Why it’s best to have a testicle lump checked out

Blake Wynia, MD

Urology

It’s common for men to find testicle lumps, and most are harmless. But some lumps can be a sign of a more serious condition. Urologist Blake Wynia, MD, explained why it’s best to see a doctor if you find a lump on your testicle.

“Examination by a doctor is the only way to know if a lump is not cancerous,” said Dr. Wynia. “These lumps are typically hard and painless, so they’re often ignored. This can delay treatment by about 4–6 months, at which point the options for treatment may be more limited than if it were detected earlier.”

How common is testicular cancer?

Approximately 8,000 men are diagnosed with testicular cancer each year, and about 400 men die from the disease.  “It’s the most common solid tumor in young men aged 20–34,” said Dr. Wynia. “It can grow rapidly and spread quickly.”

How is testicular cancer diagnosed?

A doctor will examine the testicles and do an ultrasound imaging test. If cancer is suspected, additional steps might be taken. Biopsy is not recommended because it can alter the predictable pathway of spread, so surgery might be used to remove the entire testicle and spermatic cord (also called a radical orchiectomy).

There are various subtypes of testicular cancer, including:

• Seminoma
• Embryonal cell
• Choriocarcinoma
• Yolk sac
• Teratoma  

A pathology report will reveal the cancer’s subtype, which will determine treatment. A CT scan will be used to look for spread into lymph node chains.  Finally, serum tumor markers will be used to measure tumor activity.

How is testicular cancer treated?

Dr. Wynia said treatment could involve the following, depending on the subtype of testicular cancer and the degree of spread:

• No further treatment after orchiectomy
• Radiation therapy alone
• Chemotherapy alone
• Surgery to remove lymph nodes
• A combination of the above

After the above treatment and at prescribed intervals, men (regardless of their cancer subtype) will get CT scans and serum tumor markers to make sure the cancer is cured.

“Testicular cancer is highly sensitive to chemotherapy, radiation therapy and surgery with cure rates at 90–95%, even in advanced cases,” said Dr. Wynia. “Treatment is so successful that they are evolving to minimize the burden of treatment without sacrificing their success.