Testicular cancer

Testicular cancer is the general term used for all types of testicular cancer. Most testicular cancers develop from cells in the testicles called germ cells. They are also called germ cell tumours (GCTs).

There are 2 main types of testicular germ cell tumours:

• seminomas – they usually affect those aged 15 to 50
• non-seminomas – they usually affect those aged 15 to 35.

There are also some rarer types of testicular cancer. We have more information about testicular cancer types.

From puberty onwards, it is important to check your testicles regularly. It is usually possible to cure testicular cancer but it is easier to treat when it is diagnosed early.

Usually, you begin by seeing your GP, who will examine you. If your GP thinks your symptoms may be linked to testicular cancer, they will refer you to a hospital to be seen within 2 weeks. Sometimes, your GP will arrange for an ultrasound scan of the testicle before you visit the hospital.

At the hospital, you will see a urologist. This is a doctor who specialises in treating problems with the testicles, penis, prostate, bladder and kidneys. They will examine you and ask about your general health and any previous health problems you may have had.

They will arrange an ultrasound scan of the scrotum and testicles. They will also arrange blood tests.

Some hospitals have testicular one-stop clinics. This means as well as seeing a urology doctor, you may have an ultrasound on the same day. You will also be seen by a specialist nurse.

If the ultrasound shows the lump is highly likely to be testicular cancer, the whole testicle needs to be closely examined. The only way to get a definite diagnosis is to have surgery to remove the whole of the affected testicle. This operation is called an orchidectomy. This is because taking just a small piece of tissue (biopsy) may miss a cancer.

On rare occasions, the surgeon will remove only part of the testicle. For example, this may happen when someone has only one testicle. Or it may happen if the scan does not show clearly how likely it is to be cancer.

A doctor called a pathologist will examine the removed tissue using a microscope. This is to see if there are any cancer cells. If there are, the sample will show which type of testicular cancer you have.

After testicular cancer is diagnosed, you may also have a chest x-ray or a CT scan. This is to check that your lungs are not affected. The results help your doctors decide the best treatment for you.

As well as confirming a diagnosis, removing the testicle removes the cancer. It is the main treatment for testicular cancer that has not spread.

If the other testicle is healthy, an orchidectomy will not affect your ability to get an erection or your fertility. Fertility is being able to make someone pregnant.

There may be times when members of your healthcare team ask about your sexual orientation or gender identity. This information can help your team give the right care and support to you and the people close to you. You may find it makes things easier or less stressful for you.

If the questions they ask do not fit who you are or how you identify, tell your team. If you are unsure or uncomfortable answering a question, it is okay to check why the person is asking. You can ask them why they need this information and why they think it is relevant to your care.

You usually have surgery to diagnose and also remove the cancer (orchidectomy). After surgery, your doctors and team of specialists meet to talk about the best treatment for you. They are called a multidisciplinary team. They will talk to you about possible further treatment options and explain what might be best for your situation. They can talk to you about things to think about when making treatment decisions.

Treatment options depend on:

• the stage of testicular cancer you have
• whether it is non-seminoma or seminoma
• the risk of the testicular cancer coming back.

After surgery, treatment options for testicular cancer include:

If testicular cancer comes back, treatment can still usually cure it. This is even if the cancer has spread to other parts of the body. Treatment will depend on the type of testicular cancer, the areas affected and previous treatment.

We have more information about testicular cancer treatment. You may be offered some treatments as part of a clinical trial.

Treatments used for testicular cancer do not usually affect your ability to have sex or make someone pregnant (your fertility). But it is common to worry about this.

We have more information about how treatment may affect your sex life and fertility. This includes information on contraception during treatment, having children in the future, testosterone replacement and storing sperm (sperm banking).

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

• use plain English
• explain medical words
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• use illustrations to explain text
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We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

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