Ball cancer is the common name for testicular cancer, a disease where abnormal cells grow in one or both testicles. It’s relatively rare, affecting about 1 in every 250 males during their lifetime, with roughly 9,810 new cases expected in the United States in 2026. But it’s also one of the most treatable cancers: when caught early, the five-year survival rate is 99%.
Types of Testicular Cancer
Most testicular cancers start in germ cells, the cells that produce sperm. These germ cell tumors fall into two main categories: seminomas and nonseminomas. The distinction matters because the two types behave differently and respond to different treatments.
Seminomas tend to grow and spread more slowly. Nonseminomas are typically more aggressive and spread more quickly. If a tumor contains a mix of both types, it’s classified and treated as a nonseminoma. A small number of testicular cancers arise from other cell types, but germ cell tumors account for the vast majority of cases.
Who’s Most at Risk
About half of testicular cancers occur in men between the ages of 20 and 45, making it one of the most common cancers in younger men. But it can develop at any age, from infancy to old age.
The strongest risk factor is an undescended testicle, a condition where one or both testicles don’t move down into the scrotum before birth. Males born with this condition are many times more likely to develop testicular cancer. Interestingly, about 1 in 4 cases in men with this history actually develop in the normally descended testicle, not the one that stayed in the abdomen.
Other risk factors include having a father or brother with testicular cancer, a previous cancer in the other testicle (about 3 to 4% of cured men develop cancer in the remaining one), and HIV infection. White, American Indian, and Alaska Native men are several times more likely to develop the disease than Black, Asian American, and Pacific Islander men. Most men diagnosed, though, have no family history and no obvious risk factors.
What It Feels Like
The most common sign is a painless lump or swelling in one testicle. Many people expect cancer to hurt, so they dismiss a lump that doesn’t. Other signs to watch for include:
- A change in how the testicle feels, such as firmness or heaviness
- A dull ache in the lower abdomen or groin
- A sudden buildup of fluid in the scrotum
- Pain or discomfort in a testicle or the scrotum
These symptoms don’t always mean cancer. Infections, cysts, and fluid collections can cause similar changes. But any new lump or persistent change in how a testicle feels is worth getting checked, because early detection makes a significant difference in treatment simplicity and outcomes.
How to Check Yourself
Health providers recommend starting monthly self-exams at age 15. The easiest time is during or right after a warm shower, when the scrotal skin is relaxed. Here’s what to do:
- Lift the penis out of the way and visually inspect your scrotum for any swelling.
- Gently grip the top of the scrotum and locate one testicle.
- Roll the testicle slowly between your fingers, checking each side from top to bottom. You’re feeling for any hard lumps or changes in size or shape.
- Feel for the epididymis at the top-back of the testicle. This is a soft, squishy tube that carries sperm. It’s normal for it to feel slightly tender.
- Repeat on the other side.
The goal isn’t to diagnose anything yourself. It’s to learn what your normal feels like so you’ll notice a change quickly.
How It’s Diagnosed
If you notice something unusual, the first step is typically an ultrasound of the scrotum. This imaging test is nearly 100% sensitive when combined with a physical exam, and it can distinguish between a mass inside the testicle (more concerning) and something outside it (often benign, like a fluid-filled cyst).
Doctors also measure three proteins in the blood that testicular tumors can produce. These markers help confirm a diagnosis, determine the cancer type, and track how well treatment is working. In nonseminomas especially, the level of these markers after treatment is one of the strongest predictors of long-term outcomes. A rise in marker levels is often the earliest sign of a relapse, sometimes before any symptoms appear.
Treatment and What to Expect
The first step for nearly every case of testicular cancer is surgery to remove the affected testicle. This is done through a small incision in the groin, not the scrotum. You can function normally with one testicle, both in terms of hormone production and sexual activity.
What happens after surgery depends on the type and stage. For stage I cancers (confined to the testicle), many men need nothing more than regular monitoring with blood tests and imaging over the following years. Some receive a short course of chemotherapy or, for seminomas, radiation therapy to reduce the small chance of recurrence.
More advanced cancers, where the disease has spread to lymph nodes or other organs, typically require chemotherapy after surgery. In some cases, a second surgery removes any remaining masses. Even at the most advanced stage, the five-year survival rate is 72%, which is remarkably high compared to most other cancers at that stage. For cancer that hasn’t spread beyond the testicle, survival is 99%. Regional spread (typically to nearby lymph nodes) still carries a 96% survival rate.
Effects on Fertility and Sexual Health
Losing one testicle doesn’t automatically mean infertility. The remaining testicle usually continues producing testosterone and sperm. However, some treatments, particularly chemotherapy, can damage sperm production temporarily or permanently. Some men regain fertility after treatment ends; others don’t.
For this reason, sperm banking before treatment is standard practice. You provide one or more semen samples, which are tested for sperm count, motility, and shape, then frozen for future use. For men who can’t produce a sample through ejaculation, there are surgical techniques to collect sperm directly. The key is to bank sperm before treatment starts, since some cancers require urgent chemotherapy that doesn’t allow time to wait.
Testosterone levels typically remain normal with one healthy testicle. If they drop, hormone replacement can restore energy, sex drive, and other functions that testosterone supports.