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Testicular cancer: symptoms and prognosis

by Josephine Andrews
Published: Last Updated on 245 views

Testicular cancer is the most common malignant tumor in men between the ages of 25 and 45. It is generally easily treatable and often curable. Regular palpation of the testicles from puberty helps to detect testicular cancer at an early stage. Read more about testicular cancer here.

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

C62

quick overview

  • Symptoms: Palpable, painless hardening in the scrotum; enlarged testicle (with a feeling of heaviness); enlarged, painful breasts; advanced symptoms such as cough and chest pain in lung metastases
  • Prognosis: Generally very treatable; in most cases successful healing possible; one of the highest cancer survival rates; Relapses are rare; Fertility and libido are mostly preserved
  • Causes and risk factors: Exact cause unknown, genetic factors suspected; correspondingly increased risk in the family; there is also an increased risk of undescended testicles or malformation of the urethral opening
  • Diagnosis: medical history; palpation of the testicles and breast ; ultrasonic ; blood test , magnetic resonance imaging, computed tomography ; possible exposure of the testicle
  • Treatment: Removal of the affected testicle; then, depending on the stage of the tumor and the type of testicular cancer, monitoring, chemotherapy or radiotherapy ; Possibly removal of affected lymph nodes
  • Prevention: regular self-examination of the testicles; Preventive check-up for risk groups

What is testicular cancer?

Testicular cancer is the most common cancer in men between the ages of 25 and 45. The average age of the patients is 38 years. Testicular cancer accounts for 20 to 30 percent of all cancers in this age group. Younger and older men get sick much less often.

Testicular cancer is a malignant tumor of the testicular tissue. Usually only one testicle is affected. The most common forms of testicular cancer are so-called seminomas, followed by non-seminomas.

Overall, testicular cancer is a rare cancer. It accounts for an average of 1.6 percent of all new cancer cases. There are only about ten cases per 100,000 men.

What are the symptoms?

Testicular cancer can be recognized by some typical symptoms:

Palpable hardening

One of the most common testicular cancer symptoms is a painless hardening within the scrotum: the surface of the testicle feels lumpy or bumpy. Hard lumps in the testicle (possibly testicular cancer) are palpable for every man with regular self-examinations . It is important to compare the modified testicle with the second testicle. In this way, differences can be better identified.

In around 95 percent of all cases, testicular cancer affects only one of the two testicles. In the remaining five percent of patients, cancer cells develop in both testicles.

increase in size and heaviness

If a testicle enlarges, this is also a possible sign of testicular cancer. Most patients report this symptom when they first go to the doctor. On the one hand, this increase in size may be due to the growth of the tumor itself. On the other hand, an accumulation of fluid ( hydrocele or hydrocele) is a possible reason.

Due to the increase in size, the affected testicle feels heavy. In some sufferers, this feeling of heaviness is accompanied by apulling sensation that sometimes extends to the groin.

pains

In some patients, pain in the testicle area is another symptom of testicular cancer. Bleeding within the cancerous tissue causes stinging or stinging in some cases. However, pain is rarely the first sign of testicular cancer.

If there is pain in the area of ​​​​the testicles, there is no need to immediately think of testicular cancer. It is usually caused by inflammation of the testicles (orchitis) or inflammation of the epididymis (epididymitis). An examination by a urologist brings certainty.

In advanced testicular cancer, the lymph nodes in the abdomen in the back of the enlargement. This may cause back pain .

breast growth

Some testicular tumors produce female hormones . In some patients, increased estrogen levels can be detected in the blood . The pregnancy hormone beta-human chorionic gonadotropin (β-HCG) is also produced by some testicular tumors. As a result of hormone production, men’s breasts enlargement (on one or both sides). Doctors refer to this testicular cancer symptom as real gynecomastia because the glandular tissue in the breast actually multiplies here. False gynecomastia, on the other hand, describes breast growth due to fat storage.

β-HCG is also considered an important tumor marker. This is a blood value that is typical for some testicular carcinomas. It helps to diagnose testicular cancer and assess the course of the disease.

The enlarged breasts hurt in some cases.

Symptoms due to spread (metastases)

If testicular cancer progresses, it is possible for cancer cells to spread throughout the body via lymphatic and blood vessels and form new growths somewhere. Such metastases from testicular cancer occur mainly in the lungs . However, other organs are often affected as well, such as the brain , bones and liver . Depending on the organ affected, corresponding symptoms occur.

