Young men are at risk for testicular cancer

Testicular cancer is rare, but it's the most common cancer affecting young men — and rates have been steadily rising for decades. Because it often occurs earlier in life and can be painless in its early stages, many young men don't recognize the signs or assume symptoms aren't serious. Understanding who is at risk, what symptoms to watch for and when to see a doctor can make a meaningful difference in outcomes.

What age is testicular cancer most common

Testicular cancer is the most common cancer in men between the ages of 15 and 35. While still rare, testicular cancer has been increasing in the U.S. and many other countries for several decades.

"Although the number of new cases of testicular cancer has doubled in the last 40 years, the number of deaths caused by testicular cancer has decreased greatly because of better treatments," says Lauren Young, MD, medical oncologist at Main Line Health. "Testicular cancer can usually be cured, even in late stages of the disease."

Risk factors for testicular cancer

You may be more likely to develop testicular cancer if you:

• Have an undescended testicle (cryptorchidism)*
• Have a testicle that is not normal, such as a small testicle that does not work the way it should*
• Are a white man
• Have a personal or family history of testicular cancer
• Have Klinefelter syndrome, a genetic disorder

*Note: Men with cryptorchidism or a testicle that is not normal have an increased risk of testicular cancer in one or both testicles and need to be followed closely.

Screening for testicular cancer

There is no standard or routine screening test used for early detection of testicular cancer. Most often, testicular cancer is first found by men themselves, or by a doctor during a routine medical exam or an exam for another condition such as infertility.

Symptoms of testicular cancer

• A lump or swelling in either testicle, often painless
• A feeling of heaviness in the scrotum
• A dull ache in the lower abdomen or the groin
• A sudden swelling in the scrotum
• Pain or discomfort in a testicle or in the scrotum
• Enlargement or tenderness of the breast tissue
• Low back pain

"While these symptoms don't necessarily mean cancer, you should see your healthcare clinician if symptoms last longer than two weeks," says Dr. Young.

Your doctor may do a blood test and ultrasound. If cancer is found, additional imaging tests like CT scan or MRI can help determine if the cancer has spread.

Treating testicular cancer

"The outlook is excellent for men with testicular cancer, even when it has spread," Dr. Young says.

Depending on the type and stage of the cancer, treatment may include a combination of:

• Surgery to remove the testicle and some of the lymph nodes
• Chemotherapy to kill any remaining cancer cells
• Radiation therapy to kill cancer cells or keep them from growing

Your doctor may also recommend a minimally invasive procedure called retroperitoneal lymph node dissection (RPLND) to remove the lymph nodes behind your abdominal organs, depending on your stage of cancer.

Effect on fertility

Testicular cancer or its treatment can make you infertile. If you hope to father a child in the future, you may want to bank your sperm before treatment begins.

Talking about testicular cancer

Men are often uncomfortable sharing concerns about testicular issues. "As with any cancer, finding it early leads to better outcomes," explains Dr. Young.

"If you find a lump, notice any changes, experience pain or have any concerns, talk with your healthcare clinician," says Dr. Young.

"You may feel awkward, but waiting can make a difference in your treatment, quality of life and long-term results."

Next steps

Schedule an appointment with a testicular cancer specialist

Learn more about Lauren Young, MD

Learn more about primary care at Main Line Health

Learn more about cancer care at Main Line Health

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