Cancer Pathway

Testicular Cancer: your pathway, step by step

Testicular cancer mostly affects young men and is one of the most curable cancers, even when it has spread. Fertility needs to be thought about before treatment starts. This guide explains the steps, one stage at a time.

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Written for patients and reviewed by Dr. Anshuman Singh, Uro-Oncologist, on 7 October 2026.

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What is testicular cancer?

Almost all testicular cancers are germ cell tumours, in two main kinds: seminoma and non-seminoma. They are treated a little differently, so the type found after surgery matters.

The first step is nearly always the same: removal of the affected testicle, which is both the treatment and the test. Further treatment then depends on the stage and on blood markers.

How testicular cancer is usually found

  • A lump or hardness in a testicle, usually painless, often found by the man himself.
  • Swelling, a feeling of heaviness, or a dull ache in the scrotum or lower tummy.
  • Less often: back pain, breathlessness or breast tenderness from spread or hormones.
  • A lump in the scrotum should be examined by a urologist promptly. A needle biopsy through the scrotum is avoided.

Step 1

The tests that decide the plan

Treatment is chosen only after these results are put together.

Ultrasound of the scrotum
Tells whether a lump is inside the testicle and likely to be cancer.
Tumour marker blood tests
AFP, beta-hCG and LDH are checked before the operation and again afterwards. They help with the type, the stage and the group of risk.
CT scan of the chest, abdomen and pelvis
Shows whether lymph nodes at the back of the tummy or other organs are involved.
Sperm banking
Offered before any treatment. Chemotherapy, radiotherapy and some operations can affect fertility, so storing sperm first is strongly advised for men who may want children.

Step 2

Find what applies to you

Choose your stage and a few details. The page then shows what it means, the options, what to take into account and what to ask, with a checklist you can download.

Living with treatment

Side effects and recovery

These depend on the treatment chosen. Most can be reduced or managed, so ask about them before you decide.

Fertility and hormones
Sperm count can fall with chemotherapy and surgery. Testosterone can be low after treatment and is checked in follow-up.
Chemotherapy effects
Tiredness, nausea, hair loss, low blood counts, ringing in the ears and numbness or tingling in the fingers and toes.
Lung effects of bleomycin
Rarely scarring of the lung. Report cough or breathlessness early, and avoid smoking.
Ejaculation after lymph node surgery
Nerve-sparing surgery usually protects it. Ask about the chance in your case.

After treatment

Follow-up

  • Examination, markers and scans at regular intervals for at least five years, with the most frequent checks in the first two years.
  • Check the remaining testicle yourself every month.
  • Long-term health checks: testosterone, cholesterol, blood pressure and heart health, since treatment can affect them years later.

When to get help quickly

  • Fever of 38°C or above during chemotherapy, or any shivering.
  • New cough, breathlessness or chest pain.
  • A new lump, swelling or pain in the other testicle.
  • Severe vomiting, or being unable to keep fluids down.

Common questions

Questions patients ask

Is testicular cancer curable?

Yes. It is one of the most curable cancers. Most men with early disease are cured, and the great majority of men with spread are also cured with chemotherapy.

Will I be able to have children?

Many men do. Because treatment can reduce sperm production, banking sperm before treatment is advised. Natural recovery is common after some treatments.

Will losing a testicle affect my sexual life?

One healthy testicle usually produces enough testosterone and sperm for a normal sexual life. A prosthesis can restore appearance if you wish.

Why is a needle biopsy avoided?

A needle through the scrotum can spread cancer cells. The testicle is removed through a cut in the groin, which is both safer and gives a full diagnosis.

How often should I check myself afterwards?

Check the remaining testicle monthly, after a warm bath, and report any lump, swelling or change promptly.

Want to talk through your own reports?

This guide is general information and does not replace a medical opinion. An unhurried one-to-one discussion with Dr. Anshuman Singh, with your family welcome, so that you understand every option before you decide. Bring your reports and scans to a consultation with Dr. Anshuman Singh, in the clinic or by teleconsultation.

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