Seminoma

What is seminoma cancer?

Seminoma is a type of germ cell tumor that most commonly affects one or both of your testicles (testicular cancer). In people assigned male at birth (AMAB), germ cells form sperm.

Although rare, seminoma is very curable and has a high survival rate with proper treatment. Treatment typically requires surgically removing your affected testicle. This won’t affect your ability to get an erection or orgasm, or have biological children. If a provider must remove both testicles, you’ll still retain sexual function and, if you wish to have biological children, you can bank your sperm and use an assisted reproductive technique, like in vitro fertilization (IVF).

Is a seminoma a cancer?

Yes, testicular seminoma is a type of cancer. It usually affects your testicles. But it can also affect other areas of your body, including:

• The space in your chest (mediastinum) that contains your heart.
• The space behind your abdominal cavity (retroperitoneum), which includes your urinary system and kidneys.

What are the types of seminoma?

There are two main subtypes of seminoma. These are:

• Classic (typical) seminoma.
• Spermatocytic seminoma.

Classic (typical) seminoma

Classic seminoma usually affects people between the ages of 25 and 45. It doesn’t cause your body to make higher levels of alpha-fetoprotein (AFP). AFP is a protein that develops in the liver during fetal development. High AFP levels in adults may be a sign of some types of cancer, including other subtypes of testicular cancer. But if you have classic seminoma, you don’t have elevated AFP.

Spermatocytic seminoma

Spermatocytic seminoma usually affects people ages 50 and older. It usually grows slowly and isn’t likely to spread to other areas of your body.

How common is seminoma?

Testicular cancer is rare — it affects about 1 in 250 people who have testicles. But the number of cases is increasing, which is attributed to an increase in seminoma. According to the U.S. Centers for Disease Control and Prevention (CDC), 54% of all testicular cancers diagnosed in the U.S. from 2001 to 2020 are seminomas. The American Cancer Society estimates there will be about 9,760 diagnosed cases of testicular cancer in the U.S. in 2024.

Even though testicular cancer overall is rare, it’s the most common cancer in people AMAB between 15 and 35 years old. According to the CDC, seminoma most commonly affects people in their 30s to 60s.

What are the symptoms of a seminoma?

Seminoma symptoms usually include swelling or a painless lump on your testicle. Other symptoms may include:

• A feeling of heaviness in your testicles, perineum or scrotum.
• A dull ache in your testicles, perineum or scrotum.

Rarely, you may also experience:

• Sudden, sharp (acute) pain in or around your testicles.
• Blood in your semen (hematospermia).

If seminoma spreads (metastasizes), symptoms may include:

• Lumps on the lymph nodes in your neck.
• Cough.
• Shortness of breath (dyspnea).
• Nausea and vomiting.
• Gastrointestinal bleeding.
• Bone pain.

Is seminoma aggressive?

In early stages, seminoma isn’t aggressive. But sometimes, it may grow quickly. If you have seminoma, a healthcare provider will monitor you to make sure it doesn’t spread.

What causes seminoma?

During typical fetal development, germ cells develop and eventually make their way to the fetus’s ovaries (ova or egg cells) or testicles (sperm). But if you have seminoma, your germ cells don’t develop into fully formed sperm. They divide and multiply, eventually growing into masses (tumors). Medical experts aren’t sure why germ cells sometimes don’t develop into typical sperm.

Who does seminoma affect?

Seminoma can affect anyone with testicles at any age. But you’re more likely to have seminoma if you:

• Are between your 30s and 60s.
• Are white.
• Have a personal or biological family history of seminoma.
• Have a personal history of undescended testicles.

How is seminoma diagnosed?

A healthcare provider can diagnose seminoma. They’ll:

• Review your medical history.
• Ask about your symptoms.
• Perform a physical exam, which will include checking your testicles or lymph nodes for lumps.

If they suspect testicular cancer, they may recommend additional tests to make an official diagnosis.

What tests will be done to diagnose seminoma?

A healthcare provider may recommend one or more of the following tests to diagnose seminoma:

• Testicular ultrasound.
• Other imaging tests.
• Serum tumor marker test.
• Orchiectomy.

After diagnosing seminoma, a provider will use cancer staging to determine the size of your tumor and if it has spread to other areas of your body.

Testicular ultrasound

A testicular ultrasound is a noninvasive imaging test that uses sound waves to show real-time images or video of your testicles.

Other imaging tests

A CT scan (computed tomography scan), X-ray or MRI (magnetic resonance imaging) can determine if testicular cancer has spread to other areas of your body.

Serum tumor marker test

This is a type of blood test that looks for tumor markers. Tumor markers are substances that cancer cells make, or that healthy cells make in response to cancer. A serum tumor marker test will look for the substances alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (beta-HCG) and lactate dehydrogenase (LDH). Different types of testicular cancers will produce different types and quantities of tumor markers. Having negative tumor markers also doesn’t rule out the presence of testicular cancer. Some tumors don’t make any tumor markers.

