below.

Undescended testicles

Undescended testicles (cryptorchidism) is the most significant risk factor for testicular cancer.

About 3-5% of boys are born with their testicles inside their abdomen. They usually descend into the scrotum during the first year of life, but in some boys the testicles don't descend.

In most cases, testicles that don't descend by the time a boy is one year old descend at a later stage. If the testicles don't descend naturally, an operation known as an orchidopexy can be carried out to move the testicles into the correct position inside the scrotum.

It's important that undescended testicles move down into the scrotum during early childhood because boys with undescended testicles have a higher risk of developing testicular cancer than boys whose testicles descend normally. It's also much easier to observe the testicles when they're in the scrotum.

Men with undescended testicles are about three times more likely to develop testicular cancer than men whose testicles descend at birth or shortly after.

Family history

Having a close relative with a history of testicular cancer or an undescended testicle increases your risk of also developing it.

For example, if your father had testicular cancer, you're around four times more likely to develop it than someone with no family history of the condition. If your brother had testicular cancer, you're about eight times more likely to develop it.

Current research suggests a number of genes may be involved in the development of testicular cancer in families where more than one person has had the condition. This is an ongoing area of research in which patients and their families may be asked to take part.

Previous testicular cancer

Men who've previously been diagnosed with testicular cancer are between four to 12 times more likely to develop it in the other testicle.

For this reason, if you've previously been diagnosed with testicular cancer, it's very important that you keep a close eye on the other testicle. Read: What should my testicles look and feel like?

If you've been diagnosed with testicular cancer, you also need to be observed for signs of recurrence for between five and 10 years, so it's very important that you attend your follow-up appointments.

Cancer Research UK has more information about testicular cancer risks and causes.

Outlook

Testicular cancer is one of the most treatable types of cancer, and the outlook is one of the best for cancers.

In England and Wales, almost all men (99%) survive for a year or more after being diagnosed with testicular cancer, and 98% survive for five years or more after diagnosis.

Cancer Research UK has more information about survival rates for testicular cancer.

Almost all men who are treated for testicular germ cell tumours are cured, and it's rare for the condition to return more than five years later.

Treatment almost always includes the surgical removal of the affected testicle – called orchidectomy or orchiectomy – which doesn't usually affect fertility or the ability to have sex.

In some cases, chemotherapy or, less commonly, radiotherapy may be used for seminomas (but not non-seminomas).

Read more about treating testicular cancer.