Testicular cancer: know its symptoms, diagnosis and treatment options

Testicular cancer is the most common cancer in young men between 15 and 35 years old. Although it can also affect men of other ages, it is more common in this age group. Therefore, it has a significant impact on the young male population.

Testicular self-examination is a crucial and simple practice that all men should perform regularly as it plays a vital role in early detection of testicular cancer and therefore improving prognosis and cure rates. Awareness about testicular cancer is essential, and public education and the promotion of testicular self-examination can help identify early signs of the disease and encourage seeking medical care.

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What is testicular cancer?

Testicular cancer is a type of cancer that originates in the germ cells of the testicles, which are the male reproductive organs responsible for producing sperm and male sex hormones, such as testosterone. It is a relatively rare, but highly treatable, cancer and mainly affects young men, usually between the ages of 15 and 35, although it can occur at any age.

What causes testicular cancer?

The exact cause of testicular cancer is not always clear in each individual case, but a number of risk factors have been identified that can increase the likelihood of developing this disease. A risk factor is not a direct cause, but has been associated with an increased risk of developing testicular cancer.

Risk factors for testicular cancer

  • Age: Testicular cancer is more common in young men, especially between the ages of 15 and 35. However, it can occur at any age.
  • Family background: Men with a family history of testicular cancer have a higher risk of developing the disease. If a father or brother has had testicular cancer, the risk is higher.
  • Cryptorchidism: Cryptorchidism is a condition in which one or both testicles do not descend into the scrotum during fetal development. Men who have had cryptorchidism have a higher risk of developing testicular cancer, especially if the problem was not surgically corrected in childhood.
  • Genetic factors: Some inherited genetic mutations, such as Klinefelter syndrome, may increase the risk of testicular cancer.
  • History of previous testicular cancer: Men who have had testicular cancer in one testicle have a higher risk of developing the disease in the other testicle.
  • Exposure to environmental factors: Although it is not entirely clear, some studies have suggested that certain environmental and occupational factors could be related to an increased risk of testicular cancer. These factors may include exposure to pesticides, ionizing radiation, and certain chemicals.

It is important to keep in mind that the presence of one or more risk factors does not guarantee that someone will develop testicular cancer. Many men with testicular cancer have no known risk factors, and others with risk factors never develop the disease.

Types of testicular cancer

The two main types of testicular cancer are:

  • Seminomas: They represent approximately 40-45% of all testicular cancers. They are slow-growing cancers and originate in germ cells that resemble immature sperm.
  • No seminomas: They constitute around 50-55% of all testicular cancers. These cancers can include several subtypes, such as teratoma, choriocarcinoma, embryonal carcinoma, and yolk sac tumor, among others.

What is the most common testicular cancer?

The most common type of testicular cancer may vary depending on the geographic region and population studied. In general, germ cell tumors represent the vast majority of testicular cancers, and within these, seminomas and non-seminomas are the most prevalent.

Symptoms of testicular cancer

Symptoms of testicular cancer can vary and may include:

  • A lump or swelling in one or both testicles.
  • Pain or discomfort in the testicle or scrotum.
  • Sensation of heaviness in the scrotum.
  • Changes in the shape or size of the testicle.
  • Accumulation of fluid in the scrotum.

It is important to note that not all lumps in the testicles are cancerous; In many cases, they can be caused by other benign conditions. However, if a man notices any unusual changes or symptoms in his testicles, it is essential that he seek urological care immediately for a proper and timely diagnosis.

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How to do a testicular self-examination? How the testicles should feel to the touch

Performing a testicular self-examination regularly is an important practice to detect any changes or abnormalities in the testicles early. The steps to perform a testicular self-examination:

  • Find a suitable time: Find a time when you are relaxed and calm. You can perform the self-exam after a hot shower, as the scrotum will be more relaxed.
  • Visually inspect: Stand in front of a mirror and visually examine your testicles. Look for any changes in the size, shape, or appearance of the testicles. It is normal for one testicle to be slightly larger or hang lower than the other.
  • Hold the scrotum: Place your thumbs on top of the scrotum and your index and middle fingers under the scrotum to gently support it.
  • Examine each testicle separately: With the scrotum supported, feel each testicle with your fingers. Roll the testicle between your fingers to feel for any lumps, nodules, or changes in texture. The normal testicle should feel soft and firm, similar to a small ball.
  • Check the epididymis: Behind each testicle, you will feel a cord-like structure called the epididymis. It is normal for the epididymis to be a little swollen, but it should not be painful.
  • Repeat in the other direction: Repeat the exam on the other testicle, holding the scrotum with the other hand.
  • Pay attention to any abnormalities: If you find any lumps, bumps, thickening, or any unusual changes in your testicles or epididymis, don't panic. Not all lumps are cancerous, but it is important to report any changes to your urologist for further evaluation.
  • Perform self-examination regularly: Perform a testicular self-exam to familiarize yourself with the normal shape and size of your testicles and to be able to detect any changes in the future.

If you find anything unusual or have any concerns, it is essential that you consult a urologist for a proper evaluation. Early detection is key to the successful treatment of testicular cancer and other testicular conditions.

