Testicular Cancer: Symptoms, Causes and Expert Care

Testicular cancer starts in one or both testicles – the small organs inside the scrotum that produce sperm and testosterone. It is not very common overall, but it is the most frequent solid cancer seen in young men, especially between 15 and 35 years of age. The reassuring part is that testicular cancer is highly curable, even when it has spread, if treated properly and on time.

In many men, the first clue is very simple: a painless lump or swelling in one testicle. Others notice a feeling of heaviness, a dull ache in the groin or lower abdomen, or a change in size or firmness compared to the other side. Because it often doesn’t cause severe pain in the beginning, people can ignore it for months, hoping it will go away on its own.

Understanding what is testicular cancer, how it behaves and what to look out for, helps you act early. With modern imaging, surgery, chemotherapy and expert follow-up, most patients go back to normal life, work and relationships after treatment.

What is Testicular Cancer?

In simple words, testicular cancer means that abnormal cells in the testicle have started growing in an uncontrolled way and are not following the body’s usual rules. They may form a lump (tumour) inside the testicle, which can then grow and, if untreated, spread to nearby lymph nodes or other organs.
Most cases are germ cell tumours, arising from the cells that normally make sperm. These are divided into two major types of testicular cancer:

• Seminomas – usually slower growing and very sensitive to radiation and chemotherapy
• Non-seminomas – a group including embryonal carcinoma, yolk sac tumour, choriocarcinoma and teratoma; often faster growing but also very responsive to chemotherapy
  There are also rarer tumours like Leydig cell, Sertoli cell tumours and lymphoma, but they are much less common. Regardless of type, prompt diagnosis is the key.

Recognizing Testicular Cancer Symptoms

Not every change in the scrotum is cancer, but certain testicular cancer symptoms are important to notice and never ignore. Common signs of testicular cancer include:

• Painless lump in a testicle
  • The most classic symptom
  • May feel like a pea, marble or firm area in the testicle
• Change in size or shape of a testicle
  • One side may become larger, harder, or feel “different” from the other
• Feeling of heaviness in the scrotum
  • A dragging or full sensation that persists
• Dull ache or discomfort
  • In the testicle, scrotum, groin or lower abdomen
  • Often mild and easy to dismiss
• Sudden fluid collection in the scrotum
  • Swelling or a fluid-filled sac (hydrocele) without clear injury
• Pain or tenderness
  • Some men do have pain, especially if there is bleeding within the tumour, but many do not
• Back pain, chest symptoms or breathlessness (advanced cases)
  • When cancer has already spread to lymph nodes or lungs
• Breast swelling or tenderness (rare)
  • Certain tumours can produce hormones that affect breast tissue
    If you notice any of these changes for more than 2–3 weeks, especially a new lump, it is much better to get it checked than to wait and worry.

Early Warning Signs and Self-Examination

Early testicular cancer symptoms can be subtle. A quick self-check once a month can really help:
Get familiar with your normal

• After a warm shower, gently hold the scrotum in your hands
• Feel each testicle between thumb and fingers, one side at a time
  What you’re looking for
• A small, firm, painless lump
• Any area that feels harder than the rest of the testicle
• Noticeable change in size or shape compared to the other side
  Other red flags
• Persistent dull ache in the groin or scrotum
• A new feeling of heaviness or swelling that doesn’t settle
• Any change that keeps returning after “home remedies”
  How often to do a testicular self-exam
• About once a month is usually enough
• If you have known risk factors (like an undescended testicle in childhood), your doctor may give more specific advice
  If something feels new or suspicious, don’t panic—but do book an appointment with a doctor.

Causes and Risk Factors for Testicular Cancer

The exact causes of testicular cancer are not fully understood. Most men who develop it are otherwise healthy and active. It’s not caused by masturbation, sexual activity or tight clothes. What we know is that certain testicular cancer risk factors make it more likely:

• Undescended testicle (cryptorchidism) – when one or both testicles did not move down into the scrotum properly in childhood
• Family history – a father or brother with testicular cancer increases your risk
• Previous testicular cancer – if you’ve had cancer in one testicle, the other has a higher chance than average
• Infertility and abnormal semen tests – men being evaluated for infertility have a slightly higher risk
• Certain genetic patterns and conditions – still being studied
  Many men have no identifiable risk factor at all. So the absence of risk factors doesn’t mean you can ignore a lump; and having a risk factor doesn’t mean you will definitely get cancer. It simply means you should be a little more attentive and proactive.