Orchiectomy

A surgeon will remove your affected testicle and send it to a pathologist to examine it for cancer cells. Providers use an orchiectomy to both diagnose and treat seminoma.

What are the stages of seminoma?

Healthcare providers stage testicular cancer from 0 to 3 for seminomas and non-seminomas. Non-seminomas are another type of testicular germ cell tumor. They grow larger and spread faster than seminomas. Unlike other types of cancer, there isn’t a stage 4. In general, the lower the stage number, the slower the cancer grows. Stages 1 through 3 also have substages (A, B, C or S) to go into more detail.

Providers may also use the TNM system to provide further detail:

• Tumor (T). The size of the tumor and whether it has spread to nearby areas.
• Node (N). Whether cancer has spread to nearby lymph nodes or your abdomen.
• Metastasis (M). Whether cancer has spread to distant parts of your body.
• Serum tumor markers (S). Whether blood tests indicate high tumor marker levels.

This information can be confusing or even overwhelming. But it’s essential information for your providers to diagnose and plan your treatment.

How is seminoma treated?

For all seminoma stages, healthcare providers recommend a radical inguinal orchiectomy. During a radical inguinal orchiectomy, a surgeon removes your affected testicle(s) and spermatic cord. Your spermatic cord carries semen from your testicles to your penis during ejaculation. It also supplies blood to your testicles and contains nerves, lymph vessels and the vas deferens. The surgeon will close off the blood vessels and lymphatic vessels to prevent cancer from spreading to other areas.

Other seminoma treatments depend on your cancer staging after a radical inguinal orchiectomy. They may involve one or more of the following:

• Active surveillance. A provider may recommend active surveillance after a radical inguinal orchiectomy to treat early-stage seminoma. It involves regular monitoring and tests to see if seminoma spreads.
• Chemotherapy. Chemotherapy uses medicines to destroy cancer cells.
• Radiation therapy (radiotherapy). Radiation therapy uses high-powered X-rays to destroy cancer cells.

Can seminoma be prevented?

You can’t prevent seminoma. But it’s a good idea to perform monthly testicular self-exams to help keep track of any changes to the look and feel of your testicles. Schedule an appointment with a healthcare provider if you notice any lumps or size changes.

You may also be able to lower your overall cancer risk by:

• Quitting smoking and vaping.
• Getting 20 to 30 minutes of physical activity each day.
• Eating lots of fruits, vegetables and whole grains.
• Limiting how much alcohol you drink.
• Maintaining a healthy weight for you.

What can I expect if I have seminoma?

The outlook for seminoma is very good. It’s usually very treatable:

• The overall survival rate is higher than 95%.
• The survival rate is 99% with early diagnosis and if the cancer doesn’t spread beyond your testicle.
• The survival rate is 96% if it spreads to nearby lymph nodes.
• The survival rate is over 70% even if it affects other areas of your body.

After seminoma treatment, you’ll need regular checkups for the rest of your life to make sure cancer doesn’t come back. Your checkups may include:

• Physical examination of your unaffected testicle (contralateral testicle).
• Regular blood tests for tumor markers.
• Periodic X-rays or CT scans.

What is the mortality rate for seminoma?

Even though seminoma is usually treatable, there’s still a small chance it could be fatal. According to the American Cancer Society, about 1 in 5,000 cases of testicular cancer is fatal.

How do I take care of myself?

Even though seminoma has a very good outlook, finding out you have testicular cancer can stir many different feelings. Whatever you’re feeling is perfectly OK. Some days you may feel confident. Other days you may feel angry or frustrated. It’s important to take the time you need to process your feelings. The following tips may help:

• Make sure to rest when you’re tired.
• Find a good way to manage your stress. This may include physical activity, yoga, meditation or art therapy.
• Look into cancer survivorship programs.
• Find a testicular cancer support group.
• Lean on your family or close friends for support.

When should I see a healthcare provider?

Schedule an appointment with a healthcare provider if you notice any lumps or other changes to your testicles. They can diagnose what kind of mass you have and, if necessary, recommend additional testing and treatment.

If you receive treatment for seminoma, be sure to schedule regular checkups with a provider to monitor your overall health and ensure it doesn’t return.

What questions should I ask a healthcare provider?

Here are some questions to ask your healthcare provider after you receive a seminoma diagnosis:

• Has the cancer spread to other areas of my body?
• Which treatments do you recommend?
• What are the benefits and risks of your recommended treatments?
• How long will treatment take?
• Can I still have biological children?
• Can I get a prosthetic testicle?
• What’s my outlook?

What is worse seminoma or non-seminoma?

Seminoma tumors usually respond to treatment better than non-seminoma tumors. Non-seminoma tumors consist of more than one type of cell and usually grow faster than seminoma tumors.