Testicular Cancer
Testicular cancer is rare, but it is the most common solid tumor in young adult men. In the United States, about 1 in 250 males will develop testicular cancer at some point in life, yet the cure rate is higher than 95 percent in most cases.
At Riverstone Urology in Cypress, Dr. Russell Libby focuses on fast diagnosis, clear explanations, and treatment plans that protect both long term health and quality of life. When needed, he coordinates closely with medical and radiation oncologists to build a complete cancer care team around you.
What Is Testicular Cancer?
Testicular cancer happens when cells in one or both testicles change and begin to grow out of control. The testicles sit inside the scrotum and make testosterone and sperm. Most tumors start in the germ cells, the cells that form sperm.
Even though testicular cancer is uncommon overall, it appears most often in younger and middle aged men, especially between ages 20 and 34.
Symptoms To Watch For
Many Men First Notice A Change By Accident, In The Shower Or While Dressing. Common Symptoms Include:
- A painless lump or firm area in one testicle
- Swelling or enlargement of a testicle
- A feeling of heaviness in the scrotum
- Sudden fluid buildup in the scrotum
- Dull ache in the lower abdomen, groin, or testicle
- Pain or discomfort in the testicle or scrotum
- Breast tenderness or enlargement
- Back pain when cancer has spread to lymph nodes
Pain is not required for a serious problem. A painless lump still needs attention. Any new lump or change in one testicle compared with the other deserves an exam by a urologist.
Who Is At Higher Risk
Doctors Do Not Fully Understand Why Some Men Develop Testicular Cancer And Others Do Not. Certain Factors Raise Risk:
- Age 15 to 35, with highest rates in the twenties and early thirties
- History of an undescended testicle (cryptorchidism), even if repaired
- Abnormal testicular development or some genetic conditions
- Prior testicular cancer in the other testicle
- Family history of testicular cancer
- White race, especially non-Hispanic white men
Most men with testicular cancer have no clear risk factor. That is why paying attention to changes matters for everyone.
Self-Exam And Early Detection
Routine screening of all men with office exams or formal self-exam programs is not recommended by every national group, but many urologists still encourage young men to know what “normal” feels like.
A Simple Monthly Check In The Shower Works Well
- Use warm water so the scrotal skin relaxes
- Check each testicle gently with both hands
- Feel for smooth, firm, oval shape
- Notice any new lump, area of hardness, or size change
- Compare side to side
If you find something new, do not watch it for months. Call a urologist and schedule a visit. Most lumps turn out to be benign, but only an exam and imaging can sort this out.
How Testicular Cancer Is Diagnosed
At Riverstone Urology, Evaluation For A Testicular Lump Or Symptom Usually Includes:
History And Physical Exam
- Discussion of symptoms, timing, and risk factors
- Careful exam of the testicles, scrotum, groin, and lymph nodes
Scrotal Ultrasound
Ultrasound is the main test to see if a lump looks solid or cystic and whether it appears suspicious for cancer.
Blood Tests For Tumor Markers
Certain tumors raise blood levels of markers such as AFP, beta-hCG, and LDH. These markers help with diagnosis, staging, and follow up.
Imaging To Look For Spread
If tests suggest cancer, CT scans of the chest, abdomen, and pelvis often follow to check lymph nodes and other organs.
In most cases, doctors do not do a needle biopsy of the lump. The standard next step when cancer is likely is removal of the entire testicle through a groin incision, called a radical inguinal orchiectomy. This allows a full pathologic diagnosis and prevents cancer cells from spreading into the scrotum.
Staging And Types
After Orchiectomy, The Pathologist And Cancer Team Determine:
- Cancer type
- Seminoma
- Non-seminoma
- Tumor size and features
- Involvement of lymph vessels or blood vessels
- Presence of spread on imaging and markers
Stage I means cancer is limited to the testicle. Higher stages reflect spread to lymph nodes or distant organs.
