The testicles, or testes, have two primary roles:

• Producing sperm – essential for male fertility. 
• Producing testosterone – the hormone responsible for male characteristics such as muscle mass, facial hair, and deep voice. 

When abnormal cells grow uncontrollably in the testicles, they form a tumor. This tumor can remain localized or spread (metastasize) to other organs such as the lymph nodes, lungs, or liver.

Testicular cancers are broadly categorized into germ cell tumors (GCTs), which make up 90–95% of cases, and non-germ cell tumors.

1. Seminomas

• Grow more slowly. 
• Usually occur in men between 25 and 45. 
• Very sensitive to radiation and chemotherapy. 

2. Non-Seminomas

• Tend to grow and spread faster. 
• More common in younger men (teens to early 30s). 
• Includes subtypes such as embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma. 

3. Stromal Tumors

• Rare, developing from the supportive and hormone-producing tissues. 
• Include Leydig cell and Sertoli cell tumors. 
• Often non-cancerous but may sometimes spread. 

While the exact cause of testicular cancer remains unclear, several factors increase risk:

• Undescended testicle (cryptorchidism) – Men born with one or both testicles not descended into the scrotum have higher risk. 
• Family history – Having a father or brother with testicular cancer increases risk. 
• Age – Most cases occur between ages 15–45. 
• Race – More common in Caucasian men than in African or Asian men. 
• Previous testicular cancer – Men who had it in one testicle are at greater risk of developing it in the other. 
• HIV infection – Slightly increases risk.
  

Early stages are often painless, making self-examination essential. Common symptoms include:

• Lump or swelling in one testicle – usually painless. 
• Change in testicle size or shape – one feels heavier or harder than the other. 
• Dull ache in the lower abdomen or groin. 
• Pain or discomfort in the scrotum. 
• Sudden collection of fluid in the scrotum. 
• Enlargement or tenderness of breasts – caused by hormone changes. 
• Back pain, chest pain, or shortness of breath – if cancer has spread.
  

Monthly self-examination helps detect lumps or changes early. The best time is after a warm shower when the scrotum is relaxed. Steps include:

1. Hold the scrotum gently in both hands. 
2. Examine each testicle separately. 
3. Roll testicle gently between fingers, feeling for lumps or hardness. 
4. Report any unusual changes to a doctor immediately. 

To confirm diagnosis, doctors use several methods:

• Ultrasound – the first imaging test to identify lumps. 
• Blood tests – check tumor markers like alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (β-hCG), and lactate dehydrogenase (LDH). 
• Radical inguinal orchiectomy – surgical removal of the affected testicle, which provides tissue for biopsy. 
• CT scan or MRI – to determine spread of cancer to lymph nodes or other organs.
  

Staging helps guide treatment:

• Stage I – Cancer confined to the testicle. 
• Stage II – Spread to nearby lymph nodes in the abdomen. 
• Stage III – Spread to distant organs like lungs, liver, or brain. 

Treatment depends on the type and stage of cancer. Testicular cancer has an excellent prognosis, with cure rates over 95% in early stages.

1. Surgery

• Radical inguinal orchiectomy – Standard treatment; removal of affected testicle. 
• Retroperitoneal lymph node dissection (RPLND) – Removes affected lymph nodes in the abdomen. 

2. Radiation Therapy

• Mainly used for seminomas. 
• Targets and destroys remaining cancer cells after surgery. 

3. Chemotherapy

• Drugs like cisplatin, etoposide, and bleomycin used to kill cancer cells. 
• Effective for both seminomas and non-seminomas. 

4. High-dose Chemotherapy with Stem Cell Transplant

• Used in advanced or recurrent cases. 
• Replaces bone marrow destroyed by high-dose drugs with healthy stem cells. 

5. Surveillance (Active Monitoring)

• For very early cases, regular check-ups and scans instead of immediate aggressive treatment. 

Since testicles play a vital role in reproduction, fertility preservation is an important discussion:

• Sperm banking – Recommended before chemotherapy or surgery. 
• Testosterone replacement therapy – May be necessary if both testicles are removed. 
• Fertility treatments – Options like IVF available if natural conception is difficult later.
  

Recovery and survivorship involve physical, emotional, and social aspects:

• Emotional health – Anxiety and depression are common; counseling helps. 
• Body image concerns – Testicular prostheses can restore natural appearance. 
• Lifestyle – Healthy diet, exercise, and avoiding smoking aid recovery. 
• Follow-up care – Regular check-ups are critical to detect recurrence.
  

• Early-stage testicular cancer – Cure rates exceed 95%. 
• Advanced cases – With modern therapies, survival rates remain above 70–80%. 
• Seminomas – Generally more curable than non-seminomas due to slower growth. 

Regular surveillance after treatment is essential for long-term survival and quality of life.

• Genetic research – Identifying mutations that increase risk. 
• Targeted therapy – Drugs under development to attack cancer cells with fewer side effects. 
• Immunotherapy – Promising results in clinical trials for resistant cases. 
• Improved fertility preservation – Advances in reproductive medicine for survivors. 

There is no guaranteed way to prevent testicular cancer, but risk can be reduced through:

• Regular self-examination for early detection. 
• Seeking medical advice for any persistent testicular pain or swelling. 
• Awareness campaigns to encourage young men to check themselves regularly.
  

Testicular cancer, though rare, is the most common cancer in young men. Fortunately, with early diagnosis and modern treatments, survival rates are among the highest of all cancers. Self-examination, prompt medical attention, and personalized treatment plans can make the difference between late and early-stage detection. With ongoing advancements in surgery, chemotherapy, and targeted therapies, the outlook for men with testicular cancer continues to improve. Awareness and early action remain the most powerful tools in overcoming this disease.