Testicular cancer is the most common solid cancer affecting young men, yet awareness of the disease remains relatively low. Globally, around one in 250 males will develop the disease, making it the most common solid cancer among men aged 15 to 35, with an average age of diagnosis of just 33. Yet despite how early in life it strikes, specialists emphasise that testicular cancer is also one of the most curable cancers today.
Dr Murali Sundram Mikaail bin Abdullah, Consultant Urologist and Robotic Surgeon at Sunway Medical Centre, Sunway City, explains that advances in treatment have dramatically changed outcomes for patients.
“Due to advances in medical treatment, testicular cancer has a five-year survival rate of approximately 95 per cent especially when early diagnosis and treatment was achieved. It is one of the most curable cancers,” he says.
The Early Sign That Should Not Be Ignored
Testicular cancer often presents with early warning signs that can be subtle and easily overlooked. Because the condition is usually painless, many men dismiss these changes or delay seeking medical advice. However, Dr Murali stresses that any painless lump in the testicle should be promptly assessed and referred to a urologist.
The early sign of testicular cancer is a painless swelling of one testicle. This may be noted by the patient himself or sometimes by his sexual partner.
To support early detection, he advises that regular testicular self-examination should be routinely performed by all men, especially those in younger age groups.
How Testicular Cancer Is Diagnosed
Once a lump is detected, diagnosis is usually straightforward. An ultrasound of the testes is the first step.
“A simple ultrasound has a 90 per cent accuracy rate for diagnosing testicular cancer. If a test is positive for cancer, then a more in-depth test like blood tests to check tumour markers and CT scans of the abdomen and lungs are also performed to determine the stage of the cancer, which shows whether it has spread beyond the testicle,” says Dr Murali.
When detected early, testicular cancer is usually limited to the testicle, known as Stage I disease. More advanced stages indicate spread to nearby lymph nodes or organs such as the lungs or bones.
Early Action, Minimal Disruption
For men diagnosed early, treatment is often straightforward and has little impact on daily life. Stage I testicular cancer is treated with an orchidectomy, a minor operation to remove the affected testicle, typically involving just a one-day hospital stay. He adds that outcomes at this stage are highly reassuring, with 70 to 85 per cent of patients cured with surgery alone. In some cases, a single course of chemotherapy may be advised as an added precaution.
“Orchidectomy usually does not affect sexual function or fertility if the remaining testis has normal function,” says Dr Murali.
Staying on Track After Treatment
Following treatment, patients are monitored closely for at least five years through regular check-ups. While a small proportion may experience recurrence during this period, effective treatment options remain available. For patients with Stage II or Stage III disease, chemotherapy remains the cornerstone of treatment.
“Chemotherapy is very effective for testicular cancers,” Dr Murali says.
But Dr Murali emphasises that even when testicular cancer is diagnosed at a more advanced stage, outcomes remain encouraging. According to him, about 70 per cent of patients can be completely cured with chemotherapy, even at advanced stages.
Surgical Advances Mean Faster Recovery
For some patients, chemotherapy may leave behind enlarged lymph nodes. In these cases, a specialised procedure known as retroperitoneal lymph node dissection (RPLND) may be recommended to remove remaining cancerous tissue. Studies have reported five-year survival rates of between 85 and 95 per cent following surgery.
Traditionally, RPLND was performed as open surgery, which typically involves a larger incision and longer recovery time. Today, robotic-assisted surgery is available in selected centres for carefully chosen patients.
“Because of the smaller incisions, recovery time is much shorter,” Dr Murali says, adding that many patients are able to return to their normal daily activities within weeks.
However, careful patient selection and surgical expertise remain essential, and open surgery continues to be considered the gold standard for more complex cases.
Ultimately, the message is clear: testicular cancer may affect young men, but it is also one of the most treatable cancers when detected early.
“Testicular cancer commonly presents as a painless swelling of the testicle. Regular testicular self-examination allows the disease to be detected at an early stage, when treatment outcomes are excellent,” he says.
For young Malaysian men, awareness is the first line of defence. Taking a moment to perform a simple self-check and seeking medical advice when something feels unusual could make the difference between early treatment and a more serious diagnosis.