Testicular cancer

Testicular cancer is a type of cancer that occurs in the testicles.

The testicles

The testicles are two oval-shaped organs that are found inside the scrotum. This is the sack of skin that hangs below the penis. They are sometimes called the testes and are the part of the body that produces sperm.

Types of testicular cancer

You may hear testicular cancers being referred to as 'germ cell tumours'. This is because it occurs in the germ cells, which, in men, are the ones that produce sperm.

There are two main types of testicular cancer:

  • Seminomas
  • Non-seminomatous germ cell tumours (these are sometimes called ‘teratomas’)

It is also possible to develop non-Hodgkin's lymphoma in the testicles.

Who does it affect?

Non-seminomatous germ cell tumours are the type of testicular cancer that usually affects men aged from about 15 to 35 years old. Seminomas are more common in those over 25.

Before he was born, your son's testicles developed inside his abdomen. They usually descend into the scrotum at birth or in the first year of life. 'Cryptorchidism' is the name for a testicle that descends later than this or needs surgery to move down into the scrotum. If your son had a condition called cryptorchidism when he was younger, he is also slightly more likely to develop testicular cancer.

What are the symptoms?
How is it diagnosed?
How is it treated?
What are the treatment side-effects?
After treatment

What are the symptoms?

The most common symptom of testicular cancer is a lump or swelling in one of the testicles. Your son may feel an ache in his testicle or lower abdomen, or his scrotum may feel heavier than normal.

How is it diagnosed?

The first step to diagnosing testicular cancer is usually a hospital appointment where a specialist will perform an ultrasound scan on the testicles and scrotum. If the ultrasound cannot rule out testicular cancer, your son will need to have the affected testicle removed. This is done by making a small cut in his groin while he is under general anaesthetic. The tissue from the testicle will then be examined under a microscope to determine if cancer is present.

How is it treated?

In some cases, removing the affected testicle may be the only treatment needed. However, if the cancer has spread or there is a risk of it coming back, your son may also need a course of chemotherapy or radiotherapy. The length and type of treatment will depend on the type of testicular cancer he has and how it responds to treatment. Talk to the specialist about your son's individual treatment plan.

What are the treatment side-effects?

It is understandable that your son may be worried about having a testicle removed. However, the loss of one testicle will not make him infertile (unable to father children in the future) or unable to have sex. During his operation, the surgeon may be able to insert an artificial testicle so he looks the same as before.

If your son is undergoing chemotherapy, he may experience side-effects such as tiredness, sickness, diarrhoea and temporary hair loss. He may also be at greater risk of infections. For more information about how side-effects can be managed, talk to the specialist or nurses, or see the side-effects section of our website.

After treatment

Fertility

While the removal of one testicle does not affect fertility, it is possible that some of the treatments for testicular cancer may still leave your son infertile. He might want to talk to the specialist about the options available to him.

Follow up

After treatment is complete your son will still need to be seen regularly at an outpatient clinic. At this clinic, the specialist will be looking for any signs that the cancer has returned (this is known as a relapse). They will also check that his major organs, such as his heart and lungs, are still functioning correctly and haven’t been affected by his cancer treatment.

Long-term follow up

Once your son's risk of relapse has reduced, the focus of on-going follow up changes to looking out for potential long term side effects of treatment. The risk of long term side effects depends on the type of cancer your son had and the treatment he received. A personalised surveillance plan is usually created that outlines the specific long term follow up and on-going investigations that he requires.

Many people are at low risk of future health problems but some will have significant on-going health needs. Talk to the specialist about the potential long-term side-effects of your son's treatment.

Updated January 2015, next planned review 2017.

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