By Renova Hospitals
February 28, 2026
Testicular Cancer: Signs, Stages, Treatment & What Every Man Should Know
Key Takeaways
- Testicular cancer is the most common cancer in men aged 15 to 44 years.
- Although it represents only about 1% of all cancers in men, it has one of the highest cure rates.
- The overall 5-year survival rate is about 95%.
- Early-stage disease has a survival rate of ~99%.
- The most common symptom is a painless lump or swelling in one testicle.
What Is Testicular Cancer?
Testicular cancer begins in the germ cells of the testicles, the cells that produce sperm. Around 90 to 95% of cases are germ cell tumours, divided into:
1. Seminoma
- Slower-growing
- Sensitive to radiation and chemotherapy
- AFP (alpha-fetoprotein) remains normal
2. Nonseminoma
- Faster-growing
- Includes embryonal carcinoma, yolk sac tumour, teratoma, and choriocarcinoma
- AFP may be elevated
Over the past 40 years, doctors have observed a steady rise in the number of testicular cancer cases, particularly in North America and Europe. However, mortality rates have declined due to Improved treatment approaches that combine surgery, chemotherapy, and careful follow-up.
Epidemiology & Statistics
United States (Recent Data)
- ~9,700–10,000 new cases annually
- ~600 deaths per year
- Lifetime risk: 1 in 250 men (0.4%)
- Average age at diagnosis: 33 years
- Most common in ages 20–34
- Overall 5-year survival: ~94.9%
Global Trends
- More common in Western & Northern Europe
- Lower incidence in Africa
- Increasing rates are noted globally
- The highest incidence among White men
Even though cases have increased, testicular cancer remains one of the most curable cancers today.
Risk Factors
The exact cause is still not fully understood, but certain factors are known to increase the risk, including:
- Cryptorchidism (undescended testicle) – 2 to 4× higher risk
- Family history (father or brother)
- Previous testicular cancer
- Infertility or impaired spermatogenesis
- Klinefelter syndrome
- Gonadal dysgenesis
- Caucasian ethnicity
- Possible environmental exposures (pesticides, PFAS chemicals)
Researchers have not identified a single major gene responsible for most cases, but chromosomal abnormality i(12p) is commonly seen in germ cell tumours.
Symptoms of Testicular Cancer
Testicular cancer usually affects one testicle.
Common Symptoms
- Painless lump
- Swelling or enlargement
- Heaviness in the scrotum
- Firmness or hardness
- Dull ache in the scrotum or lower abdomen
If the Cancer Spreads to Other Parts of the Body
- Back pain (retroperitoneal lymph nodes)
- Persistent cough or shortness of breath
- Unexplained weight loss
- Neck lymph node swelling
- Breast tenderness (due to elevated β-hCG)
These symptoms may also occur in non-cancerous conditions, but it’s essential to see a doctor if you notice any of these changes.
Diagnosis
Early evaluation includes:
1. Physical Examination
Doctors treat any solid lump inside the testicle as cancer until proven otherwise.
2. Scrotal Ultrasound
An ultrasound helps confirm whether the lump is inside the testicle and whether it appears suspicious.
3. Serum Tumour Markers
- AFP
- β-hCG
- LDH
AFP is never elevated in pure seminoma.
4. Radical Inguinal Orchiectomy
This surgery confirms the diagnosis and removes the tumour simultaneously.
Trans-scrotal biopsy is avoided due to the risk of local recurrence.
Trans-scrotal biopsy is avoided due to the risk of local recurrence.
5. Imaging for Staging
- CT scan abdomen & pelvis
- Chest CT or X-ray
- Brain imaging (if high β-hCG)
Staging & Survival Rates
Testicular cancer is staged using the TNM (Tumour–Node–Metastasis) classification system along with serum tumour markers (AFP, β-hCG, LDH) measured after orchiectomy. The stage helps determine the extent of spread and guides treatment decisions.
Survival rates vary depending on how far the cancer has spread:
- Stage I (Localised Disease):
The cancer is confined to the testicle and has not spread to lymph nodes or distant organs. Approximate 5-year survival rate: ~99% - Stage II (Regional Spread):
The cancer has spread to nearby (retroperitoneal) lymph nodes but not to distant organs. Approximate 5-year survival rate: ~96% - Stage III (Distant Metastasis):
The cancer has spread to distant organs such as the lungs, liver, or brain.
Approximate 5-year survival rate: ~74% (varies based on risk group and tumour markers) - Overall (All Stages Combined):
When considering all stages together, the overall 5-year survival rate is approximately ~95%, making testicular cancer one of the most curable solid malignancies.
Unlike many other cancers, testicular cancer does not have a Stage IV category.
Treatment Options
Treatment is tailored based on the stage of cancer and the type of tumour.
Surgery (Orchiectomy)
Usually, the first thing your doctor will suggest.
Chemotherapy
Common regimens:
- BEP (Bleomycin, Etoposide, Cisplatin)
- EP
- VIP
Platinum-based chemotherapy has dramatically improved survival rates over the years.
Radiation Therapy
Used mainly in early-stage seminoma.
Retroperitoneal Lymph Node Dissection (RPLND)
Primarily for nonseminoma cases.
High-Dose Chemotherapy + Stem Cell Support
Used in relapsed/refractory disease.
Prognosis
- Cure rate: >90% overall
- Early-stage cure rate: ~100%
- Even metastatic disease often responds to treatment
- Regular follow-up visits are important because the cancer can rarely return
More than 300,000 survivors are living in the United States.
Complications
Disease-Related
- Metastasis
- Venous thromboembolism
- Chronic fatigue
Treatment-Related
- Infertility
- Peripheral neuropathy
- Hearing loss
- Hypogonadism
- Cardiovascular disease
- Secondary malignancies
Sperm banking should be discussed before chemotherapy.
Prevention & Screening
There is no guaranteed prevention.
Self-Examination
- Perform monthly
- After a warm shower
- Gently roll each testicle between fingers
Routine screening ultrasound is not recommended for average-risk men.
Latest Advances
- Circulating microRNA (miR-371a-3p) as a promising biomarker
- Reduced-toxicity chemotherapy protocols
- Ongoing trials (e.g., TIGER trial) for salvage therapy optimisation
- Researchers are also exploring how artificial intelligence can help doctors personalise treatment plans in the future
Testicular Cancer Treatment at Renova Hospitals
At Renova Hospitals, patients receive comprehensive care from early diagnosis through advanced treatment and follow-up. Our specialists provide detailed clinical evaluation, high-resolution ultrasound, tumour marker testing (AFP, β-hCG, LDH), and advanced imaging to stage the disease accurately.
Treatment options include radical inguinal orchiectomy, platinum-based chemotherapy (BEP/EP regimens), radiation therapy for seminoma, and specialised surgical procedures when required. Our team of urologists, oncologists, radiologists, and nurses works together to plan the best treatment for each patient and focuses on early detection. Renova Hospitals aims to deliver high cure rates, fertility guidance, and long-term follow-up care for optimal recovery.
Medical Disclaimer
This information is intended to help you better understand testicular cancer. Still, it should not replace your doctor's medical advice and is based on current clinical evidence and published oncology guidelines. It does not replace professional medical advice. If you experience symptoms such as a lump, swelling, or persistent discomfort in the testicle, consult a qualified healthcare provider promptly. Early diagnosis significantly improves treatment outcomes.
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