Causes and Diagnoses

Causes and Diagnoses of Testicular Cancer

Continued research is needed to determine the exact cause of testicular cancer, but research shows that some men are more likely than others to develop testicular cancer. Possible risk factors include:

  • Age: About half of all testicular cancers occur in men between the ages of 20 and 34.
  • Cryptorchidism (undescended testicle): Even after surgical repair of an undescended testicle, there is still an increased risk.
  • Family history: If you have a brother or father with testicular cancer, you are at an increased risk of developing it too.
  • Personal history: If you had germ cell cancer in the other testicle, you are more likely to develop cancer in the remaining testicle.
  • Race and ethnicity: Men in Europe and the United States have the highest risk of getting testicular cancer; African and Asian men have the lowest risk.
  • HIV infection: Some studies have shown that men may be at a higher risk for testicular cancer if they have HIV or AIDS.


Symptoms of testicular cancer can also be caused by other, less serious problems, such as inflammation in the testicle (orchitis) or in the tissue surrounding the testicle through which sperm passes (epididymis). To find out the cause of the symptoms, your physician must perform a complete physical exam and an assessment of your family medical history. Your physician may also need to perform diagnostic testing, including:

  • Ultrasound: Used if a lump is present, an ultrasound uses sound waves to find out if a lump is solid or fluid-filled. Solid lumps are more likely to be cancerous.
  • Blood tests: These tests can help determine if certain proteins that can signify cancer are present. Some testicular cancers raise blood levels of proteins, such as alpha fetoprotein (AFP) or human chorionic gonadotropin (HCG). Your physician may be able to tell what kind of testicular cancer you have depending on which protein levels are higher. Blood tests can also help in follow up care, to make sure the cancer has not come back.
  • Biopsy/Removal: If a suspicious lump is found, a surgeon will remove the tumor so that a pathologist can see if it is cancerous. When testicular tumors are present, the entire tumor, the testicle and the spermatic cord are typically removed during the biopsy. This is done to prevent the spread of cancerous cells through the blood and lymph systems.

If cancer is found, you will need additional diagnostic tests to determine more details about the cancer. These may include:

Testicular self-exam (TSE)

Some physicians recommend performing testicular self-exams to help find testicular cancer in its early stages, when it is most treatable. Monthly testicular self-exams may be recommended in particular for men with risk factors for testicular cancer, including a history of cryptorchidism (undescended testicle), testicular cancer or a family history of testicular cancer.

The best time for testicular self-exam is just after a warm bath or shower, when the scrotal tissue is more relaxed.

While standing in front of a mirror, place the thumbs on the front side of the testicle and support it with the index and middle fingers of both hands.

Gently roll the testicle between the fingers and thumbs. Feel for lumps, hardness or thickness. Compare the feelings in each testicle.

If you find a lump, contact your physician as soon as possible.

It's not clear if testicular self-exams lower the death rate for this cancer, and they are not a substitute for routine physical exams by your physician. If you have any of the risk factors for testicular cancer, talk to your physician about the need for monthly testicular self-exams.