When it comes to checking yourself for testicular cancer, don’t drop the ball: In 2025, there was an estimated 9,720 cases of testicular cancer, and an estimated 600 men that died from the disease. What’s more: the most frequently diagnosed are men aged 20-34.
In recognition of Testicular Cancer Awareness Month this April, Daniel Cole, MD, MHS, hematologist and medical oncologist at Highland Medical, Hematology Oncology, provided insight on symptoms, treatment, and prevention.
An unexpected cause
There are multiple causes of testicular cancer: anatomic, hormonal, genetic, environmental and infectious.
Specifically, these causes can include Cryptorchidism, also known as undescended testicle, which surgical correction prior to puberty may decrease the risk; and chromosomal disorders such as Klinefelter and Down Syndrome predispose to cases. There is also an increased risk for those who have HIV and had increased estrogen exposure from their mother before birth or around delivery.
But Dr. Cole shared one cause that may surprise you.
“Interestingly, marijuana use has been associated with the development of testicular cancer,” said Dr. Cole.
Symptoms
When diagnosing testicular cancer, a painless mass in one testicle is the most common presentation. Patients may also have a dull ache or sense of heaviness in the pelvis, scrotum or around the anus.
There are also some symptoms that shouldn’t be overlooked.
“Gynecomastia, enlargement of male breasts, can present as an unusual symptom,” said Dr. Cole. “If the patient presents in the metastatic setting, respiratory symptoms such as cough or shortness of breath, gastrointestinal symptoms, back or bone pain, as well as leg swelling of one or both legs from obstruction of the blood vessels by mass or a blood clot are all symptoms you may not expect.”
The good news
Testicular cancer is highly curable, and the treatment depends on the stage. Dr. Cole said that while the treatment of testicular cancer has not changed in the past several years, what has changed is their experience with these agents and learning about the disease over time.
“If surgery is needed, it can be performed on an outpatient basis,” said Dr. Cole. “If chemotherapy is needed, the medications that are known to work well have been around for many years. We now can give less cycles and therefore less side effects to the men who don't need as much chemotherapy.”
When a suspicious mass is found on testicular exam, it is followed up with a testicular ultrasound, lab testing, and CT of the abdomen and pelvis and chest x-ray. A patient may undergo surgery if it is confined to the testicle, and that may be the only treatment. If there are pelvic lymph nodes involved or if the bloodwork is abnormal, the patient may need either chemotherapy or surgery to remove the pelvic lymph nodes or both. Patients with metastatic disease are treated with chemotherapy.
“Thankfully, the tumors can be very sensitive to chemotherapy and many patients with advanced disease can still have a good outcome,” said Dr. Cole.
Preventive Measures
The most important screening test for testicular cancer is a physical exam. Interestingly, while testicular self-exams have been encouraged to be performed monthly, the data recommending them to everyone are conflicting. The United States Preventive Services Task Force (USPSTF) actually recommends against screening all men for testicular cancer. However, if a young man has a suspicious mass in the testes, they should see their doctor.
Dr. Cole also shared that you can never go wrong with a healthy diet and exercise, which have been shown to reduce risk of all types of cancer. Avoiding Marijuana use may also be helpful.
To learn more, visit Hematology & Oncology | Highland Medical or call 845-480-7440.
