It is the cancer that develops in the testicles—a walnut-shaped gland present underneath the ski,n lying below the penis, called the scrotum. Like any other cancer, testicular cancer is also a very serious condition, and it is the most common cancer in young men aged 15 to 35. Fortunately, testicular cancer has a very high cure rate when diagnosed and treated early.
Approx. 80-90% of the tumors arise from the germ cells, commonly known as the germ cell tumor (GCT). Based on the initial examination of how they look under the microscope, they can be divided into
They spread more slowly than NSGCT and affect people aged 40-50. Sometimes it can grow rapidly; its subtypes include
Classic Seminoma- Commonly occurs (More than 95% of cases)
Spermatocytic Seminoma- Mainly affects older men.
Note- Seminoma can secrete Human Chorionic Gonadotrophin(HCG) but not other tumor markers. If seminoma spreads, it can be best treated with chemotherapy/Radiation therapy or, under some conditions, may require surgery.
Variable in appearance, they spread rapidly, and Seminoma types mainly affect people in their late teens, 20s, and early 30s. They are classified into four types such as
Embryonal Carcinoma: Rapidly growing and potentially aggressive form of tumor present in ~40% of the tumors.
Yolk sac Carcinoma: The most common tumor in children. It secretes alpha-fetoprotein.
Choriocarcinoma: A very rare and highly aggressive form of cancer.
Teratoma: Often mixed NSGCT, grows locally and can be observed in retroperitoneal lymph nodes, usually chemo/Radiation therapy resistant, and can be best removed with the surgical method.
Stromal tumor
Sometimes a tumor may develop from the supportive tissue around the testicles; although rare, they are responsible for approximately 5% of the testis cancer. Its types include
Leydig cell tumors- Leydig cells synthesise and secrete the testicular hormone called testosterone can be cured with surgery.
Sertoli cell tumors- They nourish the developing sperm and are usually benign tumors.
Here is the summary in the table given below:
|
Type |
Description |
|---|---|
|
Germ Cell Tumors (GCT) |
~90% of cases |
|
- Seminoma |
Slow-growing, usually affects men 30-50 |
|
- Non-seminomatous GCT (NSGCT) |
Faster growing usually affects younger men, 15-35 |
|
- Embryonal Carcinoma |
Aggressive, ~40% of NSGCT cases |
|
- Yolk Sac Tumor |
Most common in children, elevates AFP |
|
- Choriocarcinoma |
Rare, highly aggressive |
|
- Teratoma |
Often mixed tumors, sometimes chemo-resistant |
|
Stromal Tumors |
Rare (~5% of cases) |
|
- Leydig Cell Tumors |
Usually benign, can secrete testosterone |
|
- Sertoli Cell Tumors |
Generally benign |
Testicular cancer is rare but is common among males 15-35 years of age, affecting 1 in every 250 males.
Symptoms depend upon the stage and the condition of the patient. In many cases, testicular cancer may not cause any symptoms until it has advanced. symptoms include
Testicular cancer happens when the testicular cells divide uncontrollably, leading to the formation of a cancerous mass or tumor that interferes with the normal testicular cells.
In time, as the tumor grows beyond the testicle, some of the cells break up and spread to the other parts of the body. Most often these cancerous cells spread in the lymph nodes, liver, and lun,g known as metastatic testicular cancer.
Testicular cancer starts in the germ cells that make sperm. It's still unclear what causes DNA change in the Germ cells.
Several factors can increase the risk of Testicular cancer. Risk factors do not directly cause testicular cancer, but can increase the possibility of developing it.
Age: People between the ages of 15-45 years are at more risk of developing this cancer
Undescended Testicles (Cryptorchidism): It is a condition in which the testicles that are formed in the fetus during development have not descended or dropped out.ff This condition may require surgery, as being born with this condition can increase the risk of cancer.
Family History- A Family history of Testicular cancer (first-degree relative) can increase the risk of testicular cancer. Certain inherited conditions, like Klinefelter syndrome (XXY genetic condition), also increase the risk of cancer.
Race- It is seen that the testicular cancer is most common among whites (non-Hispanic).
Infertility- History or factors associated with male fertility may also be related to an increased risk of testicular cancer.r
Testicular cancer diagnosis includes investigation of the lump or other changes in the testicle during a self-exam. Sometimes it can be diagnosed during the physical examination.
Medical history and physical examination- Your providers will ask you about symptoms and family history to check for testicular cancer.
It includes:
Serum tumor marker test: It is a blood test to check the level of certain tumor markers, such as Alpha-fetoprotein and human Chorionic gonadotropin, that are elevated in different cancers. For example, some types of seminomas could elevate HCG and NSGCT in case of AFP, and vice versa in non-seminomas. Lactate dehydrogenase (LDH), a nonspecific marker, could indicate cancer spread.
