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:
- Non-seminomatous germ cell tumours (these are sometimes called ‘teratomas’)
It may be that you have one of these types, or a mix of both. It is also possible to develop non-Hodgkin 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 you were born, your testicles developed inside your 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 you had a condition called cryptorchidism when you were younger, you are also slightly more likely to develop testicular cancer.
What are the symptoms?
The most common symptom of testicular cancer is a lump or swelling in one of your testicles. This could be pea-sized or larger. You may feel an ache in your testicle or lower abdomen, or your 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 your testicles and scrotum. If the ultrasound cannot rule out testicular cancer, you will need to have the affected testicle removed. This is done by making a small cut in your groin while you are 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 you need. However, if the cancer has spread or there is a risk of it coming back, you may also need a course of chemotherapy or radiotherapy. The length and type of treatment will depend on the type of testicular cancer you have and how it responds to treatment. Talk to your specialist about your individual treatment plan.
What are the treatment side effects?
It is understandable that you may be worried about having one of your testicles removed. However, the loss of one testicle will not make you infertile (unable to father children in the future) or unable to have sex. During your operation, the surgeon may be able to insert an artificial testicle so your scrotum looks the same as before.
If you are undergoing chemotherapy, you may experience tiredness, sickness, diarrhoea and temporary hair loss. You may also be at greater risk of infections. For more information about how side effects can be managed, talk to your specialist or nurses, or see the side effects section of our website.
While the removal of one testicle does not affect your fertility, it is possible that some of the treatments for testicular cancer may still leave you infertile. You might want to talk to your specialist about storing some of your sperm before starting chemotherapy treatment. This stored sperm can be used if you and your partner want to have children later in your life.
You might like to read our guidance about cancer and fertility. Here you can find information about fertility preservation treatment, coming to terms with fertility issues, talking to a partner and other ways of starting a family in the future.
After your treatment is complete you will still need to be seen regularly at an outpatient clinic. At this clinic, your specialist will be looking for any signs that your cancer has returned (this is known as a relapse). They will also check that your major organs, such as your heart and lungs, are still functioning correctly and haven’t been affected by your cancer treatment.
Long-term follow up
Once your risk of relapse has reduced, the focus of ongoing 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 you had and the treatment you received. A personalised surveillance plan is usually created that outlines the specific long term follow up and ongoing investigations that you require. Many people are at low risk of future health problems but some will have significant ongoing health needs. Talk to your specialist about the potential long-term side effects of your treatment.
Updated March 2018, next review due 2021.