Testicular cancer: Symptoms, diagnosis and treatment

What is testicular cancer?

Testicular cancer is a type of cancer that begins within the testicles. The cancer cells no longer follow normal growth patterns, multiplying uncontrollably. If untreated, the cancer can spread, which can be fatal.

This type of cancer starts within the cells of a testicle. The two testicles, or testes, are glands that produce male hormones and sperm. They hang beneath and behind a man's penis in a pouch of skin called the scrotum. The spermatic cord, composed of the sperm duct, nerves, and blood vessels, connects each testicle to the body.

Although testicular cancer is rare, it is the most common type of cancer in men aged 15 to 40

The basics -- testicles

Testicular cancers begin in the testicles themselves. Testicular cancer may spread slowly or rapidly through the lymphatic system or blood vessels, depending on its type, but the path is consistent: Once the cancer cells are free to spread to nearby lymph or blood vessels, they could be carried to the lungs, to the liver, to the bones, and possibly to the brain.

Thanks to advances in diagnosis and treatment, testicular cancer is among the most curable of cancers, if detected early. Over 90% of patients are diagnosed with small, localised cancers that are highly treatable. Improved detection and treatment techniques have raised the overall five-year survival rate above 90%. Even if cancer has spread to nearby organs at diagnosis, patients still have a good chance of long-term survival.

What causes testicular cancer?

Doctors don't know why a man develops testicular cancer. However, doctors have found links between testicular cancer and other factors. These are described here.

Testicular cancer is more likely to occur in men who also had a condition called an undescended testicle (cryptorchidism.) The testicles normally develop within the abdominal/pelvic cavity and in most cases they migrate to the groin and scrotum prior to birth. With cryptorchidism, an abnormality within the testicle itself keeps the testicle from making its way into the scrotum. The undescended testicle then remains somewhere along the normal path, within the abdomen or groin. 

Even if an undescended testicle is surgically brought down into the scrotum, it is still at greater risk of developing testicular cancer. However, the normal position allows for better and closer examination.

Testicular cancer is more common in those who have close relatives with the condition.

Men with fertility problems are more likely to be diagnosed with testicular cancer. All men with fertility problems should be checked for cancer of the testicle.

Other factors that increase the risk of testicular cancer include having HIV/AIDS, being Caucasian, and being taller in height than average. Men whose mothers had bleeding in pregnancy are also at greater risk of developing testicular cancer.

In the past it was thought that testicular injury and vasectomy increased the risk of testicular cancer but this is no longer believed to be true.

Non-cancerous growths in the testicle are rare, so it’s important that all masses are checked by a GP to determine if it is cancer or something else.