Testicular cancer mainly afflicts younger men.

Many types of cancer occur more commonly in older adults. For most men, concerns about cancers of the prostate, colon, and other areas of the body grow with age.

Testicular cancer is one exception, occurring more often in young and middle-aged men. In fact, the average age of a man diagnosed with testicular cancer is 33, according to The American Cancer Society. So, if you’re a younger man, while you may not need to consider prostate or colorectal cancer screening just yet, you should be aware of any potential testicular cancer symptoms and report them to your doctor. If caught early, testicular cancer is curable in most cases.

Testicular Cancer Symptoms

Only about one in every 263 American men will develop testicular cancer, making the disease relatively uncommon compared to other cancers, the ACS notes.

In most cases, a painless lump or swelling in the testicle is the first sign of testicular cancer. Usually, the cancer does not cause pain, but some men experience dull aching in the scrotum, groin, or abdomen, or they develop discomfort in a testicle. (Note that several benign conditions, including inflammation or injury to the testicle, can produce warning signs that resemble testicular cancer symptoms.) In other cases, men experience no symptoms at all, and their cancer is found incidentally during an exam for other medical conditions.

If testicular cancer progresses, it may spread to the liver and cause abdominal pain, trigger low-back pain if it spreads to certain lymph nodes, or cause chest pain, shortness of breath, and coughing if it advances to the lungs.

Detection and Diagnosis

Testicular cancer often can be found in its early stages. Experts generally recommend that an examination of the testicles should be included as part of a routine physical exam.

Some physicians advise men to conduct periodic self-exams, feeling for lumps, masses, or other changes in the testicles. If you choose to perform a self-exam, understand that one testicle may be larger or hang lower than the other, which is normal. Also, each testicle has blood vessels and tubes that may feel like abnormal lumps, so keep that in mind as you perform a self-exam. Tell your doctor about any troubling findings, such as significant changes in the size, shape, and feel of your testicles.

Your physician will examine your testicles and also inspect nearby areas, such as the abdomen, to look for any indications of cancer spread. If the doctor finds a lump, he or she will perform an ultrasound, a non-invasive test, to determine whether the lump is the result of a benign condition or a cancerous tumor. Your physician also may order blood tests to check for proteins suggestive of testicular cancer. If cancer is present, these blood markers may provide clues as to the type of cancer you have and the extent of the cancer.

Treatments Are Effective

Treatment for testicular cancer usually is successful—a man’s risk of dying from the disease is only about one in 5,000, according to the ACS.

Orchiectomy, a surgical procedure to remove one or both testicles, is the primary treatment for testicular cancer. Radiation or chemotherapy may be given to kill remaining cancer cells. For men who want to preserve a more natural look after surgery, the surgeon may implant a saline-filled prosthesis into the scrotum to fill the space once occupied by the testicles.
Men who have only one testicle removed can still father children, but those who have both taken out become infertile. Additionally, removing the testicles significantly reduces testosterone levels, which may cause loss of libido, erectile problems, hot flashes, declines in muscle mass, and fatigue. Testosterone replacement therapy can counter these side effects.

Radiation therapy is used primarily for men with a form of testicular cancer known as seminoma, and it may be used to kill testicular cancer that has spread to nearby lymph nodes. Chemotherapy is an option for cancer that has spread beyond the testicles or to reduce the risk of recurrent testicular cancer. A stem cell transplant and high-dose chemotherapy becomes an option if the cancer recurs despite initial chemotherapy.

Originally published May 2016 and updated.