What are the testicles?

The testicles are male sex glands that produce sperm and the hormone testosterone. The testicles are two walnut-shaped glands inside the scrotum. The scrotum is the sac of skin that lies below the penis.

What is testicular cancer?

Testicular cancer is a disease that occurs when cancerous (malignant) cells develop in the tissues of a testicle. The development of cancerous cells in both testicles can occur, but is very rare. Testicular cancer is the most common cancer in men aged 20 to 35. The disease usually is curable.

What are the risk factors for developing testicular cancer?

Risk factors for developing testicular cancer include:

  • Undescended testicle(s) — This is when one or both testicles do not move down into the scrotum before birth.
  • Klinefelter's syndrome — This is a disorder in which males are born with an extra X chromosome in all or most of their cells. Certain other genetic syndromes are also associated with higher risk.
  • Race — Non-Hispanic, white men are more likely to develop this cancer than are men of other races and ethnicities.
  • Personal or family history — Men with a brother or father who had testis cancer have an increased risk of developing testis cancer themselves. Men who have had testis cancer themselves in one testicle are at increased risk of developing a second cancer in the other testicle.

What are the stages of testicular cancer?

Stage 0 — Abnormal cells have developed but are still confined within the tubules where sperm cells start to develop.

Stage I - This stage consists of the stages IA, IB, and IS.

  • In Stage IA, the cancer is confined to the testicle and the epididymis, and all tumor marker levels are normal. The cancer has not spread to the outer layer of the double membrane that surrounds the testicle and has not grown into the blood or lymph vessels.
  • In Stage IB, at least one of the following applies: The cancer invades into the blood vessels or lymphatics within the testicle; the cancer has spread to the outer layer of the membrane around the testicle; and/or the cancer invades into the spermatic cord or the scrotum. In stage IB, all tumor marker levels are normal.
  • In Stage IS, the cancer is anywhere within the testicle, spermatic cord, or scrotum and one or more of the tumor markers is elevated.

Stage II - This stage consists of Stage IIA, Stage IIB, and Stage IIC and refers to patients whose cancer has spread to the lymph nodes in the back of the abdomen (this part of the body is referred to as the retroperitoneum) but not to anywhere else. If patients with cancer in their lymph nodes have moderately or highly elevated tumor markers, then they are stage III rather than stage II.

  • In Stage IIA, the cancer has spread to a maximum of five lymph nodes in the abdomen. None of the lymph nodes is larger than 2 centimeters in size. Tumor markers must be either normal or only mildly elevated.
  • In stage IIB, the cancer has spread to more than 5 nodes, none of which is larger than 5 centimeters, or the cancer has spread to 5 or fewer nodes and there is a lymph node mass measuring between 2 and 5 centimeters. Tumor markers must be either normal or mildly elevated.
  • In Stage IIC, the cancer has spread to at least one lymph node in the abdomen that is larger than 5 cm diameter. Tumor markers must be either normal or only mildly elevated.

Stage III - This stage is divided into Stage IIIA, Stage IIIB, and Stage IIIC and is determined after an inguinal orchiectomy (removal of a testicle through an incision in the groin) is performed.

  • In Stage IIIA, the cancer has spread to lymph nodes beyond the abdomen (such as lymph nodes in the chest) and/or to the lungs. Tumor markers must be normal or only mildly elevated.
  • In stage IIIB, the cancer has spread to lymph nodes in the abdomen or elsewhere (such as lymph nodes in the chest) and/or to the lungs and the tumor markers are moderately elevated.
  • In stage IIIC, either the cancer has spread to an organ other than the lungs (such as the liver, the bones, or the brain) or the tumor markers are highly elevated and the cancer has spread to at least one lymph node or organ.

What are the symptoms of testicular cancer?

The following symptoms can be signs of testicular cancer or of another condition. Consult a doctor if you have any of these symptoms:

  • Swelling in the scrotum
  • Lump or swelling in either testicle
  • Build-up of fluid on the scrotum
  • Dull ache in the groin or lower abdomen
  • Pain or discomfort in the scrotum or a testicle