For example, lung metastases often cause coughing (sometimes with bloody sputum) and shortness of breath. Chest pain is also a common symptom. Testicular cancer metastases in the bones cause bone pain. Liver metastases are expressed, among other things, by nausea, loss of appetite and unwanted weight loss in a short time. If cancer cells spread in the brain, neurological deficits may be added to the usual signs of testicular cancer.

What is the life expectancy with testicular cancer?

Testicular cancer can usually be treated well and usually cured. Five years after a testicular cancer diagnosis, about 96 percent of patients are still alive (5-year survival rate) — the rate hardly changes even after ten years (95 percent). Testicular cancer is one of the cancers with the highest probability of survival.

A prominent example is the racing cyclist Lance Armstrong, who won the Tour de France again in 1997, a year after surviving testicular cancer, which was even accompanied by metastases in the brain.

This good prognosis is mainly due to the fact that testicular carcinoma is detected at an early stage in most patients. The chances of success of the treatment are then high. However, if the cancer has already spread by the time it is diagnosed, the chances of recovery are reduced. However, the prognosis in individual cases is also influenced, for example, by

  • what type of tumor is present (seminomas generally have a better prognosis than non-seminomas),
  • How well the patient responds to therapy
  • where metastases have already formed in the body (the prognosis is usually better for lymph node and lung metastases than for metastases in the liver, bones or head),
  • how long it takes after the last chemotherapy for the cancer to progress again (the longer, the cheaper),
  • which measured values ​​​​the tumor markers show.

If left untreated, the malignant forms of testicular cancer are usually fatal. How quickly the disease progresses depends on the type of tumor and the individual case.

keyword fertility

Many patients fear that treatment for testicular cancer will make them infertile or that they will no longer feel sexual desire. In most cases, however, those affected can be reassured: the majority of patients only have unilateral testicular cancer . Then only the diseased testicle has to be removed. The remaining testicle is usually sufficient to maintain sexuality and fertility.

However, seed production may be somewhat affected afterwards. There are also men whose sperm production is impaired even before the disease and the treatment.

The topics of fertility and sexual reluctance are usually even more important for the (few) patients who suffer from bilateral testicular cancer or who haveal ready lost a testicle due to a previous illness . During the operation, the doctor then tries to remove only malignant tumor tissue and to preserve as much testicular tissue as possible.

However, if it is necessary to completely remove both testicles (or the only testicle present), it is no longer possible for the person concerned to father children. The sex hormone testosterone is also no longer produced. Its absence reduces sexual desire and the ability to have an erection.

Doctors generally recommend that all testicular cancer patients have their fertility tested before starting treatment . The best way to do this is to analyze a sample of the ejaculation in the laboratory for the number, shape and “swimming ability” of the sperm ( spermiogram ). Alternatively, the FSH (follicle-stimulating hormone) blood level can also be measured: if it is elevated, this may indicate reduced sperm production.

Also before the start of treatment, it is worth considering for testicular cancer patients whether they would like to have their sperm frozen to be on the safe side ( cryopreservation ). This enables later artificial insemination if the patient is no longer naturally capable of fathering after testicular cancer treatment. The patient usually pays for the preservation (350 to 650 euros) and storage (200 to 450 euros per year) himself.

It is advisable for patients to ask their own health insurance company in advance whether they will cover the costs. Sometimes registers make an exception.

The testosterone that is missing after a testicular cancer operation can be replaced with injections, tablets, gel preparations or patches.

relapse

In order to detect a possible testicular cancer recurrence (recurrence) at an early stage, the doctor regularly examines successfully treated patients. In the early days, the check-ups are very close-meshed. Later, the time intervals between them become longer. This is especially true when there are no symptoms and no signs of a possible relapse.

The likelihood of testicular cancer recurring depends particularly on the tumor stage when it is first diagnosed and on the type of initial treatment . For example, if early-stage testicular cancer is only monitored after surgery (surveillance strategy), the risk of recurrence is higher than with post-surgery chemotherapy.

If there is a relapse, it is usually within the first two to three years after the initial treatment. Later recurrences are rarer. The patients then receive what is known as salvage chemotherapy : This is high-dose chemotherapy. It is much more effective than the normal doses of chemotherapy normally used in the initial treatment of testicular cancer.

