Testicular Cancer

Testicular cancer begins when abnormal cells grow in one or both testicles (testes), the glands that produce testosterone and sperm. Almost all cases start in the germ cells that make sperm. These germ-cell tumors are broadly classified as seminomas and nonseminomas because they behave and are treated differently.

Understanding Testicular Cancer

Testicular cancer is the most common cancer in young adult men (roughly ages 20–39) and is highly curable, even when it has spread.

Types

Seminoma

tends to grow more slowly and is more sensitive to radiation.

Nonseminoma

often grows and spreads more quickly; any mixed tumor with nonseminoma elements is treated as a nonseminoma.

Signs & Symptoms

Lump or swelling in a testicle (often painless), a sense of heaviness in the scrotum, or dull ache in the groin/abdomen.
Some tumors can alter hormone levels and cause breast tenderness/growth. (Other benign conditions can cause similar symptoms—evaluation is important.)

Who Gets It & Risk Factors

Age: most diagnoses occur in young and middle aged men.
Older age and male sex
Undescended testicle (cryptorchidism), abnormal testicular development, personal or family history of testicular cancer increase risk. (Most men diagnosed have no known risk factors.)

Screening

There is no evidence that routine screening (e.g., population testicular self exam or clinician exam) reduces deaths from testicular cancer; because treatments are highly effective, screening can lead to unnecessary procedures without proven mortality benefit. Discuss your risk and symptom awareness with your clinician.

Diagnosis

Evaluation typically includes:

to characterize a testicular mass (first-line imaging).

to help classify and stage the tumor; note that seminomas do not make AFP, so an elevated AFP means the tumor is treated as a nonseminoma.

(surgical removal of the tumorbearing testicle) both confirms the diagnosis and often cures early cancer; the tissue determines the precise type.

Your pathology report will describe the histology, tumor location (cardia vs noncardia), and may include biomarker testing (e.g., HER2, PDL1, MSI/dMMR) that can influence treatment decisions in advanced disease.

Staging & Risk Grouping

After orchiectomy, staging (0–III) considers tumor extent, lymphnode involvement, metastases, and post-surgery tumor marker levels. Clinicians also use risk grouping (especially for metastatic disease) to guide treatment intensity.

Treatment Options

Your plan is personalized based on tumor type (seminoma vs nonseminoma), stage/markers, imaging, and your preferences. Care is coordinated by a multidisciplinary team (urology, medical oncology, radiation oncology, radiology, pathology, fertility counseling).

Surgery (inguinal orchiectomy)

standard first step for most tumors; some patients may also need retroperitoneal lymphnode dissection (RPLND) depending on type/stage and team strategy.

Active surveillance (Stage I)

careful follow-up with markers and imaging to avoid over treatment while maintaining excellent cure rates—commonly used after orchiectomy in selected seminoma and nonseminoma cases.

Chemotherapy

cures many patients with nodepositive or metastatic disease; regimen selection depends on histology/risk group. (Testicular cancer is highly chemosensitive.)

Radiation therapy

an option primarily for seminoma in certain stage settings; not used for nonseminoma.

Fertility & survivorship: Treatment (including surgery, chemo, or radiation) can affect fertility; ask about sperm banking before therapy. Most men with low-stage disease and many with advanced disease are cured and go on to long lives.

Prognosis

Outcomes are excellent: cure rates exceed 90% for seminoma overall and approach 100% for many low-stage seminomas and nonseminomas with appropriate therapy.

Follow-Up Care

After treatment (or while on surveillance), follow-up usually includes:

Physical exams, serum tumor markers, and scheduled imaging (modality/frequency depend on type, stage, and time since treatment).
Monitoring and support for long-term effects, including fertility, hormone levels, cardiovascular risk, and psychosocial well-being.

Why Choose Illinois CancerCare

Integrated urology–medical oncology–radiation oncology collaboration, with rapid access to scrotal ultrasound, tumor markers, and guideline based care—close to home.
Personalized surveillance plans that minimize unnecessary treatment while keeping cure rates high, and fertility counseling (including timely referral for sperm banking).
Access to clinical trials and referral pathways, when appropriate.

Sources & Patient Friendly References

All information was taken from the NCI (National Cancer Institute) and ACS (American Cancer Society).