Patient information from BMJ

Testicular cancer

Last published:Jun 05, 2025

It can be frightening to hear your doctor talk about cancer. But most men with testicular cancer will have their cancer cured. And most men can still have a normal sex life and have children afterward. 

This information may help you talk to your doctor about your concerns if you’ve been told you have testicular cancer.

What is testicular cancer?

Cancer is a disease that occurs when cells in the body grow and spread in a way that is out of control. Cancer can occur anywhere in your body. Testicular cancer is when cancer cells begin to grow in your testicle. These cells form a lump called a tumor. If it's not treated, cancer cells could break off from the tumor and spread to other parts of your body.

It might be worrying to hear your doctor talking about cancer cells spreading in your body. But testicular cancer is much easier to treat than most types of cancer. Even men whose cancer is at a late stage have a good chance of being cured.

What are the symptoms of testicular cancer?

The most common symptom of testicular cancer is a lump or swelling in your testicle. It's rare to get cancer in both testicles, so the lump is usually just on one side. Some men don't notice a lump but find that one testicle has got bigger or smaller. You may have an uncomfortable feeling in one testicle. But the lump is not usually painful.

Testicular cancer may be more common in people whose fathers or male relatives had this type of cancer. It also happens more often in people who had an undescended testicle when they were a child.

Your doctor may tell you what stage your cancer is at when you are diagnosed. The stage of testicular cancer is usually described as a number between 0 and 4. This tells you how far the cancer has spread in your body.

Remember, even testicular cancer that's spread outside your testicle can very often be completely cured.

What are the treatment options for testicular cancer?

The first treatment you'll probably need is an operation to remove the testicle that has cancer. Men who have very small tumors might just be able to have the tumor removed, rather than the whole testicle. But this is rare.

You may not like the idea of having a testicle removed, but it's actually a pretty simple operation. Your other testicle can make all the hormones and sperm that you need for having children and living a normal life.

After surgery you might need radiation therapy or chemotherapy (treatment with anti-cancer medications). But if your cancer was caught early, the operation may be all you need.

What happens during surgery for testicular cancer?

Before surgery you'll be given a general anesthetic so you will be asleep through the operation. The surgeon will make a cut low down on your abdomen, near your groin. He or she will be able to reach your testicle through this cut.

You may be worried that your testicles will look different after surgery. But you're unlikely to need a cut in your scrotum. And you can have an artificial testicle (an implant) to replace the one that's been removed.

You'll probably spend a couple of days recovering in the hospital. You should also allow three or four weeks of recovery time at home. You'll be given pain relievers to help with any pain you get.

Like all operations, surgery to remove a testicle carries some risks. These don't happen often, but your doctor should discuss them with you. Some possible problems after your operation are:

• bleeding

• an infection

• severe bruising (called a hematoma), or

• nerve damage (this could cause a numb feeling in your groin).

Some men need another operation to remove any cancer that has spread to their lymph nodes. Lymph nodes help your body to fight disease. The ones that may need to be removed if you have testicular cancer are in the area between your belly button (navel) and your back.

Your doctor might recommend lymph node surgery for certain types of tumor.

It used to be quite common to get some nerve damage during the operation to remove lymph nodes. Nerve damage can cause a problem called dry climax. You may also hear it called retrograde ejaculation. It means that semen enters your bladder instead of coming out of your penis when you have an orgasm.

Newer ways of removing lymph nodes help to prevent side effects such as this.

Watchful waiting after surgery

For some men with early cancer an operation will be the only treatment they need. Your doctor may suggest what's called "watchful waiting". This is when you have regular check-ups rather than more treatment. 

Watchful waiting means you avoid the side effects of radiation therapy and chemotherapy. But there is a greater chance that your cancer will come back. If your cancer does come back you'll still be able to have radiation therapy or chemotherapy to get rid of it.

If watchful waiting is an option, you and your doctor can talk about what's important to you. You may want to avoid the risk of side effects of further treatment. Or you may not like the idea of waiting to see if your cancer comes back. The decision will be yours.

Chemotherapy

Chemotherapy is a treatment that kills cancer cells. It's used to get rid of any cancer that might be left in your body after surgery.

Chemotherapy is usually given as a drip. Each dose of chemotherapy is called a cycle. It's given over a few days. The number of cycles you need depends on how far your cancer has spread.

If the first treatment doesn’t work, testicular cancer can often be cured by trying a different type of chemotherapy. This is what doctors call "second-line" chemotherapy.

Chemotherapy has side effects. Common problems include nausea and diarrhea.

Higher doses of chemotherapy can cause:

• inflammation (swelling) in your mouth

• hair loss, and

• anemia, which can make you feel tired.

Radiation therapy

Radiation therapy uses high-energy x-rays to kill any cancer cells left behind after surgery. You'll need to go to the hospital for treatment. A large machine generates the x-rays. Radiation therapy isn't painful during treatment.

You'll have short bursts of treatment several days a week for a few weeks. You may be given a lower dose of radiation if you have earlier-stage testicular cancer. This reduces the chance of side effects.

One of the most common side effects of radiation therapy is feeling very tired. It can also cause nausea. Your doctor may suggest that you take medication to control the nausea.

What happens next?

There's a very good chance that your testicular cancer can be completely cured. Nearly 100 percent of men recover from early-stage testicular cancer.​NIH: cancer stat facts: testicular cancer​https://seer.cancer.gov/statfacts/html/testis.html​ And even men whose testicular cancer has spread are likely to make a full recovery.

Will I be able to have sex?

Yes. Treatment for testicular cancer will not affect your ability to have sex.

But you might not get back to normal right away. Testicular cancer is a serious illness and treatment can be tiring. All these things can affect your attitude to life, including how you feel about sex.

Will I be able to have children?

Many men have children after having testicular cancer.

But the treatments may affect your fertility. Both chemotherapy and radiation therapy can damage your sperm. But this damage is often temporary.

Whatever treatment you have, before it starts, you should be able to have your sperm frozen if you choose to. If your doctor doesn't mention this, be sure to ask about it.

If you intend to have children your doctor will probably advise you not to get your partner pregnant for some time after your treatment finishes.

You may be asked to wait six months or a year. That's because there could be a chance of birth defects in the baby if your sperm have been damaged. Waiting for a while gives your sperm time to get back to normal.

If your partner has problems becoming pregnant after this time, talk to your doctor about fertility treatments.

It isn’t common, but if you do need both testicles removed you won't be able to have children after your operation. But you should still be able to have your sperm frozen before surgery.