Undescended Testicle (Cryptorchidism)

Cryptorchidism refers to a testicle that failed to descend properly into the scrotum before birth or in early infancy. Men with a history of an undescended testicle have a significantly higher risk of testicular cancer in that testicle, and a slightly increased risk in the other one as well.
Early surgery (orchiopexy) lowers the risk compared to leaving the testicle undescended, but it does not make the risk completely normal. If you had this issue as a child, it is wise to do regular self-checks and see a doctor promptly if you notice any change.

Family History and Other Factors

If a close relative (especially a father or brother) has had testicular cancer, your own risk is higher than in the general population. This suggests a genetic component, although the exact genes are still being studied.
Other factors sometimes linked with testicular cancer include:

• Infertility or very abnormal semen analysis
• Previous testicular cancer in the opposite testicle
• Certain infections or immune conditions, including HIV in some cases
  While you cannot change your family history or childhood events, you can act early if you notice symptoms and discuss your risk openly with your doctor.

Types of Testicular Cancer

Most types of testicular cancer are germ cell tumours, meaning they arise from sperm-forming cells. These form the large majority of cases and are the reason testicular cancer is so responsive to treatment.
Germ cell tumours are broadly divided into:

• Seminomas
• Non-seminomas – a group including embryonal carcinoma, yolk sac tumour, choriocarcinoma and teratoma
  Some tumours are “pure” (only seminoma or only one non-seminoma type), while many are mixed germ cell tumours, containing more than one pattern.
  There are also rarer non-germ cell tumours:
• Leydig cell tumours
• Sertoli cell tumours
• Lymphoma involving the testis, more often in older men
  Each type behaves differently and responds differently to treatment. That is why accurate typing by a pathologist after surgery is so important.

Seminomas vs. Non-Seminomas

When doctors talk about seminoma testicular cancer versus non-seminoma testicular cancer, they are usually thinking about behaviour and best treatment:
Seminomas

• Often appear slightly later (30s–40s, but can be younger)
• Grow more slowly on average
• Very sensitive to radiation and chemotherapy
• Often have excellent outcomes, even in more advanced stages
  Non-seminomas
• Usually occur in slightly younger men (late teens to 30s)
• Tend to grow more quickly
• More likely to spread early through blood and lymph
  Respond very well to chemotherapy, but treatment planning can be more complex
  Many men have mixed tumours, where treatment decisions are based mainly on the non-seminoma component.

Diagnosing Testicular Cancer and Testicular Cancer Tumor

Diagnosing testicular cancer usually starts with a simple concern: “I’ve found a lump,” or “this side feels different.” From there, the process is structured but not complicated. A specialist (usually a urologist or oncologist) will:

• Take a detailed history of symptoms and risk factors
• Examine the testicles, scrotum and groin lymph nodes
• Order a scrotal ultrasound, which is painless and very accurate at identifying a testicular cancer tumour and telling solid masses from fluid or cysts
• Check blood tumour markers (AFP, beta-hCG, LDH)
  If cancer is strongly suspected, the usual next step is surgery to remove the affected testicle through a small groin cut. This operation both treats the primary tumour and provides tissue for an exact diagnosis and staging. Unlike many other cancers, we usually do not do a needle biopsy through the scrotum, as that can increase the risk of spreading cells into the scrotal tissues.

Diagnostic Tests at Onco Life Cancer Centre

At Onco Life Cancer Centre, typical tests for testicular cancer diagnosis in India include:

• Scrotal ultrasound
  First-line imaging to confirm a solid mass and assess its features
• Blood tests
  Tumour markers (AFP, beta-hCG, LDH)
  General blood tests for overall health and treatment planning
• CT scan of abdomen, pelvis and sometimes chest
  To look for enlarged lymph nodes or spread to other organs
• Radical inguinal orchiectomy
  Surgical removal of the affected testicle through a groin incision for definitive diagnosis and treatment
• Additional imaging when needed
  MRI or PET-CT in selected complex cases
  Fertility assessment and sperm banking consultation before treatment
  All results are reviewed in a multidisciplinary meeting so you get a clear, unified explanation and plan.

