Urologic Cancers – Testicular Cancer
Testicular cancer is uncommon overall, but it is the most frequent solid cancer in young adult men, especially between ages 20 and 34.
At Riverstone Urology Specialists in Cypress, Dr. Russell Libby evaluates testicular lumps and testicular cancer with a clear focus, fast diagnosis, and treatment plans that protect long term health and fertility whenever possible.
What Is Testicular Cancer?
Testicular cancer starts when cells in one testicle, sometimes both, grow out of control and form a tumor. The testicles sit in the scrotum and produce testosterone and sperm.
Key Points
- Testicular cancer accounts for about 1 percent of male cancers
- Lifetime risk is about 1 in 250 males in the United States
- Most cases appear in young and middle aged men, with an average age at diagnosis of about 33
- Cure rates are high, especially when you treat early, with 5 year survival around 95 percent in national data
Symptoms
Early Testicular Cancer Often Causes A Change In One Testicle That Does Not Hurt. Common Symptoms Include
- A painless lump, knot, or firm area on a testicle
- Swelling or enlargement of a testicle
- A feeling of heaviness in the scrotum
- Dull ache in the lower abdomen, groin, or scrotum
- Sudden fluid collection in the scrotum
- Breast soreness or growth from hormone changes
- Back pain or shortness of breath in advanced cases
Pain is not required. A painless lump still needs prompt evaluation.
Who Faces Higher Risk
Researchers still study why some men develop testicular cancer and others do not. Many patients have no known risk factor.
Patterns Linked To Higher Risk Include
- History of an undescended testicle, even if corrected in childhood
- Abnormal testicular development, such as Klinefelter syndrome
- Family history of testicular cancer
- Prior testicular cancer in the other testicle
- White race in population studies
Risk factors do not guarantee disease. They simply raise the need for attention to any testicular change.
Self Exam And Early Detection
Monthly self exam helps men notice changes early. Many experts encourage awareness and self checks, especially when risk is higher.
Simple Approach
- Perform the exam in a warm shower, when the scrotal skin relaxes
- Support the scrotum with one hand and roll each testicle gently between thumb and fingers of the other hand
- Look for a firm lump, size difference, or new heaviness
- Learn what feels normal so changes stand out
A small ridge behind the testicle (the epididymis) is normal. A hard lump on the testicle itself is not. Any new lump or change deserves a visit with a urologist, even without pain.
When To See Dr. Libby
You Should Schedule An Appointment With Riverstone Urology If You Notice
- A lump, swelling, or firm area in one testicle
- Persistent ache in the groin, testicle, or lower abdomen
- Sudden fluid buildup or a heavy feeling in the scrotum
- Breast tenderness or growth along with testicular changes
- Any testicle change that worries you
Do not wait for pain or large swelling. Early evaluation often leads to simpler treatment and better outcomes.
How Testicular Cancer Is Diagnosed
Diagnosis Starts With A Focused History And Exam, Then Moves Through Standard Tests.
History And Physical Exam
Dr. Libby reviews
- When you first noticed a lump or change
- Pain, heaviness, or growth in the scrotum
- Past history of undescended testicle or prior cancer
- Family history and other health issues
He then examines the scrotum and groin to confirm the presence of a mass and to rule out other causes such as cysts, infections, or hernias.
Scrotal Ultrasound
- Uses sound waves to create images of the testicles
- Distinguishes a solid tumor from a fluid filled cyst
- Guides the next step in treatment planning
Blood Tests For Tumor Markers
Certain blood tests look for markers linked to testicular cancer, such as AFP, beta hCG, and LDH. Levels help with diagnosis, staging, and follow up.
Imaging For Staging
If cancer appears likely, CT scans of the abdomen and chest, and sometimes other imaging, check lymph nodes and organs for spread.
Surgery And Staging
When A Solid, Suspicious Mass Appears In One Testicle, The Standard First Treatment Is Radical Inguinal Orchiectomy.
- The surgeon removes the affected testicle and spermatic cord through a small groin incision
- The scrotum itself is not opened
- Pathologists examine the tissue to confirm the diagnosis and tumor type
Main Tumor Types
- Seminoma
- Non seminoma (includes embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma)
Tumor type, size, and spread pattern define the stage and guide further treatment.
Most men maintain normal testosterone and fertility from the remaining testicle. Sperm banking before surgery or chemotherapy offers added reassurance for future family plans.
Treatment Options At Riverstone Urology
Testicular cancer responds well to treatment. Care usually follows national guidelines that match therapy to stage and risk.
Common Pieces Of A Plan Include
Active Surveillance
For many men with early stage, low risk tumors after orchiectomy
- Regular physical exams
- Tumor marker blood tests
- Scheduled CT scans and chest imaging
Surveillance avoids chemotherapy or radiation unless there are clear signs of recurrence.
Chemotherapy
For higher risk early stage disease or spread outside the testicle
- Standard regimens use combinations such as BEP
- Often delivered in cycles over several weeks
- Aims to clear remaining cancer cells throughout the body
Testicular cancer responds strongly to these medicines, which supports high cure rates even in advanced stages.
Radiation Therapy
Radiation treats certain seminoma cases, especially early stages, by directing focused energy at lymph nodes in the abdomen. Many centers now favor surveillance or chemotherapy instead of radiation for some patients because long term risks receive closer attention than in the past.
Retroperitoneal Lymph Node Dissection, RPLND
In selected non seminoma cases with lymph node involvement, surgery to remove lymph nodes in the back of the abdomen offers both staging and treatment. This complex operation belongs in experienced hands and often follows careful review with oncology partners.
Dr. Libby works closely with medical and radiation oncologists so your plan reflects the latest evidence and your personal priorities.
Life After Testicular Cancer Treatment
Most men with testicular cancer live a normal life span after treatment. National data show 5 year survival near 95 percent, and many patients remain cancer free far beyond that point.
Long Term Follow Up Focuses On
- Regular exams and tumor marker checks
- Periodic imaging based on stage and treatment
- Monitoring testosterone levels and sexual function
- Support for fertility, mental health, and body image
If one testicle remains, many men keep normal hormone levels and fertility. If levels drop, testosterone replacement therapy offers a straightforward solution, with careful monitoring.
Testicular Cancer Care At Riverstone Urology
At Riverstone Urology In Cypress, Serving Northwest Houston And Nearby Communities, Patients With Testicular Concerns Receive
- Quick access for new testicular lumps or pain
- Clear, direct explanations of findings and next steps
- Coordination of imaging, lab work, and surgery when needed
- Close collaboration with oncology teams for chemotherapy, radiation, and advanced care
- Long term survivorship follow up that respects work, family, and life goals
If you notice a lump, swelling, or new heaviness in a testicle, contact Riverstone Urology and schedule an evaluation with Dr. Libby. A prompt visit often turns fear into a clear plan and gives testicular cancer the best chance for cure.