Testicular cancer

Testicular cancer is a cancer that develops in your testicles. Your testicles are the two small, egg-shaped glands behind your penis that produce sperm. Testicular cancer usually only affects one testicle, but it can occur in both.

The most common symptom of testicular cancer is a painless lump or swelling in one of your testicles.

Less common symptoms may include:

• a feeling of heaviness in the scrotum (the sac of skin that holds your testicles)
• a change in the size or shape of your testicle
• uneven testicles
• pain in your testicles, scrotum, stomach or back
• enlarged, tender nipples
• coughing or breathlessness (rarely)

Sometimes testicular cancer doesn't cause any symptoms.

It is not known why some people develop testicular cancer. There are factors that can increase your risk, including:

• a history of cancer in the other testicle
• undescended testicles (when your testicles don't move into the scrotum after you are born)
• family history of testicular cancer
• fertility problems
• living with HIV or AIDS
• being born with hypospadias (a difference affecting the penis)
• some intersex variations

Hot baths, tight clothes and injury to the testicles do not increase your risk of testicular cancer.

You should see your doctor if you notice a lump, swelling or other unusual change in your testicle. Also see your doctor if you have any other symptoms of testicular cancer.

To diagnose testicular cancer, your doctor will ask about your symptoms and examine your testicles.

If they find a lump, they may refer you for the following tests:

• ultrasound scan — to check for abnormalities
• CT scan or MRI scan — to see if cancer has spread
• blood test — to detect tumour markers
• biopsy — where a small sample of tissue is taken from the testicle to check for cancer cells

Your doctor will use the results to work out the stage of the cancer:

• Stage 1 — cancer is found only in the testicle
• Stage 2 — cancer has spread outside the testicle to the lymph nodes in the abdomen (tummy) or pelvis
• Stage 3 — cancer has spread beyond the lymph nodes to other areas of the body

Treatment for testicular cancer depends on the type of testicular cancer and whether or not it has spread. The affected testicle is usually removed through surgery (called an orchidectomy). The tissue is then checked in a laboratory to confirm the type and stage of cancer. After the surgery, you may not need further treatment other than regular check-ups.

You may need to have chemotherapy or radiotherapy if cancer cells have spread. You may also need further surgery.

You may choose to have a silicone implant (prosthesis) to replace the removed testicle. This will look and feel like a normal testicle. You can discuss the timing of the procedure with your doctor, either during or after the orchidectomy.

Your remaining testicle should produce enough testosterone to maintain muscle and bone strength, libido (sex drive) and energy levels. However, some people develop low testosterone levels after treatment. This can be treated with testosterone replacement therapy.

Fertility

Having one testicle removed will not usually affect your fertility. Your other testicle should produce enough sperm.

Treatments such as chemotherapy and radiotherapy can affect your fertility. If fertility is important to you, talk to your doctor about sperm banking before starting treatment.

Life after treatment

After you have been treated for cancer, it is common to feel anxious that the cancer will return. It can also take time to adjust to the physical and emotional changes involved in losing a testicle.

If you are struggling, seek support from your doctor or a therapist. You can also connect with others who have gone through testicular cancer.

Testicular cancer isn't preventable, but if it is found early, it can usually be cured.

Males who are aged 15 years or older should check their testicles for lumps every month. The test only takes a few minutes and is easy to do. Most lumps are not cancer, but you should always have a doctor check any lump right away.

Learn about testicular self-exam (Opens in new tab) (self-checking).

Some people may develop complications after testicular cancer. This is more likely if you need to have chemotherapy or radiotherapy.

Complications may include:

• fertility problems
• low testosterone levels
• a higher risk of heart disease and stroke
• developing another type of cancer

Cancer Council Australia (Opens in new tab) offers services and support to people affected by cancer. Call them on 13 11 20.

CanTeen (Opens in new tab) provides support for young people aged 12 to 25 affected by cancer. Call them on 1800 226 833.

Cancer Australia (Opens in new tab) has resources on the social and emotional impact of cancer.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Languages other than English

The Cancer Council provides booklets, factsheets and videos in several languages (Opens in new tab).

Our Mob and Cancer has information on testicular cancer for Aboriginal and/or Torres Strait Islander people (Opens in new tab).