Testicular cancer diagnosis

Diagnosing testicular cancer involves several steps to confirm the presence of the disease and determine the type and stage of the cancer. Procedures and tests commonly used to diagnose testicular cancer are:

  • Medical history and physical examination: The urologist will begin by asking questions about any symptoms the patient may have and their medical history. He or she will then perform a physical exam, including an examination of the testicles and surrounding area to look for any abnormalities.
  • Testicular ultrasound: Ultrasound is an imaging technique that uses sound waves to create detailed images of internal organs. A testicular ultrasound can help identify the presence of masses in the testicles and provide information about their size and characteristics.
  • Blood test: Blood tests may be done to measure levels of specific tumor markers, such as alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH). These markers may be elevated in certain types of testicular cancer and may help in diagnosis and treatment monitoring.
  • Testicular biopsy: If the presence of a testicular tumor is suspected, a biopsy should be performed. In this procedure, a sample of testicular tissue is obtained for pathological analysis. The biopsy allows you to confirm the diagnosis of cancer and determine the specific type of testicular cancer, such as seminoma or non-seminoma.
  • Computed tomography (CT) or magnetic resonance imaging (MRI): These imaging tests may be done to evaluate whether the cancer has spread to other parts of the body, such as the lymph nodes, lungs, or abdomen.
  • Cancer staging: Once the diagnosis of testicular cancer has been confirmed, a process called staging is performed to determine the extent of the cancer and the stage at which it is. Staging is essential to plan appropriate treatment and predict prognosis. The stages range from stage I (localized cancer) to stage IV (cancer spread to distant organs)

How dangerous is testicular cancer?

The prognosis for testicular cancer is usually very favorable, especially when it is detected and treated in early stages. Cure rates for testicular cancer are one of the highest among all types of cancer. However, the prognosis can vary depending on several factors, such as the type of testicular cancer, stage at diagnosis, and response to treatment.

Here are some factors that affect the prognosis of testicular cancer:

  • Histological type: Germ cell tumors, both seminomas and non-seminomas, have high cure rates in general. Seminomas tend to grow more slowly and are usually diagnosed in early stages, increasing the chances of a cure. Non-seminomas, although they can be more aggressive, also have good survival rates, especially when detected early and treated appropriately.
  • Disease stage: The stage at which testicular cancer is diagnosed is a crucial factor in prognosis. Testicular cancers in early stages (stages I and II), when the disease is located in the testicle and nearby lymph nodes, have very high cure rates. As cancer spreads to distant organs (stages III and IV), the prognosis may be more guarded, but survival rates are still encouraging and treatment may be effective.
  • Response to treatment: The response of testicular cancer to treatment also influences prognosis. Most testicular cancers are very sensitive to radiotherapy and chemotherapy, which improves the prospects for a cure.
  • Age and general health: In general, young men in good general health have a better prognosis than those who are older or have other medical conditions that could complicate treatment.

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Testicular cancer treatment

Testicular cancer treatment depends on the type and stage of the cancer, as well as other individual patient factors. The most common treatments for testicular cancer are:

  • Orchiectomy: Surgery to remove the affected testicle is the initial treatment in most cases of testicular cancer. Orchiectomy not only provides a tissue sample for analysis and confirmation of the diagnosis, but also removes the primary tumor.
  • Radiotherapy: Radiation therapy may be used after orchiectomy in certain cases, especially to treat nearby lymph nodes that could harbor cancer cells.
  • Chemotherapy: Chemotherapy is a treatment that uses drugs to destroy or stop the growth of cancer cells. It is commonly used to treat testicular cancer in advanced stages or when the cancer has returned after initial treatment.
  • Lymph node surgery (Lymphadenectomy): If the cancer has spread to the retroperitoneal lymph nodes, surgery to remove the affected nodes may be done after orchiectomy and before or after chemotherapy.
  • Targeted therapies: In more advanced or chemotherapy-resistant cases, targeted therapies that focus on specific mechanisms of tumor growth can be used.

Testicular cancer and its treatment can affect a man's fertility. Some treatments, such as surgery or radiation therapy, can damage testicular tissues and reduce sperm production. It is important for young men diagnosed with testicular cancer to consider sperm preservation before undergoing treatments that could affect their ability to conceive in the future.

Treatment for testicular cancer is usually highly effective, and most men respond well to treatment with high cure rates. It is essential to develop an individualized treatment plan based on your specific situation.

How many people are cured of testicular cancer?

Survival rates for testicular cancer are generally very high, meaning that most patients have a good prognosis and can fully recover with appropriate treatment. Survival rates can vary depending on the type and stage of cancer, as well as other individual patient factors. Survival rates according to stages:

  1. Early stages (stages I and II): In general, survival rates for early-stage testicular cancers are extremely high, around 95% to 99%. This means that the vast majority of men diagnosed at these stages survive the disease.
  2. Advanced stages (stages III and IV): Even in more advanced stages where the cancer has spread to distant lymph nodes or to organs outside the lymph nodes, survival rates remain encouraging. In general, survival rates for these stages are approximately 70% to 95%, depending on the degree of extension and response to treatment.

Urologists specialists in testicular cancer in Madrid

At Ramírez Urología, we have the best team of doctors specialized in the treatment of testicular cancer. Our experience and multidisciplinary approach allow us to offer comprehensive and personalized care for each patient.

If you are worried about testicular cancer and you are looking for reliable and detailed information about this disease, we invite you to visit our website: There you will find relevant resources and data that will help you better understand this condition.

Also, if you wish, you can make an appointment online, our team will be happy to assist you and begin working together on your treatment and care.

At Ramirez Urology, we are committed to providing the best medical care and support to those facing testicular cancer. We are here to accompany you every step of the process and provide you with the care you need for a successful recovery.