Early Detection: Testicular Cancer Awareness Month


pril is Testicular Cancer Awareness month, so we turned to Dr. Alexander Gomelsky, professor and chair of LSU Health Shreveport’s Urology Department for more information about men’s risk factors and treatments.

While testicular cancer accounts for roughly 1 percent of cancer cases in men, it is the most common tumor in young men, ages 20-40. In the U.S., nearly 10,000 new cases of testicular cancer are diagnosed each year; however, only 440 deaths are expected annually. This means that, with early detection and treatment, a man’s lifetime risk of dying from testicular cancer is low (1 in 5,000 men).



Risk Factors for Testicular Cancer

Many men who develop testicular cancer have no risk factors at all. However, certain conditions such as undescended testicles, intra-tubular germ cell neoplasia (a precancerous condition), and a family and personal history of testicular cancer may increase the odds of developing testicular cancer.  The incidence of testicular cancer is highest among non-Hispanic white men and lowest among African Americans.


Signs and Symptoms

The most common presentation of testicular cancer is a painless testicular mass.  A man with metastatic testicular cancer (cancer that has spread beyond the testes to the lymph nodes or other organs) may present with an abdominal mass, back pain, and shortness of breath. Rare presentations include breast tenderness and early puberty in boys.


Initial Treatment

Removal of the testis with the mass (radical orchiectomy) is the first step. Compared to a simple orchiectomy, which is performed through the scrotum, a radical orchiectomy is performed through the groin. This ensures removal of the testis and much of its blood supply without interfering with its lymphatic drainage.  In rare cases, removal of only the testicular mass may be performed (partial orchiectomy).


Types of Testicular Cancer

There are two primary types of testicular cancers. Localized seminoma accounts for 50 percent and arises from young germ cells. Non-seminomas evolve from more mature germ cells and can include embryonal carcinoma, yolk sac tumors, choriocarcinoma, teratoma, and mixed tumors (which can include non-seminomatous elements and seminoma). 


Additional Treatment of Testicular Cancer

Depending on the type and stage (presence of extratesticular cancer), testicular cancer has many treatment options. Most men with seminoma are cured with orchiectomy alone, while the remainder are typically cured with radiation therapy. Low stage non-seminomas may either undergo close surveillance or undergo a retroperitoneal lymph node dissection, a surgical procedure to remove the abdominal lymph nodes that may contain microscopic cancer deposits.  Occasionally, chemotherapy is an option in this population.  Those with more advanced stages of non-seminoma typically undergo several cycles of chemotherapy.  All treated men should undergo close surveillance for 5 years or longer.



Testicular cancer is more common in young men who may have almost no symptoms. Timely imaging, bloodwork, and orchiectomy confirms the diagnosis. The multitude of effective additional treatments has made this condition one of the most curable cancers. Testicular cancer is treated successfully in 95 percent of cases and, if treated early, the cure rate rises to 98 percent.