But it has more severe side effects. Among other things, the bone marrow and thus blood formation are damaged much more severely in high-dose therapy. For this reason, the treating physicians usually transfer blood-forming stem cells to the patient ( stem cell transplantation ).

Patients first receive normal doses of chemotherapy to kill as many cancer cells as possible. Then they are given growth factors that stimulate blood formation. This creates enough stem cells that can be filtered out of the patient’s blood. After the high-dose chemotherapy (salvage chemotherapy), the removed blood stem cells are then given back to the patient via a vein. The stem cells settle in the damaged bone marrow and start producing new blood cells.

Overall, a recurrence is rather rare in testicular cancer. 50 to 70 percent of patients respond favorably to the high-dose chemotherapy that is then administered.

Causes and risk factors

Testicular cancer (testicular carcinoma) in adult men arises in more than 90 percent of cases from the germ cells in the testicles. They are called germ cell tumors (germinal tumors) . Non-germinal tumors make up the small remainder . They arise from the supporting and connective tissue of the testicles.

Doctors divide germ cell tumors into two main groups: seminomas and non-seminomas.

seminoma arises from degenerated stem cells of the sperm (spermatogonia). It is the most common form of malignant germ cell tumor in the testicle. The average age of the patients is around 40 years.

The term non-seminoma includes all other forms of germinal testicular cancer that arise from other tissue types. These include:

  • yolk sac tumor
  • choriocarcinoma
  • Embryonic carcinoma
  • Teratoma or the malignant form of teratocarcinoma

Patients with a non-seminoma are on average 25 years old.

The preliminary stage of seminomas and non-seminomas is called testicular intraepithelial neoplasia (TIN) (intraepithelial = located within the cover tissue, neoplasia = new formation). The neoplasms develop from embryonic germ cells before birth. They remain dormant in the testicles and may later develop into testicular cancer.

Far less common than germ cell tumors are non-germinal tumors (germ line tumors, gonadal stromal tumors). These are cell proliferations that arise from the supporting and connective tissue cells of the testicles. They are either benign or malignant. The most important representative of malignant sex cord tumors is Leydig cell testicular cancer . It emerges from the Leydig cells. They produce the sex hormone testosterone and thus stimulate sperm production, among other things.

Non-germinal tumors mainly occur in children. They are very rare in adult men (most likely in old age).

Why does testicular cancer develop?

The exact cause of testicular cancer is not yet known. However, researchers have identified some risk factors for its development in the past.

Previous testicular cancer disease

Previous testicular cancer is the most important risk factor: anyone who has ever had testicular cancer has a 30-fold increased risk of developing a malignant testicular tumor again. However, overall relapses are rare.

undescended testicles

Normally, during fetal development (sometimes after birth), the two testicles migrate from the abdominal cavity into the scrotum. In the case of undescended testicles (maldescensus testis), on the other hand, one of the testicles or both testicles remain either in the abdominal cavity or in the groin (abdominal or groin testicles). Sometimes the testicle is found at the entrance to the testicle and will push into the scrotum under pressure, but will immediately slide back down. Then one speaks of sliding testicles.

Undescended testicles increase the likelihood of developing testicular cancer. This danger still exists even if the undescended testicles are surgically corrected: the risk of testicular cancer in the case of undescended testicles operated on is 2.75 to 8 times higher than with a normal testicle system.

In the case of sliding testicles in particular, the risk of degeneration depends on the duration of the malposition. Above the scrotum, the body temperature of 35 to 37 degrees Celsius is significantly higher than in the scrotum (around 33 degrees Celsius). The higher temperature has the potential to damage testicular tissue. Therefore, the risk of testicular cancer is increased with (earlier) undescended testicles.

Malformation of the urethral orifice

If the opening of the urethra is below the glans (ie on the underside of the penis ), doctors speak of hypospadias. Studies suggest that this misalignment increases the risk of testicular cancer.

Hypospadias and undescended testicles appear to have a similar genetic cause. That is why they often appear together. However, they also appear separately.

genetic factors

According to studies, it is highly likely that hereditary factors also influence the development of testicular carcinoma. Because the same tumor occurs more frequently in some families. Brothers of those affected are up to twelve times more likely to also develop testicular cancer. Statistically speaking, sons of sick fathers also develop testicular carcinoma more frequently than sons of healthy fathers.

In addition, testicular cancer has been found to be much more common in Caucasian men than in African men.