This staging guides the plan, from simple surveillance to more intensive treatment.
Treatment Options At Riverstone Urology
Most men with testicular cancer are cured with standard treatments. Exact plans depend on cancer type, stage, and marker levels, along with your age and general health.
If Your Psa Or Exam Looks Concerning, Dr. Libby May Suggest Further Testing. Typical Steps Include:
Surgery: Radical Inguinal Orchiectomy
This is the first treatment for almost all testicular cancers.
- Performed through a small incision in the groin
- Entire testicle and spermatic cord are removed on the affected side
- Tissue goes to the lab for a full evaluation
Many men live healthy lives with a single testicle. The remaining testicle often provides enough testosterone and sperm, although fertility discussions are important.
Fertility Preservation
Before surgery, Dr. Libby often talks with younger men about sperm banking, especially if chemotherapy, radiation, or more surgery may follow. Kids and future family plans matter, and decisions are easier when you hear your options early.
Active Surveillance
For some Stage I cancers, especially many seminomas and selected non-seminomas after orchiectomy, close follow up is a standard choice.
This typically includes
- Regular physical exams
- Tumor marker blood tests
- Periodic CT scans or other imaging
Treatment starts only if tests show that cancer has returned or progressed. This approach avoids unnecessary chemotherapy or radiation in men whose cancer may already be cured by surgery alone.
Chemotherapy
Chemotherapy uses medicines that kill rapidly dividing cells. It treats testicular cancer that has spread or has higher risk features. Modern regimens cure most men with advanced disease, especially when started early.
Radiation Therapy
Radiation targets lymph nodes in the abdomen for certain seminoma cases, especially in some Stage I and Stage II situations. The use of radiation has decreased over time as chemotherapy and surveillance improved, but it still fits some men.
Retroperitoneal Lymph Node Surgery
For selected non-seminoma patients, especially when lymph nodes remain enlarged after chemotherapy, surgery to remove retroperitoneal lymph nodes is an option. This can be done through an open approach or, in some centers, through minimally invasive techniques.
Dr. Libby works with regional oncology teams so surgery, medical oncology, and radiation oncology all align around one plan.
Life After Treatment
Testicular Cancer Survivors Usually Need Structured Follow Up For Several Years. Typical Long Term Care Includes:
- Regular visits and physical exams
- Tumor marker testing on a set schedule
- Periodic imaging
- Monitoring of testosterone levels and fertility concerns
- Counseling about exercise, heart health, and second cancer risk from prior treatment
Most men return to normal activity and work. Emotional recovery can take longer than physical recovery, so conversation about stress, anxiety, and intimacy is part of good survivorship care.
When To See Dr. Libby
You Should Schedule A Visit With Riverstone Urology If You:
- Feel a new lump or firm area in one testicle
- Notice swelling, heaviness, or a change in size on one side
- Have dull ache in the groin or scrotum that does not go away
- Had an undescended testicle or prior testicular cancer and now see a change
- Already have a diagnosis and want a second opinion on treatment options
If you notice a sudden painful swelling in the scrotum, go to the emergency room or call a doctor right away. Testicular torsion and other emergencies can mimic cancer and need fast treatment.
Testicular Cancer Care At Riverstone Urology
Testicular cancer often appears during the years when men expect to feel healthiest. The shock is real, but the outlook is usually excellent when care is prompt and coordinated.
At Riverstone Urology In Cypress, Serving The Greater Northwest Houston Area, Dr. Libby Offers
- Fast evaluation of testicular lumps and symptoms
- Guideline based staging and treatment planning
- Access to surgery, chemotherapy, and radiation partners as needed
- Focus on fertility, hormones, and long term health, not only cure
If you are worried about a testicular change or have been told you might have testicular cancer, contact Riverstone Urology to schedule a consultation with Dr. Libby. Early action gives you the widest range of options and the strongest chance for a cure.