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Oganes E. Dilanyan
Urologist, MD, PhD

Testicular cancer

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In this article

Testicular cancer also known as malignant testicular tumour is always a shock. A young and seemingly healthy male finds changes is his scrotum or can feel a lump on his testicle while washing or going to the toilet. They go to the doctor and after an ultrasound he gets referred for testicle removal.

Diagnosis: testicular cancer

The first thought of any patient with malignant testicular tumour is “this is just a dream and I am going to wake up soon.  Losing a testicle is a big shock for any man and sometimes one’s thoughts are that it would be better to die with the testicle intact rather than live without one. 
Which brings about three paradoxes: firstly, in many cases it is possible to remove only the tumour and save the testicle, secondly, removing the testicle will not in most cases make the man impotent, and thirdly, the healthy testicle will take over producing the sperm and fertility will not be adversely affected. 
All these points are thoroughly discussed with the patient and they are never left alone with their disease.

Surgery for testicular cancer

  • Testicular cancer removal while saving the testicle. We use this type of surgery when it is not clear if the tumour is benign or malignant. Histology test is carried out during surgery and the decision is then made to remove or preserve the testicle.
  • Removal of the testicle with the spermatic cord. We use mini-access for this procedure but remove the testicle with the spermatic cord through the abdominal canal.
  • Testicular Implants – these are done upon the patient’s request and are used purely for aesthetic reasons.
  • Lymphadenectomy – removal of lymph nodes affected by the tumour.
Do not delay treatment

Testicular cancer is life threatening. The later the treatment is started the worse the results. Book your appointment today! 

Testicular cancer is a relatively rare condition most often seen in men aged 15 to 49. Testicular cancer cells are characterised by abnormaly fast growth and the ability to quickly metastasise. The cells destroy healthy tissue and live by using it while spreading to remote lymph nodes and other organs and damaging them.  

“The scrotum started increasing in size, I examined it in the bathroom and felt a hard round lump inside the testicle”; “There was no pain, nothing bothered me, I was being investigated for infertility and after an ultrasound I was told I had testicular cancer”; “I had some strange pain in the groin for the last two months, and no other symptoms”. 
The above are the most common complaints of the patients that come to see mw with testicular cancer diagnosis. It is important to understand that it can be completely asymptomatic and therefore one needs to visit a urologist and have a scrotum ultrasound once a year.  

The main symptoms of testicular cancer are as follows: 
- Increase in testicle size and appearance of a hard nodule. This can be felt during self-examination.
- Infertility. Often the reason for male infertility is a malignant tumour of the testicle, which simply poisons the organ and hinders spermatogenesis. 
- Metastasis manifesting as a nodular grown in the top part of the collar bone – this appears in the later stages of testicular cancer
- Increased size of mammary glands in men known as gynecomastia.

The very first symptoms of testicular cancer are the enlarged testicle and the appearance of a hard painless lump that can be felt during self-examination 

Save your time and money

If you have detected any of the signs or symptoms of testicular cancer, please get in touch for immediate diagnosis and prompt treatment.

Testicular cancer diagnosis


There are several investigations that are necessary when testicular cancer of any kind is suspected. The first and the most important is the ultrasound of the scrotum also known as a testicle scan. This investigation allows us to detect the tumour and assess its size. We also perform the colour doppler scan in order to see the blood flow in the testicle and the tumour.

In the presence of any form of cancer it’s a race against time so we perform the following investigations as quickly as possible

Testicular cancer diagnosis

Testicular cancer tumour markers

When malignant testicular tumour is suspected it is essential to quickly perform a blood test measuring Beta HCG, Alpha-fetoprotein LDH. These tumour markers allow us to determine the type of tumour and plan appropriate treatment.

Lymph nodes MRI

When testicular cancer is suspected, MRI scan is performed in order to assess the size and the level of damage to the lymph nodes. This is because the first metastasis is usually found in the lymph nodes. 

Chest CT

Unfortunately, quite often testicular cancer is diagnosed in the later stages during which the cancer metastasises into the lungs.  This CT scan is performed to assess the damage to the lungs. 


It has been noted that testicular puncture biopsy can cause the tumour to disseminate and spread to the scrotum and lymph nodes.

This is why we never use puncture biopsy.

Treatment of testicular cancer

Malignant testicular cancer responds well to treatment in different stages. For each patient we assemble a tumour board consisting of an oncology surgeon, oncologist urologist surgeon, chemotherapy specialist and a radiotherapy specialist.  This approach allows us to have the best possible results from treatment, ensure effective follow up and if there is any doubt about the malignant nature of the tumour we can preserve the organ.

Treatment of testicular cancer


When treating testicular cancer surgery is always first choice. Firstly, if the testicle needs to be removed it has to be done properly and remove it together with the spermatic cord from the abdominal canal.  This procedure can only be done in specialised facilities. We also use laparoscopic surgery when removing lymph nodes affected by the tumour. 


When the spreading of cancer I suspected a patient can be prescribed a number of chemotherapy cycles based on the histology results. We work with one of the best facilities offering modern chemotherapy treatment which allows us to maximise the success rate in this area of treatment. 


Another component of testicular cancer treatment in various stages is radiotherapy. Еще одним компонентом. This type of treatment relies heavily on the quality of the equipment and competence of the professional administering the treatment, therefore as part of our tumour board we have a specialised radiotherapy facility that uses Varian equipment.

Testicular Cancer Surgery

We offer three types of surgery for testicular cancer: 

Testicular Cancer Surgery

Tumour resection

When there are doubts about the malignant nature of the tumour, we only remove the tumour and perform an urgent histology test during the surgery. If the results show that the tumour is benign the testicle is saved. 

Testicle removal

When it is necessary to remove the testicle, we perform a procedure called orchifuniculectomy, removing the testicle together with the spermatic cord from the abdominal canal. For aesthetic reasons we offer testicular prostheses during the operation. 

Lymph node removal

If the oncologist decides that it is necessary to remove the lymph nodes before commencing chemotherapy, we perform laparoscopic lymphadenectomy.  Unlike open surgery this procedure allows to avoid pain and inflammation and allows for quick recovery. 

Do not delay treatment!

For those living in Moscow we recommend booking a face to face consultation at the time convenient for you.
Moscow, Malyi Ivanovski pereulok, 11.6, building 1, Phone.: +7 499 344-03-03

Our advantages when treating testicular cancer

Professional Approach:  Up to date cancer treatment in line with recommendations of leading European associations. 

Our team: Specialised science based surgical oncology and urology team.

Board of doctors: every patient is reviewed by an oncologist, chemotherapy specialist and radiotherapy specialist. 

Equipment: Specialised surgical equipment by Karl Storz, Covidien and Philips Medical for precise diagnosis and effective treatment. 

Comfort: no queueing or waiting for a consultation and premium inpatient facility.

Safety: we only use methods recommended by professional associations such as EAU and AAU.

Result: Precise diagnosis and effective treatment of cancers. 

We are also GCP certified, which confirms we provide the highest standards of diagnosis and treatment. 

Information for foreign patients:

If you require treatment for testicular cancer in Moscow please contact us. We will arrange admission to hospital on the day of your arrival, carry out all necessary investigations and perform surgery as soon as possible.