Estrogen excess in pregnancy

By far the most common form of testicular cancer (germ cell tumors) arises from a preliminary stage called TIN (testicular intraepithelial neoplasia). It is based on germ cells that develop incorrectly in the embryo even before birth. One of the reasons for this is a hormone imbalance during pregnancy, more precisely: an excess of female hormones (oestrogens). This very likely disrupts the development of the testicles in the unborn child and may lead to the precancerous stage TIN.

A slight excess of estrogen is observed, for example, in pregnant women who are expecting their first child or twins, or who are older than 30 years. In some cases, taking medication with estrogens can also increase hormone levels in pregnant women. However, nowadays pregnant women are rarely treated with hormones.

infertility

The risk of testicular cancer is also increased in an infertile man. Infertility is based either on underdeveloped testicles ( hypogonadism ) or on a lack or complete absence of sperm in the semen (oligospermia or azoospermia).

The causes of infertility are different. Sometimes it is the result of an inflammation of the testicles (orchitis) caused by the mumps virus. Deviations (anomalies) in the genetic material also make men infertile, for example Klinefelter syndrome .

external influences

The number of testicular cancer cases has increased significantly worldwide in the last 20 years. Experts therefore assume that external influences in childhood and early adulthood also promote the development of cancer. But this needs more detailed research.

diagnosis and examination

Men are well advised to regularly examine and feel their testicles themselves, especially between the ages of 20 and 40. If you notice a change in the scrotum, it is best to see a urologist as soon as possible. This specialist for urinary and genital organs then clarifies the suspicion of testicular cancer by means of a number of examinations.

You can read exactly how the testicles are palpated in our article Palpation of the testicles .

doctor-patient conversation

First of all, the doctor talks to the patient in detail in order to collect his or her medical history ( anamnesis ). The doctor asks about any symptoms that occur, for example:

  • Have you noticed a hardening in the scrotum?
  • Do you feel a feeling of heaviness in said place or even pain?
  • Have you noticed any other changes in yourself, such as increased breast size?

In the conversation, the doctor will also clarify possible risk factors: Have you already had a testicular tumor in the past? Did you have undescended testicles? Does anyone in your family have testicular cancer?

Every piece of information is important, even that which seems rather insignificant to the patient himself. For example, swelling in the groin, back pain or coughing may indicate cancerous colonization (metastases) and thus advanced testicular cancer.

testicles

The anamnesis interview is followed by a physical examination. The bimanual examination of the testicles is particularly important. The doctor holds the testicles with one hand while he feels them for irregularities with the other. In this way, he examines both testicles carefully, even if only one shows suspicious changes. The side comparison often provides important information (testicular cancer usually affects only one testicle). The following applies to the palpation examination: Any enlargement or hardening in and on the testicles is suspicious of a tumor.

Every man is well advised to regularly feel his testicles himself. In this way, he discovers suspicious changes at an early stage and then consults a doctor. If it is indeed testicular cancer, early diagnosis improves the chances of recovery.

Palpation examination of the breast

As part of the physical examination, the doctor will also feel the man’s chest if he suspects testicular cancer. In many cases, the female hormones produced by a testicular tumor cause the mammary glands to swell painfully.

Ultrasonic

The doctor carries out the ultrasound examination to clarify testicular cancer with a high-resolution transducer. Typical are irregular areas that appear darker than the surrounding tissue. Even smaller and non-palpable testicular cancer foci can be detected in the ultrasound. The examination is carried out on both testicles to rule out bilateral involvement.

blood test

If testicular cancer is suspected, a comprehensive blood test is important. On the one hand, the doctor obtains information about the general condition of the patient and the function of individual organs . On the other hand, so-called tumor markers are determined in the blood. These are proteins that are either only detectable in the case of cancer or are produced in noticeably increased amounts in cancer patients.

One such tumor marker in testicular cancer is alpha-fetoprotein (AFP) . This protein is produced in the yolk sac of an unborn child during pregnancy. In adults, it is only produced in very small amounts by liver and intestinal cells. If a man has an elevated AFP level, this indicates testicular cancer – particularly certain forms of non-seminomas (yolk sac tumor and embryonic carcinoma). In the case of a seminoma, on the other hand, the AFP value is normal.

