Testicular Cancer

Testicular cancer is a type of cancer that starts in the testicles, the organs located in the scrotum responsible for producing sperm and male hormones.

Dr Png Keng Siang
Consultant Urologist & Robotic Surgeon

Signs and Symptoms of Testicular Cancer

Recognising the signs and symptoms of testicular cancer is important for early diagnosis and treatment. Common symptoms include:

Lump or Swelling in the Testicle

Often the first sign, this can be a painless lump or an enlargement of a testicle.

Pain or Discomfort

Some men experience a dull ache or a feeling of heaviness in the scrotum.

Changes in Feel or Texture

Noticeable changes in how the testicle feels or an increase in firmness.

Ache in the Lower Abdomen or Groin

Sometimes the discomfort may extend to the lower abdomen or groin area.

Sudden Fluid Accumulation

An unexpected buildup of fluid in the scrotum.

Breast Tenderness or Growth

Though rare, hormonal changes associated with testicular cancer can cause breast growth or tenderness.

These symptoms do not necessarily mean cancer, as other conditions can cause similar signs. However, any persistent changes should prompt medical attention.

Risk Factors for Testicular Cancer

Several factors can increase the likelihood of developing testicular cancer. Understanding these can help in early detection and prevention:

Family History

Having a family member, especially a father or brother, who has had testicular cancer increases risk.

Personal History

Men who have previously had testicular cancer are at a higher risk of developing it in the other testicle.

Undescended Testicle (Cryptorchidism)

Men born with a condition where one or both testicles fail to descend from the abdomen into the scrotum are at greater risk.

Race and Ethnicity

Testicular cancer is more common in white men than in men of other races.

HIV Infection

There is some evidence to suggest that men infected with HIV have a slightly higher risk of testicular cancer.

Diagnostic Procedures for Testicular Cancer

To diagnose testicular cancer, a combination of methods is used to identify the presence and extent of the disease. Here’s an overview of the key diagnostic procedures:

The initial step typically involves examining the testicles for any signs of swelling, lumps, or abnormalities in size and texture.

This imaging technique uses high-frequency sound waves to create detailed images of the testicles and scrotum. It helps to determine the nature of any lumps, whether they are solid (likely cancerous) or filled with fluid (likely non-cancerous).

Certain proteins, known as tumour markers, can be elevated in the blood when testicular cancer is present. Common markers include alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (β-hCG), and lactate dehydrogenase (LDH).

If cancer is confirmed, additional imaging tests like CT scans or MRIs might be used to check if the cancer has spread to other parts of the body.

Treatment Options for Testicular Cancer

The treatment of testicular cancer depends on the type and stage of the cancer, but several common approaches may be used either alone or in combination:

Surgery

The primary treatment for nearly all stages and types of testicular cancer is surgical removal of the affected testicle (radical inguinal orchiectomy). This procedure is often sufficient for early-stage cancers.

Radiation Therapy

This may be used, especially in cases of seminomas, a type of testicular cancer that is particularly sensitive to radiation. Radiation is aimed at the remaining testicle or areas in the abdomen where the cancer might have spread.

Chemotherapy

Used for treating both seminomas and non-seminomas, chemotherapy is effective in killing cancer cells that have spread beyond the testicle. It’s often used after surgery to kill any remaining cancer cells and, in advanced cases, to shrink tumours before other treatments.

Surveillance

In cases where the cancer is caught early and treated surgically, ongoing surveillance with regular check-ups and imaging may be recommended to monitor for recurrence.

High-Dose Chemotherapy and Stem Cell Transplant

For certain aggressive or recurrent cancers, high-dose chemotherapy followed by a stem cell transplant might be an option.

Dr Png Keng Siang

Consultant Urologist & Robotic Surgeon

Dr Png is a United States fellowship-trained urologist who received his urology specialist board certification from Singapore. He is the first and only urologist in Singapore to be inducted into the Fellow, American College of Surgeons (FACS) after completing a minimally invasive surgery fellowship in the USA at the Indiana University School of Medicine, where he sub-specialised in robotic and laparoscopic surgery for urological cancers.

  • Joint Committee of Specialist Training Site Accreditor, Urology Residency Program
  • President of the Robotic Surgery Society of Singapore
Prior To Private Practice:
  • Director of the Robotic Urological Surgery Fellowship Program, Tan Tock Seng Hospital
  • Director of the National Healthcare Group Urology Residency Program & Adjunct Assistant Professor, NUS Yong Loo Lin School of Medicine
  • Member of the American Urological Association, Endourological Society (USA)
  • Executive Committee of the Singapore Urological Association, 2013 to 2020
Read Full Bio

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    Testicular Cancer

    Frequently Asked
    Questions

    Does the removal of a testicle affect fertility or sexual function?

    The removal of one testicle usually doesn’t affect fertility or the ability to have sex, as the remaining testicle can still produce sperm and hormones. However, if both testicles are removed or if aggressive chemotherapy is needed, fertility may be affected.

    Are there any lifestyle changes I should consider after treatment?

    After treatment, maintaining a healthy lifestyle is important. This includes regular physical activity, a balanced diet, and avoiding tobacco. Regular follow-up appointments are also necessary to monitor for any signs of recurrence or long-term side effects of treatment.

    Is there a risk of the cancer returning after treatment?

    As with most cancers, there is a risk of recurrence with testicular cancer. The risk varies depending on the type and stage of cancer initially diagnosed. Regular follow-ups are necessary for early detection of any recurrence.