Types of Testicular Cancer

Doctors at NYU Langone’s Perlmutter Cancer Center identify several different types of testicular cancer to provide the best treatment. The testicles are two small, egg-shaped glands located below the penis in a sac of loose skin called the scrotum. Testicular cancer, which is most common in men between the ages of 20 and 40, begins when cells in the testicles grow uncontrollably, forming a mass called a tumor.

A tumor may be benign, or noncancerous, meaning it does not spread; or it may be malignant, or cancerous, meaning it can spread to other parts of the body.

Most testicular cancers develop in the germ cells, which produce sperm. These cancers are referred to as germ cell tumors. There are two different types of germ cell cancers—seminomas, which are usually slow growing, and nonseminomas, which tend to grow more quickly.

Nonseminoma tumors are more likely than the seminoma type to metastasize, or spread, beyond the testicle. About half of all germ cell tumors are seminomas. Many early seminomas can be cured with surgical removal of the testicle.

Testicular tumors may also have a combination of seminoma and nonseminoma cancer cells. A small percentage of testicular cancers are stromal or sex-cord tumors, lymphoma, and other types of tumors.

Rarely, testicular tumors begin in stromal cells, which make testosterone—a hormone that plays a role in the development of a man’s reproductive organs, bones, muscle mass, and body hair growth. These tumors are not typically cancerous, and are distinct from germ cell tumors.

Without treatment, germ cell tumors may spread to other parts of the body through the bloodstream or through the lymphatic system—the organs, vessels, and nodes that drain excess fluids from the body’s tissues and trap foreign substances, such as viruses and bacteria. Cancer can spread to the lymph nodes—small glands located throughout the body that help to filter out foreign matter, such as bacteria and viruses—when cancer cells escape and invade the lymphatic system.

A tumor in the testicle may also be a secondary cancer, meaning a cancer from another part of the body has spread to the testicle. One example is lymphoma, which usually begins in lymph nodes elsewhere in the body.

Men are at risk of developing testicular cancer if they have a family history of the condition or were born with undescended testes, testicles that did not drop down out of the abdomen into the scrotum.

Symptoms of testicular cancer include a lump or swelling in the testicle that may or may not be painful, a dull ache or sharp pains in the groin or lower abdomen, or a feeling of “heaviness” in the testicles.

Men with more advanced testicular cancer may experience pain in the abdomen, back, or flank.