Testicular Cancer

Testicular cancer is typically discovered as a hard lump on one of the testes (the male sexual and reproductive glands located in the scrotum). It can metastasize (spread) throughout the lymph nodes in the lower abdomen or even to the lungs. While testicular cancer is relatively rare, accounting for about one percent of cancers in men, it is the leading cancer for men ages 15 to 35.

As recently as 50 years ago, this type of cancer had a low survival rate. Today, developments and discoveries at the Indiana University Health Melvin & Bren Simon Cancer Center have led to a cure rate of 95 percent, including 80 percent of men who have metastatic disease. Testicular cancer is now one of the most survivable cancers, even for patients in advanced stages.

While the majority of testicular cancer patients are referred by their physician, referrals are not necessary to make an appointment. We treat post-pubescent patients age 15 and older.

As a result of surgical techniques that were developed and refined by the testicular cancer experts at the IU Health Melvin & Bren Simon Cancer Center, the lives of generations of young men affected by the disease—and their children or unborn children—have been positively affected. Many men have benefitted from leading edge treatment at the IU Health Simon Cancer Center, since without proper treatment, sexual function can be diminished.

IU Health Simon Cancer Center offers expert urologists, pathologists and medical oncologists to guide your treatment. In addition, thoracic (chest) surgeons, general surgeons, head and neck surgeons and, occasionally, vascular surgeons may be involved in your care.

These experts have years of experience in treating testicular cancer, including pathology (the study of disease and the changes it produces in the body), surgical interventions, treatment of recurrent testicular cancer, the study of long-term testicular cancer and cancer survivorship.

Most men with testicular cancer first notice swelling or pain in the testes, back pain or pulmonary pain. Following a diagnostic ultrasound and blood test, your IU Health Simon Cancer Center physician will provide the stage of your cancer, a prognosis and determine your course of treatment.

The three stages of testicular cancer include:

  • Stage 1. Cancer is confined to the testicle.
  • Stage 2. Cancer is present in the testicle and lymph nodes of the abdomen.
  • Stage 3. The disease is also present in the chest or other sites where it has metastasized.

There are two major types of testicular cancer.

  • Seminoma. These cancerous tumors usually occur in men between age 25 and 45, and tend to grow and spread more slowly than nonseminomas.
  • Nonseminoma. These types of tumors usually occur in men between their late teens and early 30s. They grow more quickly than seminomas, and they are more difficult to treat.

Most men with testicular cancer are cured because they are diagnosed at an early stage. They can expect to live many more years free of the disease. 

Testicular Cancer Treatment

The initial treatment for testicular cancer is orchiectomy or removal of the affected testicle(s). For many patients, this is the only therapy required. Following orchiectomy, the treatment differs based on the stage and type of your testicular cancer.

  • Stage 1–Seminoma. After orchiectomy, patients have three options: surveillance, radiation therapy or chemotherapy. The cure rate for this type of testicular cancer exceeds 99 percent.
  • Stage 1–Nonseminoma. Following orchiectomy, the patient will undergo surveillance, surgery to remove lymph nodes in the abdomen or chemotherapy. The cure rate exceeds 99 percent.
  • Stage 2–Seminoma. After orchiectomy, the treatment consists of radiation or chemotherapy. The cure rate is 98 percent.
  • Stage 2–Nonseminoma. After orchiectomy, the treatment involves surgery to remove lymph nodes in the abdomen or chemotherapy. The cure rate is 98 percent.
  • Stage 3–Seminoma and Nonseminoma. Following orchiectomy, the treatment process consists of three or four cycles of platinum-based chemotherapy. These medications use platinum compounds to treat the cancer. Some patients require surgery following chemotherapy, as determined on a case-by-case basis.
  • Recurrent cancer. Treatment for recurrent cancer is individualized. Some patients can be cured with surgery, some receive standard doses of chemotherapy and others will be treated with high dose chemotherapy with stem cell transplant.

Testicular Cancer Research

Research conducted at the IU Health Simon Cancer Center directly affects the treatment of testicular cancer today. In fact, the team of specialists who treat patients at IU Health Simon Cancer Center have conducted much of the research that has improved cancer treatments over the past 40 years.

Our leading edge research is ongoing to find better treatments for patients who are not cured of testicular cancer. We focus on overcoming resistance to platinum-based chemotherapy drugs. We are also working to understand the role of the immune system in testicular cancer.

Some patients may qualify for the latest treatments through clinical trials not yet available elsewhere. More information about testicular cancer research can be found on the Indiana University School of Medicine website.

Publications

For more information about testicular cancer and its treatment, you can view these publications:

General overview and reference:
“Testicular Cancer Discoveries and Updates,” New England Journal of Medicine,” 2014

History of testicular cancer research and discoveries:
“Testicular Cancer: A Reflection of 50 Years of Discovery,” Journal of Clinical Oncology, 2014

Website

For more information, visit the International Testicular Cancer Foundation website.