Testicular Cancer Care
Leading-edge diagnosis and treatment for testicular cancer
Contact Us
Expert Care for Testicular Cancer
Beth Israel Deaconess Medical Center (BIDMC) Cancer Center specialists promptly diagnose and effectively treat testicular cancer. We understand that dealing with health issues that affect the reproductive system can be difficult, and we are sensitive to that. You will see that our testicular cancer team provides extremely compassionate care.
We offer state-of-the-art robotic surgical approaches for advanced cases of testicular cancer. You also have access to the most up-to-date chemotherapy and radiation options if necessary. Our genitourinary cancer specialists collaborate with your care team to ensure you get comprehensive care for all your needs.
What is Testicular Cancer?
Testicular cancer is an uncommon type of cancer that typically affects young men. Testicular cancer occurs when cells in the testicles start growing uncontrollably and form tumors. Researchers don’t yet know what causes testicular cancer.
Because the testicles have several different types of cells, there are multiple forms of testicular cancer. The specific type of testicular cancer you’re diagnosed with will affect your treatment options.
Testicular Cancer Screening
Luckily, regular testicular self-exams can detect most testicular cancers early before they spread to other parts of the body. Some testicular cancers don’t cause symptoms until they reach late stages. In most cases, however, swelling and lumps in the testes are the first testicular cancer symptoms.
While some doctors recommend men self-examine their testicles monthly, the American Cancer Society does not have a recommendation regarding routine self-exams. They do, however, advise men to familiarize themselves with potential symptoms of testicular cancer and see a doctor right away if they detect a lump.
Testicular Cancer Diagnosis
When you see BIDMC's testicular cancer experts at one of our cancer care locations, you’ll likely have a series of tests. Your specialist will use the results of these tests to diagnose your condition and develop a treatment plan that works best for you.
The tests may include these and others:
- Physical exam
- Diagnostic imaging for the evaluation and staging of your disease, such as a CT scan or MRI to show detailed pictures of tissues and organs, as well as abnormal cells.
- Biopsy is the removal of a tissue sample from the tumor. After removing the testicular tumor, pathologists look at the cells under a microscope to learn what type of testicular cancer you have.
- Blood tests to determine tumor marker levels. Some types of testicular cancer can increase blood levels of proteins known as tumor markers. For example, proteins including human chorionic gonadotropin (HCG) and alpha-fetoprotein (AFP) can be detected by a simple blood test and are considered tumor markers for certain types of testicular cancer.
Testicular Cancer Staging
Once you are diagnosed with testicular cancer, your doctors will work to determine if the cancer has spread and how far. This is a process known as staging. Doctors determine the stage using the results of exams, blood tests and various imaging tests.
The care team will take these steps during the staging process:
- Determine the amount of cancer present
- Calculate the severity of the cancer
- Devise the best approach to treatment
Testicular cancer care teams grade the stages of testicular cancer using the TNM staging system. When diagnosing testicular cancer, they add an additional category (Serum).
- Tumor (T): How big is the tumor, and where is it located?
- Nodes (N): Has the tumor spread to the lymph nodes? If so, in what part of the body and how many?
- Metastasis (M): Has the cancer metastasized? If so, in what part of the body and how much?
- Serum (S): Are the blood marker levels higher than usual? If so, how high are they?
The staging system for testicular cancer is complicated. Your team at BIDMC will go over it with you in more detail to ensure you're able to make informed decisions regarding your treatment.
Testicular Cancer Treatments
Our genitourinary cancer team reviews all of your medical details during our weekly multidisciplinary conference. Radiologists report on your imaging studies, and pathologists review the results of your biopsy. Urologists, medical oncologists and radiation oncologists also share their opinions. Then, the team of experts considers all the options and agrees on the best course of action for you.
Depending on the type and stage of your cancer and other factors, your testicular cancer could be treated with these steps:
- Surgery
- Radiation therapy
- Chemotherapy (chemo)
Your care team may suggest more than one type of treatment. In general, the cure rates for testicular cancer are very high — usually over 95%.
Surgery is the first treatment for nearly all testicular cancers.
Radical Inguinal Orchiectomy: Surgical Removal of Testicle
A radical inguinal orchiectomy is an operation to remove a testicle with cancer. A surgeon makes an incision in the lower abdomen and removes the entire tumor along with the testicle and spermatic cord. Men who are uncomfortable with their appearance after removal of a testicle can have a testicular prosthetic (testis implant) in the scrotum. This provides the look and feel of a real testicle.
