Greater Boston Urology Blog

Testicular Cancer: Signs, Diagnosis, and Next Steps

April is Testicular Cancer Awareness Month. While testicular cancer can happen at any age, the American Cancer Society reports that it is "largely a disease of young and middle-aged men" with 33 being the average age for diagnosis. Testicular cancer is not common (1 in 250 males will develop it in their lifetime), and the good news is that it's a very treatable cancer.

Still, even with this good news, a cancer diagnosis is always stressful. Knowledge is power, so we've asked one of our urologists, Dr. Mark V. Silva, to answer common questions about testicular cancer.

Reminder: The following is meant to be educational in nature, not medical advice. Always consult a physician regarding your specific healthcare needs.

What is testicular cancer?

DR. SILVA: Testicular cancer is not unlike other cancers that you read about. The basics are that the body loses control of a certain type of cells that proceed to grow. Testicular cancer is the uncontrolled growth of those cells in the testicle. There are several types of testicular cancer, which you would need to discuss with your urologist.

What causes testicular cancer? Are there certain risk factors?

DR. SILVA: The exact cause of testicular cancer is not known, but certain risk factors can increase a man's chance of developing it, including the following:

  • A family history of the disease
  • An undescended testicle
  • A personal history of testicular cancer
  • HIV Infection

Can testicular cancer be prevented?

DR. SILVA: Sadly, it cannot be prevented, but the disease is highly treatable when diagnosed early.

What are some signs and symptoms of testicular cancer? 

DR. SILVA: The most common symptom of testicular cancer is a painless lump or swelling in one of the testicles. Other symptoms can include a feeling of heaviness in the scrotum, a dull ache or pain in the groin or abdomen, and swelling or tenderness of the breast tissue.

How is testicular cancer diagnosed?

DR. SILVA: Testicular cancer is typically diagnosed through a physical exam, ultrasound, and blood tests. 

What are the various options for treating testicular cancer?

DR. SILVA: The first step in treatment involves surgery to remove the affected testicle. Further treatment options or surveillance is very dependent on the findings from both imaging tests as well as the pathology found in the testicle. Additional treatments include radiation and a variety of chemotherapies. 

Can testicular cancer reoccur? 

DR. SILVA: Like other cancers, testicular cancer can reoccur and progress. It is always important to follow up with your urologist as we have well-known surveillance protocols and contingency plans if there is a reoccurrence of disease.

How often should males perform a testicle self-check? At what age should they start? 

DR. SILVA: Men should start performing testicular self-exams during puberty, which typically occurs between the ages of 9 and 14. It's important for men to get to know their bodies and become familiar with what their testicles normally feel like so that they can detect any changes or abnormalities early on.

Men should perform testicular self-exams once a month, ideally after a warm bath or shower when the scrotal skin is relaxed. During the exam, they should use both hands to gently roll each testicle between their fingers, feeling for any lumps, swelling, or other changes in texture or size.

If a man notices any changes during a self-exam or experiences any other symptoms, such as pain or discomfort in the testicles or scrotum, he should see a doctor as soon as possible for further evaluation.

Is there anything else you want to make sure our readers understand about testicular cancer?

DR. SILVA: Testicular cancer is a cancer of survivors. There is a 95% survival at 5 years for all patients diagnosed with testicular cancer, and that percentage improves even more when talking about men who were diagnosed with early-stage disease. Unfortunately, I have seen men come in with advanced disease who noticed a lump months or years before and never said anything because they thought it would go away. I urge all men who feel a lump or bump to schedule a visit to get checked out.

Interested in making an appointment with Dr. Silva?

Dr. Silva is accepting new patients in our Plymouth Care Center. Click here to make an appointment with him or one of our other world-class physicians.

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