Testicular Cancer

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Testicular cancer is most common in men between the ages of 18 and 30, and is the number one cancer of men in that age group. Testicular cancer is a disease that’s largely curable. It has a 95 percent cure rate, with slightly fewer than 9,000 cases diagnosed each year, and less than 400 deaths.

Testicular self-exams once a month can pick up the vast majority of all testicular cancer cases, which usually present as a painless but sometimes as a painful mass or swelling.

While the biggest risk factors include undescended testicle (s), a family history of testicular cancer, and some genetic syndromes like Klinefelter syndrome, the majority of men have no such history.

Overview

Personalized, Multidisciplinary Care

We treat a high volume of men with testicular cancer, ranging from basic, early-stage tumors to complex and advanced cases.

Your testicular cancer care team includes specialists in testicular and urologic cancer, including urologic oncologists, surgeons, medical oncologists and radiation oncologists. Our experts meet routinely to discuss our patient's care. This ensures you receive the most effective treatments. Our urologic oncologists are fellowship trained, meaning they studied an additional two to three years to become experts in urologic oncology. Our medical oncologists are fellowship trained in genitourinary cancer, which includes testicular cancer.

State-of-the-Art Treatment  

Specialists with the Center for Prostate & Urologic Cancers at Duke Cancer Institute, part of Duke’s nationally ranked urology and cancer programs, use the latest medical and surgical techniques to treat testicular cancer and preserve as much normal function as possible.

We use advanced imaging to determine the type of testicular cancer you have, and recommend the best course of treatment. The primary treatment — and for most men, cure — is just removal of the affected testicle (s) — radical inguinal orchiectomy — and its surrounding areas. We are experts at nerve-sparing surgery, a procedure that can stop cancer from spreading while retaining your ability to have children. Some men with early stage testicular cancer do, however, have a high risk of relapse and those men will commonly choose a short course of chemotherapy to prevent it from coming back.

Only a small proportion of men will have metastatic testicular cancer (spread to lymph nodes or organs), which requires both surgery and either radiation or chemotherapy. Retroperitoneal lymph node dissection (RPLND) removes lymph nodes in the retroperitoneum after chemotherapy. 

Testicular cancer is one of the few cancers that chemotherapy can actually cure even when the cancer has spread. Even patients with advanced stages of testicular cancer can enter remission with chemotherapy that is commonly durable. We are also expertly equipped to perform a stem cell transplant, in combination with additional high-dose chemotherapy, if needed for advanced testicular cancer that does not respond to conventional chemotherapy. We do everything possible to ensure you achieve the best possible outcome, and return you to normal, healthy living as soon as possible.

Screening and Tests

Your oncologist may order blood tests that identify substances, also referred to as tumor markers, which are normally found in your blood that may indicate cancer if found in abnormally high levels. Key tumor markers in testicular cancer include lactate dehydrogenase (LDH), human chorionic gonadotropin (hCG), and α-fetoprotein (AFP). He/she may also order a CT scan and/or PET scan. 

Support & Survivorship

With early detection, early treatment can be applied successfully, and testicular cancer has become more of a survivorship cancer now.

At our survivorship clinic in the Duke Cancer Center we actively surveill men after surgery who have low risk disease. Most men who are cured with surgery can be followed with imaging and exams and bloodwork over time. While late relapses beyond five years can occur, follow-ups for up to five years is reasonable in most men to determine whether a relapse will occur.

Survivors who’ve had chemotherapy or radiation are also monitored as part of a care plan. Some of the long-term risks of chemotherapy and radiation include cardiovascular disease and secondary cancers. Some men do have problems with their sperm counts when they have testicular cancer, but sometimes surgery to remove a single testicle helps actually improves the functioning of the other one. Men who are survivors of testicular cancer, even after chemotherapy, can successfully have children, but taking precautions ahead of time to bank sperm is reasonable.

Our comprehensive support services range from helping patients minimize the side effects of treatment to coping with the emotional and psychological effects of diagnosis and treatment. A survivorship clinic is located on the 5th floor of the Duke Cancer Center. View all of our cancer support groups in our event calendar.