Testicular Cancer Treatment Options

The good news is that testicular cancer treatment is one of the great success stories in oncology. Cure rates are very high, especially when treatment is started promptly. Here is a simple, leaflet-style overview of how to treat testicular cancer:

1. First Step – Surgery

• Radical inguinal orchiectomy (removal of the affected testicle through the groin)
• Often curative for very early cancers
• Provides exact type and stage of tumour

2. After Surgery – Deciding the Next Move

Based on pathology and staging, options may include:

• Active surveillance
  For some low-risk early-stage tumours
  Regular tumour markers and scans instead of immediate further treatment
• Chemotherapy
  Standard regimens given in cycles through a vein
  Very effective for both seminomas and non-seminomas
  Used for higher-stage or higher-risk tumours
• Radiation therapy
  Mainly for certain seminoma cases
  Targets lymph node areas at risk
• Retroperitoneal lymph node dissection (RPLND)
  Specialised surgery to remove lymph nodes in the abdomen in selected non-seminoma cases

3. Supportive and Fertility Care

• Sperm banking before chemotherapy or radiation
• Management of side effects (nausea, fatigue, infections)
• Psychological support and counselling
  The plan is always individualised—no two patients are exactly the same.

Surgery for Testicular Cancer

The main testicular cancer surgery is called an orchiectomy, usually done through a small incision in the groin (radical inguinal orchiectomy). The surgeon carefully removes the testicle and spermatic cord on the affected side, while preserving surrounding structures.
Key points:

• The scrotum is not cut; this reduces the risk of spreading cancer cells.
• Most men go home the same day or the next day.
• A testicular prosthesis (implant) can be inserted during the same surgery or later, if you wish.
• One healthy testicle is usually enough for normal hormone production, erections and, in many cases, fertility.
  Your team at Onco Life will talk you through what to expect before and after the orchiectomy, including scar, recovery time and activity restrictions.

Chemotherapy and Radiation Therapy

Testicular cancer chemotherapy is often short but strong. Common regimens (like BEP) are given in cycles over a few weeks to months, depending on stage. They are highly effective at killing germ cell tumours.
Typical side effects can include:

• Fatigue and weakness
• Nausea and vomiting (usually well-controlled with medicines)
• Temporary hair loss
• Lowered immunity and increased infection risk
• Possible impact on fertility
  Radiation therapy for testicular cancer is mostly used for some seminoma cases, to treat lymph node regions in the abdomen. Seminomas are very sensitive to radiation, but because of potential long-term side effects, many patients are treated with chemotherapy or surveillance instead, depending on risk.
  At Onco Life, decisions about chemo and radiation are made jointly by medical and radiation oncologists, keeping both cure and long-term health in mind.

Life After Testicular Cancer: Follow-up and Support

Life after testicular cancer can be very positive, but it is normal to have questions and fears. Follow-up is an important part of care and typically includes:

• Regular check-ups and physical exams
• Periodic tumour marker tests
• Scheduled imaging (like chest X-ray or CT scans) to watch for recurrence
• Hormone (testosterone) level monitoring if needed
• Discussions about fertility, sexual function and family planning
  Emotionally, men may worry about masculinity, relationships, body image and future health. It helps to talk openly—with your doctor, a counsellor, your partner, or a support group. Many men go back to sports, work, travel, fatherhood and a completely normal life after treatment.
  Survivorship at Onco Life means not just “no cancer on the scan” but helping you feel like yourself again.

Why Choose Onco Life Cancer Centre for Testicular Cancer Care?

At Onco Life Cancer Centre, testicular cancer is managed by a team that understands both the science and the emotions involved in a diagnosis that affects fertility, sexuality and self-image.
Our approach includes:

• Multidisciplinary expertise – urologic surgeons, medical oncologists, radiation oncologists, radiologists, pathologists and fertility specialists working together
• Streamlined diagnostics – ultrasound, tumour markers, CT scans and histopathology coordinated quickly so you are not left waiting in uncertainty
• Individualised treatment plans – based on tumour type, stage, your age, family plans and personal preferences
• Focus on fertility and long-term health – counselling about sperm banking, hormone health, and late side effects from the very beginning
• Clear, compassionate communication – we explain your situation and options in simple language, answer family questions, and guide you step by step “The doctors didn’t just treat my cancer; they helped me understand every stage, from sperm banking to surgery to follow-ups. That made the whole journey far less frightening.”
  If you’ve noticed a lump, change or discomfort in a testicle, reaching out early to a specialised centre like Onco Life can make all the difference.

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