Minimally Invasive Surgery for Testicular Cancer
In some cases, surgeons can perform urologic surgery using minimally invasive techniques through very small incisions in the abdomen. This is called laparoscopic or robotic surgery. These techniques usually mean less blood loss during surgery and a quicker recovery time for you after surgery.
Robotic-Retroperitoneal Lymph Node Dissection (R-RPLND)
Depending on the type and stage of your cancer, your care team may recommend a second surgery. This would involve removal of lymph nodes around the large blood vessels at the back of the abdomen. To preserve normal ejaculation, our surgeons are skilled in nerve-sparing surgical techniques that may avoid damage to the nerves surrounding retroperitoneal lymph nodes in some men.
Traditionally, surgeons completed this surgery through a large abdomen incision. However, at BIDMC, we perform most of these surgeries using a robotic approach. We use several small laparoscopic incisions. With this approach, you can expect a much shorter overall recovery.
Side Effects of Testicular Cancer Surgery
Losing one testicle usually has no effect on a man's ability to get an erection and have sex. Because testicular surgery and chemotherapy may affect fertility, you may want to talk to your doctor about sperm banking. In this process, the provider collects sperm cells before cancer treatment and freezes them for you to use in the future.
Your care team may recommend chemotherapy to treat your testicular cancer. If you have advanced testicular cancer, you may have high-dose chemotherapy combined with a stem cell transplant.
Your care team may recommend radiation therapy as part of your treatment plan. BIDMC offers CyberKnife stereotactic radiosurgery, a highly precise form of radiation to treat some cases of testicular cancer.
Depending on the treatment, you may or may not have any issues. Treatment may cause these common side effects:
- Fatigue
- Increased risk of infection
- Nausea and vomiting
- Low blood counts
- Reduced sperm count and fertility issues
Some forms of chemotherapy also can result in these quality-of-life changes:
- Fatigue
- Fertility issues
- Infections
- Neuropathy (nerve pain)
Side effects of chemotherapy include hair loss and mouth sores. Radiation may cause changes in the skin in the area of treatment.
If the cancer was low stage, then you will feel similar to before treatment. If you require advanced surgery — such as RPLND — you may face reduced or absent ejaculation. If you have concerns about infertility, discuss them with your doctor before starting treatment.
Ongoing Care & Recurrence
Although men often receive a testicular cancer diagnosis at an early stage, recurrences are not uncommon. That is why it’s important for you to commit to follow-up testing, sometimes even years after your initial diagnosis.
If it recurs, testicular cancer typically does so within the first two years after treatment. Common care plans for recurrent testicular cancer usually include one or more of these treatments:
- High-dose chemotherapy
- Surgery
- Stem cell transplants
If your testicular cancer returns, your care team may suggest you enroll in a clinical trial.
More About Testicular Cancer
There are several factors that can increase your risk:
- Age. Testicular cancer can affect men of any age. However, more than half of men with testicular cancer receive the diagnosis between the ages of 20 and 34 years.
- Genetics. Men who have fathers or brothers with testicular cancer may be more likely to develop it themselves. However, most men with testicular cancer don’t have a family history of the disease.
- Race. White men are four to five times more likely to develop testicular cancer than Black or Asian-American men. Native Americans have slightly lower rates of testicular cancer.
- Undescended testicles. Cryptorchidism (undescended testicles) significantly increases the risk for developing testicular cancer. This condition affects approximately 3% of males in utero.
Some studies have indicated that those who live with human immunodeficiency virus (HIV) — and particularly AIDS — have a higher risk of developing testicular cancer.
You may qualify for one of our extensive clinical trials. We design these research studies to find new and better treatments for cancer patients based on the most updated information from around the world. We are committed to bringing you the latest in effective treatment options.
We provide supportive care and rehabilitation to help you manage symptoms of cancer and side effects of cancer treatments. We also provide ongoing survivorship services during and after treatment, as well as these offerings:
The Testicular Cancer Program at BIDMC is a multidisciplinary team that includes these and other specialists:
- Urologic surgeons
- Medical oncologists
- Radiation oncologists
- Pathologists
- Radiologists
- Registered nurses
- Nutritionists
- Oncology social workers
Cancer Programs
Our oncologists offer effective cancer services including treatment options for all types of cancer and stages of cancer.
Advancing Care, Research & Education
Cancer Center
The Cancer Center is renowned for exceptional cancer care and for pioneering discoveries in cancer treatment.
Cancer Research Institute
The Cancer Research Institute is an interdisciplinary center focused on understanding cancer with the goal of curing it.
Cancer Education & Training
The Cancer Center offers comprehensive education and training opportunities for residents, fellows and researchers.
