The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on September 21, 2021.

About testicular cancer

The testicles, or testes, are the male sex glands that produce sperm. Because they also manufacture the male sex hormone testosterone, the testicles are considered both part of the endocrine system and part of the male reproductive system.

Reproductive cells called germ cells develop into sperm through a process of cellular division called meiosis. Under normal circumstances, cell division is regulated. Sometimes, the germ cells begin to divide uncontrollably and, instead of producing functional sperm, the germ cells create copies of themselves. When this happens, the cells are considered cancerous. This kind of out-of-control division may happen in other types of cells in the testicles, but nearly 95 percent of all testicular cancers are germ cell tumors.

About 9,470 new cases of testicular cancer are expected to be diagnosed in the United States in 2021, according to the American Cancer Society.

What causes testicular cancer?

Although cancer research has not identified the exact cause of testicular cancer, certain factors have been identified that may increase a man’s testicular cancer risk. These risk factors include:

  • Family history, having a father or brother who has had testicular cancer
  • Cryptorchidism (an undescended testicle)
  • HIV infection
  • Carcinoma in situ, also called intratubular germ cell neoplasia, which generally does not form a mass but may progress to become an invasive cancer
  • Previous history of testicular cancer, with some men who have had cancer in one testicle later developing cancer in the other testicle

Learn about risk factors for testicular cancer

Who gets testicular cancer?

About 80 percent of testicular cancers occur in adult men under the age of 44, with more than half occurring in men between 20 and 34 years old.

White males have a five times greater risk of developing testicular cancer than black men, and a three times greater risk than Asian-American or Native American men. Hispanic/Latino men are at higher risk than Asian-Americans, but at a lesser risk than white males. Testicular cancer occurs most frequently in the United States and Europe.

Men who have an undescended testicle are also at increased risk of testicular cancer, specifically in the undescended testicle.

Types of testicular cancer

Many types of cells are found in the testicles, all of which may become cancerous.

Types of testicular cancer tumors may include:

  • Seminoma tumors, including classical (typical) seminomas and spermatocytic seminomas
  • Non-seminoma tumors, including embryonal carcinoma, yolk sac carcinoma, choriocarcinoma and teratoma
  • Stromal tumors, also called gonadal stromal tumors, including Leydig cell tumors and Sertoli cell tumors

Learn more about testicular cancer types

Testicular cancer symptoms

Knowing the symptoms of testicular cancer may increase the likelihood of finding the disease in its early stages. In some cases, men may discover a lump accidentally or during a routine self-examination.

Some signs of a testicular tumor are also associated with non-cancerous conditions.

Signs of testicular cancer may include:

  • Painless lumps or nodules on either testicle, or a change in how a testicle looks or feels
  • Swelling in the scrotum, sometimes caused by a sudden buildup of fluid
  • A dull ache in the lower abdomen or the scrotum
  • Pain, discomfort or a feeling of heaviness in the scrotum
  • Enlargement of the breasts, caused by the secretion in the testicular tumor of hormones that stimulate breast growth
  • Lower back pain, especially when cancer cells have spread to other parts of the body

Some testicular cancers do not produce any symptoms at all. Some non-cancerous conditions produce symptoms similar to a testicular tumor, such as testicular injury and inflammation, and viral or bacterial infections.

Learn about symptoms of testicular cancer

Diagnosing testicular cancer

Diagnostic tests for testicular cancer may include:

  • Biopsy, which is usually performed only after removing the affected testicle because of the danger of cancer cells spreading to lymph nodes
  • Laboratory tests, including blood tests, to evaluate tumor markers such as human chorionic gonadotropin (HCG) and alpha-fetoprotein (AFP)
  • Computed tomography scan (CT scan)
  • Lymphangiogram
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET)/CT scan
  • Ultrasound
  • X-rays

Learn about diagnostic procedures for testicular cancer

Testicular cancer treatments

Treatment options for testicular cancer may include:

  • Radical inguinal orchiectomy, surgery to remove the testicle with the tumor, as well as its spermatic cord
  • Retroperitoneal lymph node dissection, surgery to remove the lymph nodes behind the abdomen
  • Chemotherapy
  • Radiation therapy, including external beam radiation therapy (EBRT), intensity modulated radiation therapy (IMRT), and TomoTherapy®

Some treatments for testicular cancer may cause infertility.

Learn about treatment options for testicular cancer