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Testicular Cancer

Testicular cancer is a tumor that develops in the testicles and often presents with the appearance of a lump, pain, or swelling in the affected testicle. Although it is relatively rare, it is one of the most common cancers among young adults. Recognizing the symptoms early is crucial for a timely diagnosis and effective treatment.

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What Is Testicular Cancer?

Testicular cancer, although a rare neoplasm, is one of the most common diseases among young adults. In fact, it is the most prevalent in the 15-34 age group. In 2022, 2,470 new diagnoses were estimated in Italy (source: I numeri del cancro 2023 in Italia, AIOM-AIRTUM). The testes are the organs where the formation and maturation of sperm occurs, as well as the production of certain hormones, including testosterone.

Testicular cancer results from disruption of the cells of the testes and scrotum, which in most cases originates in the germ cells, which are responsible for sperm production. Non-germ cell tumors are less common and generally benign. Usually, the tumor affects only one testis, but those who have already had a neoplasm in one testis have an increased risk of developing another.

Testicular cancer risk factors

Although the risk factors for testicular cancer are limited and the causes of this neoplasm are still unknown, there are some situations in which the risk increases. What, then, are the main risk factors?

  • Age – Testicular cancer is most common between the ages of 15 and 34 and becomes rare over the age of 60.
  • Familiarity – A family history of testicular cancer increases the risk.
  • Cryptorchidism – Failure of one or both testes to descend into the scrotum increases the likelihood of testicular cell disruption and tumor initiation. The risk varies depending on the location of the cryptorchidism (in the abdomen or groin). Surgery to correct this condition within the first two years of life reduces the risk of developing the tumor.
  • Klinefelter syndrome – A chromosomal abnormality that causes abnormal testicular development.
  • HIV infection – Some studies suggest a possible association between HIV and an increased risk of testicular cancer. 

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What Are the Signs and Symptoms of Testicular Cancer?

Some common testicular cancer symptoms include:

  • Nodule (may be painless).
  • Swollen or enlarged testicle without a nodule.
  • Sensation of heaviness in the scrotum or lower abdomen.
  • Pain or growth of the breast (gynecomastia, rare but possible).

Prevention of testicular cancer

As with many other cancers, testicular cancer can be successfully treated if detected early. There are no specific prevention programs for testicular cancer, but it is essential to consider risk factors. In the event that one or more risk factors are present, you should consult your referring physician to consider whether and when to undergo a testicular ultrasound. However, testicular self-examination remains the first and most important step to diagnose this neoplasm early.

How to perform a testicular self-examination

Perform a testicular self-examination at least once a month to monitor for any warning bells. Here's how to do it:

  • Choose the right time – The ideal time is after a shower or a warm bath, when the scrotum is relaxed.
  • Examine one testicle at a time – Using both hands, gently roll it between your thumb and index finger, feeling for any lumps or changes in consistency.

If you notice a lump or change in the testicles, it is important to see a specialist immediately. During your annual checkup with your doctor, ask for a testicular examination. Remember that early detection is critical.

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How Do You Treat Testicular Cancer?

If diagnosed early, testicular cancer is highly treatable. Studies show that the five-year survival rate for the early stages exceeds 95%, while in cases where the disease has spread beyond the local lymph nodes, the rate is around 75%.

Treatment varies depending on the stage of the cancer and the patient's condition. The main options include:

  • Surgery – Removal of the affected testicle (orchiectomy) and, if necessary, the involved lymph nodes.
  • Radiotherapy – Used in cases where the cancer has spread to the lymph nodes, with targeted external beams.
  • Chemotherapy – Indicated for more advanced forms or to prevent recurrence.

Thanks to medical advancements, most patients with testicular cancer can be completely cured.

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Reviewed March 2025.