Another important tumor marker in testicular cancer is beta-human chorionic gonadotropin (β-HCG) . Its value is particularly high in choriocarcinoma (a form of non-seminoma), but in seminoma only about 20 percent of all cases.

Lactate dehydrogenase ( LDH ) is an enzyme found in many body cells. In the case of testicular cancer, it is only suitable as an additional tumor marker (alongside AFP and β-HCG).

The blood level of placental alkaline phosphatase (PLAP) is particularly high in seminoma. However, since the value is also increased in almost all smokers, PLAP is only of very limited use as a tumor marker in testicular cancer.

These tumor markers are not elevated in every testicular cancer patient. Conversely, healthy people may also have elevated levels. The tumor markers alone therefore do not allow a reliable diagnosis. However, they are suitable for assessing the course of testicular cancer. If, for example, the tumor markers rise again after treatment has been completed, this often signals a relapse (recurrence).

CT and MRI

Once testicular cancer has been diagnosed, computed tomography (CT) provides information about the spread of the tumor: X-rays are used to produce detailed cross-sectional images of the pelvis, abdomen and chest and possibly the head. Enlarged lymph nodes and testicular cancer metastases (the tumor has spread to other parts of the body) can generally be easily recognized on this. The doctor usually injects a contrast agent into the patient before the examination to improve the imaging.

An alternative to CT is magnetic resonance imaging (MRI): It also provides detailed cross-sectional images of the inside of the body, but with the help of magnetic fields (and not X-rays). The patient is therefore not exposed to radiation. An MRI is performed, for example, if the patient is allergic to the contrast agent used in CT.

exposure of the testicle

To confirm a testicular cancer diagnosis, the doctor surgically exposes the suspected testicle. The doctor can then usually see with the naked eye whether a malignant testicular tumor is actually present. In case of doubt, he takes a tissue sample, which is examined for cancer cells during the procedure. If so, the doctors check whether it is a seminoma or a non-seminoma. In the case of testicular cancer, the affected testicle is removed immediately.

treatment

In principle, the following treatment measures are available for testicular cancer therapy:

  • surgery
  • Surveillance strategy: “wait and see”
  • Radiation therapy (radiation)
  • chemotherapy

The attending physician proposes an individually tailored therapy plan to a testicular cancer patient.

In the Internet-based project “Second Opinion Testicular Tumors” ( https://www.zm-hodentumor.de ), doctors have the opportunity to ask testicular cancer specialists for a second assessment of the findings and the planned therapy of a patient. In this way, therapy planning can be significantly improved if necessary. Talk to your doctor about it!

The first step in testicular cancer treatment is usually surgery. The further treatment steps depend on the stage of the disease and the type of tumor (seminoma or non-seminoma – by far the most common forms of testicular cancer).

surgery

In testicular cancer surgery, the doctor surgically removes the affected testicle, its epididymis , and the spermatic cord. Doctors speak of testicular ablation or orchiectomy . In a few cases, testicular cancer can also be operated on in such a way that part of the testicle is preserved. This then usually continues to produce hormones. This procedure is particularly useful for patients who only have one testicle. To be on the safe side, however, the operated testicles are usually irradiated afterwards.

At the patient’s request, the doctor takes a grain-sized tissue sample from the other testicle during the procedure and immediately examines it under the microscope. This is advisable, since abnormal cells can also be found in the second testicle in about five percent of patients. In this case, this testicle can be removed at the same time.

If the patient wishes, the removed testicle may be replaced with a prosthesis. To do this, the doctor inserts a silicone pad of the right size and shape into the remaining scrotum. If chemotherapy is still necessary after the testicles have been removed, one waits before inserting the testicular prosthesis.

tumor stages

The doctor examines the removed testicular cancer tissue. Together with other examinations (such as computed tomography), the stage of the disease can be determined. Physicians roughly differentiate between the following tumor stages:

  • Stage I: Malignant tumor only in the testicles, no metastases
  • Stage II: Involvement of neighboring (regional) lymph nodes, but no more distant cancer metastases (distant metastases); Depending on the size or number of affected lymph nodes, stage II is further subdivided (IIA, IIB, IIC)
  • Stage III: Distant metastases are also present (eg in the lungs); further subdivision depending on the degree of severity (IIIA, IIIB, IIIC)

seminoma

The most common form of testicular cancer is seminoma. In the early stages (Stage I), further treatment after testicle removal is often limited to the surveillance strategy : the patient must have regular, thorough examinations to determine whether the cancer may have returned. In the early days, the doctor schedules these check-ups very closely. Later, the time intervals between them usually increase.

