Testicular Cancer: Why Young Men Should Know the Signs

Testicular cancer is the most common cancer in men aged 15 to 35, yet it is also one of the most curable — even at advanced stages — with cure rates above 95% when caught early. Dr. Christopher Vendryes, MD encourages young men and their families to understand the warning signs and importance of routine self-examination.

Warning Signs

The most common sign is a painless lump or swelling in one testicle. Other symptoms include a feeling of heaviness in the scrotum, dull ache in the lower abdomen or groin, sudden fluid collection (hydrocele), and rarely, breast tenderness from hormone-producing tumors.

How to Perform a Self-Exam

Examine your testicles monthly, ideally after a warm shower. Gently roll each testicle between your thumb and fingers, feeling for any lumps, hardness, or changes in size or shape. Report any new findings to a urologist promptly.

Risk Factors

An undescended testicle (cryptorchidism), family history, prior testicular cancer in the other testicle, and certain genetic conditions all increase risk. Most cases, however, occur in young men with no identifiable risk factors.

Diagnosis and Staging

A scrotal ultrasound is the first imaging test, followed by blood tumor markers (AFP, beta-hCG, LDH) and a chest/abdominal CT to assess for spread. Diagnosis is confirmed by removing the affected testicle (radical orchiectomy) — biopsy through the scrotum is avoided.

Treatment and Outcomes

Treatment depends on the cancer type (seminoma vs. non-seminoma) and stage. Options include surveillance, chemotherapy, radiation, and retroperitoneal lymph node dissection. Cure rates exceed 95% for early-stage disease and remain high even with metastatic disease.

Fertility Considerations

Sperm banking is offered before treatment because chemotherapy and radiation can affect fertility. Most men retain normal hormonal function with one remaining testicle.