Late stage testicular cancer symptoms arise when the condition has progressed and may have spread beyond the testicles to other areas. Symptoms can depend on where the cancer has spread to.

It may affect the lymph nodes and organs such as the liver, lungs, and brain. A may experience breathing issues if cancer has spread to the lungs, or abdominal pain if it affects the liver.

The American Cancer Society (ACS) says testicular cancer is not common, affecting around 1 in every 250 males. Recognizing these symptoms is crucial because they indicate the need for prompt medical attention and possibly more aggressive treatment options.

This article explores the various symptoms of late stage testicular cancer, helping people understand what to look out for and when to seek their doctor’s advice.

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A person may not experience testicular cancer symptoms, even in the later stages. However, common symptoms include the following:

  • Lump or swelling: Often, the first symptom of testicular cancer is a lump on the testicle. The testicle may also be swollen and uncomfortable.
  • Breast growth: Certain tumors secrete hormones known as human chorionic gonadotropin (hCG), which stimulate breast growth.
  • Lower back pain: Later stage testicular cancer can spread to the lymph nodes. If the cancer affects lymph nodes at the back of the abdomen, a person may experience discomfort or pain in the lower back.
  • Respiratory symptoms: If cancer spreads to the lungs, it can cause breathing difficulties, chest pain, and a cough that may occur with bloody sputum.
  • Abdominal pain: A person may experience abdominal pain or discomfort if cancer spreads to the liver. They may also experience nausea, vomiting, or a change in bowel habits.
  • Neurological symptoms: Late stage testicular cancer may spread to the brain, causing headaches or confusion. People may also have neurological symptoms such as seizures or vision problems.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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A person should contact their doctor if they notice any unexplained changes to their testicles.

People with testicles should self-examine them regularly to become familiar with their normal size, shape, and texture. If they note any unusual changes such as tenderness, lumps, hardness, or alterations in size, they should see a healthcare professional.

Additionally, if a person notices general health changes such as fatigue, continuous coughing, or pain anywhere in the body, they should consult a doctor.

If a person has a family history of testicular cancer or a personal history of undescended testicles, they should inform their doctor. They can provide recommendations on screening, monitoring, and preventive strategies to help reduce the risk of testicular cancer.

The Center for Advocacy for Cancer of the Testes International, as well as The British Association of Urological Surgeons, recommend performing a self-examination. A person should do the following:

  1. Hold the scrotum gently and look for any swelling.
  2. Take note of the size and weight of each testicle.
  3. Examine the testicles thoroughly, with thumbs at the top and fingers underneath.
  4. Roll the testicle gently, feeling for lumps or bumps. Testicles are firm but soft and should move easily in the scrotum.
  5. Feel for the epididymis, which runs behind and above the testicle carrying mature sperm. Make sure to become familiar with how it feels so as not to confuse it with many lumps or bumps.
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The exact cause of most testicular cancers remains unknown. However, certain changes in a cell’s DNA can lead to cancer development.

The DNA in cells makes up genes, which control various cell functions. Genes exist within chromosomes, with most cells containing 46 chromosomes, 23 from each parent. Genes also influence cell growth, division, and death.

There are two types of genes that relate to cell division. Oncogenes promote cell growth and division, while tumor suppressor genes slow down cell division or trigger cell death when appropriate.

Cancer can develop when changes in chromosomes activate oncogenes or deactivate tumor suppressor genes.

Most testicular cancer cells exhibit extra copies of a part of chromosome 12, known as isochromosome 12p or i12p.

Some testicular cancers also show changes in other chromosomes or abnormal numbers of chromosomes. Researchers are studying these genetic changes to understand their role in testicular cancer development.

Treatment for late stage testicular cancer depends on factors such as the person’s age and overall health, previous treatment regimes, and the type of cancer. Doctors may recommend a combination of the following treatment options:

  • Surgery: Doctors may remove the cancerous testicle in an “orchiectomy” procedure if they did not remove it during earlier stage cancer treatment.
  • Chemotherapy: This uses powerful drugs to destroy cancer cells. In late stage testicular cancer, doctors may use chemotherapy combinations, including bleomycin, etoposide, and cisplatin (BEP) or etoposide, ifosfamide, and cisplatin (VIP). During treatment, doctors monitor the person’s tumor markers. If these do not decrease, a more intense chemotherapy regimen may be beneficial.
  • Radiation therapy: If cancer has spread to the brain, doctors can surgically remove the tumors and then use radiation therapy. This cancer treatment uses high-energy particles or waves, such as X-rays or gamma rays, to destroy or damage cancer cells.

If testicular cancer is resistant to chemotherapy or has metastasized (spread) to various organs, doctors may recommend high-dose chemotherapy followed by a stem cell transplant.

Testicular cancer has an excellent outlook, meaning the chances of recovery and long-term survival are generally high.

According to the ACS, the overall 5-year survival rate for testicular cancer is 95%. This means that more than 9 in 10 people with a diagnosis of testicular cancer live for more than 5 years after diagnosis.

Even when the cancer has metastasized to distant parts of the body, the 5-year survival rate remains relatively high at about 73%.

The risk factors for testicular cancer include:

  • undescended testicles, or cryptorchidism
  • family history of testicular cancer
  • age
  • ethnicity

Because lifestyle modifications cannot change these risk factors, there is no specific way to prevent testicular cancer. Furthermore, people with a diagnosis of testicular cancer often have no identifiable risk factors.

Doctors may recommend correcting cryptorchidism in children to preserve fertility and self-esteem. However, experts are unsure how this procedure impacts the likelihood of developing testicular cancer later in life.

Late stage testicular cancer symptoms may include lower back pain, respiratory symptoms, abdominal pain, and digestive issues.

Understanding these symptoms is essential for ensuring timely intervention and treatment. Options include chemotherapy, surgery, and radiation therapy.

With prompt attention, even late stage testicular cancer can have a favorable outcome.