In order to improve the prognosis, however, it is also possible to treat a seminoma in the early stages after surgery with chemotherapy or radiotherapy . If the seminoma is already more advanced at the time the testicles are removed, patients will definitely receive either chemotherapy or radiotherapy after the procedure. Which form of therapy is the best option in the individual case depends, among other things, on the exact tumor stage.

In principle, it is also possible to combine radiotherapy and chemotherapy. This therapy variant is still being tested in clinical studies for seminoma.

You can read more about the treatment of seminoma and other important information about this most common form of testicular cancer in the seminoma article.

non seminoma

Non-seminomas are the second most common type of testicular cancer after seminoma. Here, too, the treatment steps after the testicle removal depend on the tumor stage:

Testicular Cancer Stage I

At this early stage, the monitoring strategy is usually sufficient for non-seminomas (such as seminomas) after the testicles have been removed: with the help of regular check-ups, any recurrences can be detected and treated at an early stage.

By definition, stage I testicular cancer is confined to the testicle and has not yet spread to lymph nodes or other parts of the body. Despite modern imaging methods such as computed tomography, this cannot be said with 100 percent certainty. Sometimes cancerous deposits (metastases) are so small that they are not detected in the imaging. Two factors may indicate such invisible (occult) metastases:

  • When examining the removed tumor tissue, the doctor finds that the testicular cancer has broken into neighboring lymphatic or blood vessels. The risk of occult (=hidden) metastases then increases to around fifty percent.
  • After tumor removal, the respective tumor markers in the blood do not decrease or even increase.

In such cases, there is an increased risk that the testicular cancer has already spread. To be on the safe side, the doctors then recommend chemotherapy (one cycle) rather than a monitoring strategy after the testicles have been removed : Patients are given three chemotherapeutic agents over several days: cisplatin , etoposide and bleomycin (collectively called PEB for short) .

It may also be advisable to remove the lymph nodes in the back of the abdomen ( lymphadenectomy ). The doctors then closely monitor and control the person concerned.

Testicular cancer stages IIA and IIB

In these two stages of testicular cancer, lymph nodes are already affected and enlarged. Then there are two options for further treatment after the testicle removal:

  • Either one surgically removes the affected lymph nodes , possibly followed by chemotherapy (if individual cancer cells remain in the body).
  • Or the patient receives three cycles of chemotherapy immediately after the testicular surgery. After that, any lymph nodes that are still affected can be surgically removed .

Testicular cancer stages IIC and III

In these advanced non-seminoma stages, patients are treated with three to four cycles of chemotherapy after testicle removal. If there are still affected lymph nodes after this, they are removed ( lymphadenectomy ).

Side effects of testicular cancer therapy

Chemotherapy for testicular cancer (and other forms of cancer) often has various side effects: The drugs (cytostatics) administered are very toxic for cells – not only for testicular cancer cells, but also for healthy body cells such as blood platelets, blood cells and hair root cells.

Possible side effects are therefore, for example, anemia, bleeding, hair loss, nausea and vomiting , loss of appetite, inflammation of the mucous membranes, hearing disorders and discomfort in the hands and feet. Cytostatics also attack the immune system. The patients are therefore more susceptible to pathogens during treatment.

As a rule, these side effects disappear after the end of the chemotherapy. In addition, doctors help with suitable measures and tips to alleviate the undesirable effects of the treatment (eg with remedies against nausea).

In the case of a (suspected) lymph node involvement in the back of the abdomen, doctors often treat this region with radiation therapy . The most common side effect is mild nausea. It occurs a few hours after radiation and can be relieved with medication. Other possible side effects are temporary diarrhea and skin irritations in the radiation area (such as redness, itching ).

Prevent

An important contribution to prevention is regular self-examination of the testicles by palpation. If testicular cancer is detected early in this way, the prognosis for successful healing is very good.

You can find out exactly how best to proceed with the self-examination of the testicles in the article Feeling the testicles .

Since the exact causes of testicular cancer are otherwise unknown, concrete prevention beyond a healthy lifestyle is not possible.

Anyone who belongs to the risk groups with a known family history, undescended testicles or malposition of the urethral opening is well advised to have the appropriate preventive examinations carried out by their doctor.

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