April 25, 2018

With Testicular Cancer, Early Detection Is Key

By Linda Gale, PA

Testicular cancer is a rare diagnosis accounting for only 1 percent of male cancers. It is a younger man’s cancer – the most common type of cancer in men ages 15 to 35. Fortunately, it is a curable cancer with only 5 percent diagnosed with it die from the disease.

Early detection increases the chance of a complete cure with a 99 percent cure rate if the tumor is found before it spreads.


A lump or swelling in a testicle is the most common complaint of patient’s found to have testicular cancer. The lump or swelling is most often painless. Most patients with swelling and a painful lump in the testicle do not have testicular cancer but rather a more common infection called epididymitis.

Many patients complain of a feeling of heaviness or achiness in the scrotum, behind the scrotum or lower abdomen.

If the cancer has spread to other parts of the body, there may be other symptoms like a lump in the neck, cough, loss of appetite and weight loss, bone pain, low back pain, and swelling in the legs or breast enlargement. Of course, these symptoms can be caused by other less worrisome conditions.

Undescended testicle

During development in the womb, the testicle forms in the abdomen and then descends into the scrotal sack. In a small percentage of babies, one or both of the testicles do not descend. Boys with this condition have a somewhat higher risk of developing testicular cancer.


Testicular cancer is diagnosed by a medical provider through a clinical exam and often imaging such as scrotal ultrasound. Blood tests are done to check for tumor markers that increase the suspicion for testicular cancer. Additional testing may be done such as a CT scan to check if the cancer has spread beyond the testicle.


Surgery to remove the testicle is usually advised and may often be the only treatment needed. A prosthetic testicle can be implanted in place of the removed testicle.

Sometimes, removal of some or all of the lymph nodes that testicular cancer can spread to is done.

Further treatment will depend on the type of tumor and how much it has spread. Additional treatment might include radiation and chemotherapy.

See Your Provider

Patients who notice a lump or swelling in the scrotum, with or without pain, should be seen by a provider. There is a condition called testicular torsion where the testicle may twist in the scrotum cutting off blood supply. This is a medical emergency. Other common reasons for swelling or lumps are infections and harmless cysts (common). Testicular cancer is a much less common reason for a testicular lump but important to diagnose early.

Linda Gale is a Physician Assistant with Mission Urology – McDowell and Blue Ridge Urology – Spruce Pine.

To learn more, visit mission-health.org/urology.