Testicular Cancer

Found most commonly in young men, testicular cancer is a highly treatable malignancy. Regardless of the stage of the cancer when it is discovered, the success rates for curing testicular cancer are over 90%. However, successful outcomes are dependent on the proper management of this disease.

NYU urologists work with a multidisciplinary team of NYU medical oncologists and radiation oncologists to determine the best course of treatment for each patient. The successful treatment of testicular cancer frequently involves a combination of treatment methods, including radiation therapy, chemotherapy and surgery.

Definition, risk factors and symptoms
Diagnosis and treatment
Further reading
Make an appointment with an NYU urologist who treats testicular cancer

More information on testicular cancer

Definition, risk factors and symptoms

In testicular cancer, cancer cells grow in one or both testicles, which are glands in men that make and store sperm (located in the scrotum, under the penis). If left unchecked, testicular cancer may spread to other parts of the body via the lymphatic system.

Testicular cancer is most common in men between the ages of 20 and 40. Certain risk factors, such as a family history of testicular cancer, increase the chances of developing this type of cancer. Having had undescended testes (testicles that did not descend out of the abdomen into the scrotum before birth) is also associated with testicular cancer.

The first sign of testicular cancer is usually a painless lump or swelling in the testicle. You may also experience an ache or pain in the groin or lower abdomen.

Diagnosis and treatment

In addition to taking a medical history and performing a physical exam (including a manual examination of the scrotal area), your doctor may order one or more of the following tests:

Ultrasound (creating an image of the scrotum using sound waves) may be used to determine the size and consistency of the tumor and help determine if it is benign or malignant.
Blood tests may be ordered to identify special markers that indicate the presence of a malignant tumor.
A biopsy involves removal of some tissue in or around the tumor to determine its stage and category under a microscope.
X-rays and/or a CT (CAT) scan may be used to visualize other organs if your doctor suspects that the cancer has spread to other parts of the body.

Treatment of testicular cancer depends on the type and stage of the cancer. Germ cell cancers, which account for 95% of testicular cancers, are derived from the cells directly involved in the development of sperm. Germ cell cancers can be further divided into two general groups: seminomas, which grow from the “seed” cells that eventually develop into sperm, and nonseminomas, which grow from other types of cells in the testicle. If both seminoma and nonseminoma cells are found in a single tumor, the tumor is treated as a nonseminoma.

A majority of testicular tumors are treated at least in part by surgically removing the testicle in which the tumor was found. When a testicle is removed, a prosthetic testicle may be inserted in its place for cosmetic reasons. Men who have had one testicle removed usually continue to have normal sexual function and fertility.

Early-stage cancers

Early-stage seminomas are frequently treated with radiation therapy to the lymph nodes surrounding the testicle. Early-stage nonseminomas may be treated by removal of the lymph nodes surrounding the testicle as well as removal of the cancerous testicle.

Late-stage cancers

Late-stage seminomas are typically treated by chemotherapy and on occasion by surgical removal of the testicle. After chemotherapy, your doctor will monitor the tumor periodically by PET scan to determine if it is growing. If a seminoma has spread to other parts of the body, the lymph nodes surrounding the testicle may be removed after chemotherapy.

For late-stage nonseminomas confined to the lymph nodes, chemotherapy is usually the first recommendation and may be followed by surgical removal of the lymph nodes surrounding the testicle, depending on the response to chemotherapy.

Side effects of lymph node removal

Removing the lymph nodes around the testicles may have an effect on ejaculation owing to disruption of nerve pathways controlling this process, but NYU urologic surgeons are skilled at preserving these nerves whenever possible during removal of lymph nodes.

More information on testicular cancer

Make an appointment with an NYU urologist who treats testicular cancer

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.