Testicular Cancer

Testicular cancer is a malignant tumor that develops in the testicles. It most commonly occurs in young men between the ages of 30 and 40, but it can also appear in boys under 4 years old. In some cases, it is detected incidentally after scrotal trauma.

Testicular cancer is classified based on histology, which is critical in determining treatment. Broadly, there are two main types:

• Seminomas: tend to grow and spread more slowly.
• Non-seminomas: include embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma. These often grow and spread more quickly.

The most common presentation is a painless lump or swelling in the testicle, often discovered by the patient. Other symptoms may include:

• Acute scrotal pain or discomfort
• Testicular atrophy
• Infertility
• Gynecomastia (breast enlargement) in about 5% of patients
• Rarely, nipple discharge

If the cancer has spread (metastasized), symptoms may include:

• Neck mass (lymph node involvement)
• Back pain
• Hemoptysis (coughing up blood)

The exact cause of testicular cancer is not fully understood, but both congenital and acquired factors contribute.

Congenital factors

• Cryptorchidism (undescended testicle): Men with a history of cryptorchidism have a 3–14 times higher risk. Corrective surgery (orchiopexy) is often performed but does not fully eliminate the risk.

Acquired factors

• Testicular atrophy after trauma: Suggested in some animal studies, but not clearly proven in humans.
• Hormonal exposure: Some studies suggest maternal hormone exposure (e.g., oral contraceptives during pregnancy) may increase risk.
• Viral infection: Mumps orchitis can cause testicular atrophy, increasing the risk of testicular cancer up to 15-fold. The virus itself is not carcinogenic, but the hormonal changes caused by testicular damage may promote tumor development.

There are no guaranteed methods to prevent testicular cancer, but early detection is critical because treatment is highly effective when the disease is caught early.

Monthly testicular self-examination is recommended, ideally after a warm shower or bath when the scrotum is relaxed.

1.   Stand in front of a mirror and look for swelling.
2.   Gently roll each testicle between the fingers and thumb to check for lumps or irregularities.
3.   One testicle is normally slightly larger than the other; this is not a cause for concern.
4.   Also check the epididymis (the soft structure behind the testicle).

Any new lump, swelling, or persistent discomfort should be evaluated promptly by a physician.