Testicular cancer: what you should know

November 15, 2023
8 minute read

Testicular cancer can have a profound impact on the lives of those affected.

It’s the most common form of cancer that affects younger men between the ages of 15-49. Each year, around 2,300 men are diagnosed with this form of cancer in the UK, a figure that has roughly doubled since the 1970s.  

Read on as we dive deeper into the intricacies of testicular cancer, exploring known causes, the most common types of testicular cancer, the long-term outlook for those affected, as well as how to check for testicular cancer at home and when to see your GP.

What causes testicular cancer?

Much remains to be fully understood about testicular cancer, but several specific factors are known to increase someone’s likelihood of developing this form of cancer.  

Undescended testicles  

The single most significant risk factor for developing risk testicular cancer has been identified as having a history of cryptorchidism, a medical term that essentially means undescended testicles.  

Normally, the testicles descend into the scrotum at around month eight during a pregnancy. In cases of undescended testicles, the infant is born with either one or both testicles remaining in the abdomen. This is the most common birth defect involving the male genitalia, affecting roughly 3% of full-term and 30% of premature male infants. By the third month of life, the testicles descend into the scrotum by themselves in roughly 80% of individuals. In cases where this doesn’t occur, medical intervention is required.  

Boys and men with a history of cryptorchidism have an increased risk of testicular cancer. This is not related to the fact that the testicles do not descend, as it is currently believed that the abnormality in descent indicates an abnormality in the testicle that makes cancer later in life more likely to develop.  

Family history of testicular cancer  

Having a family history of testicular cancer is another risk factor. Testicular cancer is known to be highly heritable and can be passed from generation to generation.  

If your father had testicular cancer, you will be roughly 2-4 times more likely to also develop it, compared to someone with no family history of the condition. If your brother had testicular cancer, the risk of also developing it increases to between 8-12 times.  

In such cases where a first degree relative has testicular cancer, the average age of diagnosis is two to three years younger than the general population.  

Previous testicular cancer  

Men with a personal history of testicular cancer have the highest risk of developing it again. They are between 12-18 times more likely to develop cancer again in the other testicle, compared to men without a history of testicular cancer.  

What are the different types of testicular cancer?

There are several types of testicular cancer, according to the type of cells that the cancer first develops in.  

The most common type of testicular cancer is germ testicular cancer. This accounts for around 95% of cases, and has two distinct subtypes:

  • Seminomas  
  • Non-seminomas  

Seminomas are a type of germ cell tumour that tend to grow more slowly compared to non-seminomas. They are generally more sensitive to radiation therapy and tend to occur in men between the ages of 30-50. They are usually confined to the testicle at the time of diagnosis and have a high likelihood of being cured, especially if detected early. Seminomas are typically more responsive to treatment, and they are less likely to spread to other parts of the body.

Non-seminomas are a group of more aggressive germ cell tumours that grow more quickly than seminomas. They occur often in younger men, including teenagers and those in their twenties and thirties. These tumours may contain a mix of different cell types, which can complicate treatment approaches. Non-seminomas are also more likely to spread to other parts of the body, such as lymph nodes, lungs and other organs.  

Other, less common forms of testicular cancer include, Leydig cell tumours, accounting for between 1-3% of cases, and Sertoli cell tumours, accounting for fewer than 1% of cases.

Long-term outlook after testicular cancer diagnosis

Due to being very responsive to treatment, testicular cancer has a highly favourable prognosis compared to other types of cancer.  

Almost all men treated for germ testicular cancer achieve complete remission, and the chances of re-developing it after five or more years are low. The primary treatment typically involves surgically removing the affected testicles, which most often does not impact fertility or sexual function.  

In some cases, chemotherapy or radiotherapy can be used for seminomas, though not for non-seminomas.

How to check for testicular cancer

Before we explore how to check for signs of testicular cancer, it’s crucial to get to know your body well. Here are some things to keep in mind:  

  • It’s normal for one testicle to be slightly larger than the other, or to hang lower
  • Testicles should feel smooth, without any lumps or bumps, and firm, but not hard
  • You may also feel a soft tube at the back of each testicle, which is called the epididymis. TheF epididymis is a set of tubes where sperm “matures”. It’s easy to mistake the epididymis for an unusual mass so keep this in mind  

Here’s how to perform a testicular self-examination in just a few minutes:  

  1. Set aside a few minutes during a shower. The warm water will relax the scrotum and the surrounding muscles, which will make it easier for you to perform the self-examination
  1. Start with one testicle and gently roll the scrotum with your fingers and feel the surface of the testicle  
  1. As you’re doing this, check for any lumps, bumps or unusual features. Many cancerous tumours are not painful, though be aware if you encounter any dull soreness or heaviness
  1. Switch sides and repeat the process for the other testicle.  
  1. Repeat the self-examination once monthly and take note of any changes in size over time. While the most common symptom of testicular cancer is a painless mass, some men also experience swelling of the testicles and scrotum.

When to see your GP

As mentioned, it’s recommended to perform the self-examination once a month. If you feel something unusual, seek a professional opinion right away. While most testicular masses are not cancerous, any change or irregularity in the scrotum or testicles requires a visit to your GP.

If you find an abnormality, it may not be cancer, but it could still be something that causes discomfort or affects fertility, such as cysts, an infection, injury and more.  

Your GP will examine you and recommend further tests if deemed necessary. If you are diagnosed with testicular cancer, starting treatment early is crucial as it increases the likelihood of successful treatment.

Learn more

To find out more about testicular cancer explore the NHS resource pages. If you’re the parent or guardian of young males, make time to have a conversation about how they can check their testicles regularly. Normalising self-examinations can save lives.

Do you have any additional questions? Get in touch with our friendly, professional pharmacy team who can offer you guidance and advice.

Content last reviewed on:
November 15, 2023
Next review date:
November 15, 2025
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