Ultrasound- It is a non-invasive technique that uses sound waves to produce images of the tissue of our body. USG scrotum is recommended by a doctor for diagnosing this condition
X-RAY- If cancer spreads into the lungs (chest X-ray)
MRI.- Your Radiologist may recommend you MRI Brain in case cancer spreads to the brain and spinal cord region.
CT SCAN- Advanced Imaging technique that provides a detailed 3d image of the affected region, recommended if cancer has reached the advanced stage.
Note- Biopsy is rarely performed due to the risk of spreading, and diagnosis is typically based on imaging and tumor markers.
Depending upon the cancer stage and type, and your treatment preferences, your healthcare provider may recommend that you undergo advanced surgery, chemotherapy, or radiation therapy. Here are some of the procedures:
Surgery- It is the most common way to remove the testicular cancer, regardless of the cancer stage or type
Inguinal Orchiectomy- If the diagnosis confirms Cancer, your provider will make an incision (cut) in the groin to remove the affected testicle. They would also remove blood vessels and lymphatic tissue to prevent the spread of cancer.
Retroperitoneal Lymph Node Dissection- More common for advanced non-seminoma testicular cancer. During the procedure, your provider makes an incision in your abdomen and removes the lymph nodes behind the abdominal organs.
Radiation Therapy- It uses radioisotopes to produce radiation to kill cancerous cells. Mainly for seminoma post-surgery.
Chemotherapy- It utilises drugs to kill cancerous cells. Examples include cisplatin, bleomycin, and carboplatin. Depending upon the cancer stage and type, you may receive chemotherapy instead of surgery for effective treatment.
Note-Low-stage cases may require close monitoring instead of immediate further treatment.
While testicular cancer cannot be prevented, testicular self-examination is strongly recommended for early detection. This will help you decide whether to seek a healthcare provider or not.
Testicular Cancer—Global vs. India
|
Feature |
Global (2022) |
India (2022) |
|---|---|---|
|
New Cases |
~79,481 cases; ASIR ~1.7/100k (males). The most common cancer in young men (15–49 years). |
~3,924 cases; ASIR ~0.3/100k. Mostly affects men aged 20–40. Underreporting is likely due to low awareness. |
|
Deaths |
~9,374 deaths. Low fatality due to high curability, even in advanced stages. |
~1,136 deaths. Outcomes are affected by late diagnosis and limited access to specialized care in many regions. |
|
Age & Gender |
Affects only men, especially those 20–40 years old. Self-exam and early care give excellent results. |
Same trend in India. But low awareness and social stigma can delay diagnosis and treatment. |
|
Hotspots |
High in Europe (e.g., Norway, Germany), North America, and Australia. Linked to genetics and risk factors. |
No clear hotspots in India, but higher detection in metros like Delhi, Mumbai, and Bengaluru, due to better awareness. |
|
Rural vs Urban |
Early diagnosis is better in urban/high-income settings. Rural areas may face delays in diagnosis. |
Rural areas face stigma, poor awareness, and poor access to tests like ultrasound. Urban men get earlier care. |
|
5-Year Survival |
Very high: ~97–98% overall. Localized stage >99%; even metastatic >70–80% with treatment. |
It can be ~80–90% in early-stage cases in good hospitals. But survival drops if diagnosed late or in rural settings. |
|
Common Types |
~95% are Germ Cell Tumors: Seminomas (less aggressive) and Non-seminomas (more varied, aggressive). |
Same in India. Seminomas are more treatable. Non-seminomas need aggressive chemo/surgery, especially if advanced. |
Its prognosis (prediction) is excellent, and it has been successful in treating 95% of the cases. Even people with high risk factors have, on average, a 50% chance of being cured.
Relapse may occur, but regular follow-up and monitoring improve detection. Many relapses can still be successfully treated.
It can be fatal, but through early detection and diagnosis, we can better prevent the condition. Always seek your provider early to increase your chance of being cancer-free.
Often, early-stage testicular cancer is painless, but some men may feel a dull ache or heaviness in the scrotum.
Yes, it is curable, and only early diagnosis can make the difference, which can be treated in approximately 95% of the cases, and increase the chance by 98%
Depending upon the cancer stage and type, if left untreated, it may spread to the lungs, brain. Early detection is necessary as it may double in size in only 10-30 days.
Yes, it can affect fertility in men with the introduction of Chemotherapy/Radiotherapy. The extent of impact depends upon dosage type, cancer stage, and individual age; it can temporarily or permanently cause infertility.
