Frequently Asked Questions About Testicular Cancer

Testicular Cancer Basics

• What is testicular cancer?
• What are the risks factors for testicular cancer?
• How do a perform a testicular self-exam?
• What are the chances that the cancer will grow in the other testicle?

Testicular Cancer Symptoms and Diagnosis

• What are the symptoms of testicular cancer?
• What is the first step for finding testicular cancer?
• How is testicular cancer diagnosed?

Testicular Cancer treatment

• Will I/my son still be able to have children after an orchiectomy?
• How long does it take for a child to heal from an inguinal orchiectomy?
• How long does it take for an adult to heal from an orchiectomy?

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What is testicular cancer?

Testicular cancer starts in the male gland known as a testicle or testis, part of the male reproductive system. These two small egg-shaped glands are held in a sac (scrotum) below the penis.

Testicular cancer can affect a man or boy at any age, it is most often found in men ages 15- 44. While it’s rare, accounting for about 1 percent of all male cancers, it’s very treatable. Surgery plus chemotherapy or radiation (alone or combined) can cure almost 100 percent of low stage or early disease tumors. These treatments also cure at least 85 percent of more advanced tumors.

What are the risk factors for testicular cancer?

Factors that may increase your testicular cancer risk:

• Men with a father or brother who had testicular cancer
• Men with a history of testes that don’t drop before birth (also known as undescended testes or cryptorchidism)
• Abnormal cells in the testicle called germ cell neoplasia in situ (GCNIS), most often found during an infertility test

How do I perform a testicular self-exam?

Monthly self-exams are the best way to find a tumor early. Check the testicles right after a hot bath or shower when the scrotal skin is most relaxed. The exam should be done while standing and it only takes a few minutes.

1. Check each testicle. Gently but firmly roll each testicle between the thumb and forefingers of both hands. Feel the whole surface. The firmness of the testis should be the same all around. It’s normal for one testis to be slightly larger than the other.
2. Find the epididymis and vas deferens. These are soft tube-like structures above and behind the testicle. These tubes collect and carry sperm. Just become familiar with how these cords feel.
3. Look for lumps, swelling or things that don’t seem right. Lumps or bumps are not normal (even if they cause no pain). Pain is not normal.
4. Check yourself at least once per month. Always look for any changes in size, shape, or texture.

If you find a lump, swelling, pain or other change, get it checked out. Changes are not always cancer, but if it is cancer, you have the best chance for a cure if you see your urologist right away.

What are the chances that the cancer will grow in the other testicle?

For patients diagnosed as boys, it’s very rare for a new tumor to form after treatment. In adults there is a 2 percent to 3 percent chance of a tumor growing in the opposite teste. Most often, no new tumor will grow after treatment.

What are the symptoms of testicular cancer?

The most common symptoms for testicular cancer include:

• A painless lump in the testicle (the most common sign)
• Swelling of the testicle (with or without pain) or a feeling of weight in the scrotum
• Pain or a dull ache in the testicle, scrotum or groin
• Tenderness or changes in the male breast tissue

What is the first step for finding testicular cancer?

If you have some of the risk factors for testicular cancer, some doctors may recommend a routine self-examination. This is the only screening method available for testicular cancer. After a warm shower or bath, gently move the testicle between the thumb and fingers. If you feel any lumps, contact your doctor as soon as possible. The doctor can take the steps to diagnose if the lump is non-cancerous or cancerous.

How is testicular cancer diagnosed?

If your urologist suspects your symptoms may be a sign of testicular cancer, they’ll want to test if cancer is growing and examine your scrotum, belly, lymph nodes, and other parts to look for signs of cancer. They will look for lumps, firmness or signs of swelling. Tell them if you have a history of undescended testes.

You may have one or more of these tests to confirm a diagnosis of testicular cancer:

• Testicular ultrasound: This imaging test is used to see inside the scrotum and to check a suspicious lump. Other scans or x-rays may be done if your doctor would like to see inside your chest or abdomen. This is done to see if cancer has spread to lymph nodes, the lungs or liver. MRIs are rarely used but needed in some cases to check the brain and spinal cord.
• Blood test: A blood test is taken to check tumor markers. These are proteins and hormones made by some testicular cancers. AFP, ACG and LDH tumor markers rise with some cancers but many testicular cancers will not produce tumor markers. In other words, just because tumor markers are normal does not mean that you are free of cancer. It’s of great value to ask your doctor about your tumor maker levels and learn what’s normal vs. not normal.
  
  • Serum Tumor Marker Test: Tumor markers (AFP, HCG, and LDH) should be measured before any treatment, such as surgery. If cancer is found, tumor marker tests will be repeated after treatment to track how well you’re doing over time. Some medicines and marijuana can create false positive levels of HCG. Tell your doctor about your medicine and/or marijuana use.
    
    • Pure seminomas can raise HCG levels but never AFP levels.
    • Non-seminomas often raise AFP and/or HCG levels.

Will I/my son still be able to have children after an orchiectomy?

Most boys can have children when they grow-up. Generally, normal sperm growth occurs in the final testicle, and a man can stay fertile. Still, there is a greater risk of infertility than the general population. Talk with your doctor about this before surgery. Sperm banking and fertility coaching are options. Survivors of testicular cancer can involve fertility physicians early on (often within 6 months).

How long does it take for a child to heal from an inguinal orchiectomy?

This is an outpatient procedure, so most boys return home the same day. Your son should avoid contact sports for at least two weeks but should be able to return to school within one week.

How long does it take for an adult to heal from an orchiectomy?

The scrotum will be swollen after surgery. The swelling most often goes down within two to four weeks. You should be able to do most of your normal activities after two to three weeks. Wait for the incision to heal before having sex. Avoid lifting heavy objects or things that call for a lot of physical effort for a few weeks.