Medically reviewed by Dr. C. Raghavendra Reddy, DM Medical Oncology, DNB General Medicine, Medical Oncologist · Last reviewed May 2026
Testicular cancer is one of the most curable cancers in medicine — even at advanced stages. With modern treatment, over 95% of patients achieve long-term cure. At CION Cancer Clinics, our surgical and medical oncology team delivers NCCN-protocol care — radical inguinal orchidectomy, BEP chemotherapy, active surveillance, and RPLND — across 7 NABH-accredited Hyderabad locations.
Testicular cancer has the highest cure rate of any solid organ cancer. Even at Stage III — when cancer has spread beyond the testicle to lymph nodes or lungs — the 5-year survival rate exceeds 70 to 95% depending on the risk group. For Stage I and Stage II disease, cure rates approach 99%. This is not just because it is caught early — testicular cancer cells are uniquely sensitive to chemotherapy, making it curable even at advanced stages that would carry a far worse prognosis in other cancer types.
Testicular cancer develops in the testicles — the two glands inside the scrotum that produce sperm and testosterone. It is the most common cancer in men aged 15 to 35, though it can occur at any age. The vast majority — about 90 to 95% — are germ cell tumours, falling into two main types.
A slow-growing germ cell tumour that is highly sensitive to both radiation therapy and chemotherapy. Seminomas typically affect men in their 30s and 40s. They tend to remain confined to the testicle and local lymph nodes for longer than non-seminomas, and are among the most treatment-responsive tumours in all of oncology.
A broader group of germ cell tumours that are generally more aggressive and tend to spread earlier than seminomas. They affect younger men, typically in their 20s and early 30s. Despite being more aggressive, they are equally curable with modern chemotherapy. They do not respond well to radiation, so radiation is not used.
A small number of testicular cancers are non-germ cell tumours — arising from the hormone-producing or supporting cells of the testicle. These are rare and managed differently.
Unlike most cancers, testicular cancer has no established links to diet, smoking, alcohol, or environmental toxins. The absence of lifestyle risk factors means there is nothing a patient could have done to prevent it.
Testicular cancer is one of the few cancers where the patient typically finds it first. Recognising the early signs is the most powerful tool for early diagnosis.
Many men delay seeking help because the lump is painless. Any new lump or change in a testicle that persists for more than 2 weeks should be evaluated by a doctor. A scrotal ultrasound — quick, painless, and done in a clinic — can confirm or exclude the diagnosis within minutes.
Monthly self-examination of the testicles — feeling each testicle between the thumb and fingers to check for any new lump, change in size, or unusual firmness — takes about 30 seconds and is the most effective early detection tool available. The best time is after a warm bath or shower when the scrotal skin is relaxed. Familiarising yourself with the normal size, shape, and texture of your testicles makes it easier to notice any change.
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Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
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Surgical oncology, medical oncology, and pathology working together — every case reviewed by our tumour board before treatment begins.
Diagnosis follows a fixed order — ultrasound first, then tumour markers and CT staging after orchidectomy. A biopsy through the scrotum is never done, as it risks spreading cancer cells.
A scrotal ultrasound is the first and most important test when a testicular lump is suspected. It is painless, uses no radiation, and accurately distinguishes between a cancerous and benign testicular mass within minutes. If the ultrasound shows a solid tumour within the testicle, orchidectomy is recommended — a biopsy through the scrotum is not done because it risks spreading cancer cells to the inguinal lymph nodes.
Three blood markers are measured before and after orchidectomy: AFP (a protein produced by some non-seminomas), beta-HCG (a hormone elevated in many testicular cancers), and LDH (a general marker of tumour bulk). Elevated markers confirm the diagnosis and help identify the cancer type. After orchidectomy, falling markers confirm treatment response; persistent elevation suggests residual disease.
A CT scan of the chest, abdomen, and pelvis is performed after orchidectomy to check whether the cancer has spread to the abdominal lymph nodes (retroperitoneal nodes — the first site of spread for most testicular cancers) or to the lungs (the most common site of distant spread). Staging determines all subsequent treatment decisions.
After orchidectomy, the removed testicle is examined by a pathologist who identifies the exact type of cancer. This single result — seminoma or non-seminoma — determines the entire subsequent treatment pathway.
Seminomas are slow-growing and exquisitely sensitive to both radiation and chemotherapy. For Stage I seminoma (no spread beyond the testicle), active surveillance is now the preferred option for low-risk patients — even those who relapse can be cured with chemotherapy. For Stage II seminoma (spread to abdominal lymph nodes), radiation therapy to the abdominal nodes is a highly effective, well-tolerated treatment. For advanced seminoma, BEP chemotherapy is curative in the great majority of cases.
Non-seminomas grow and spread more quickly than seminomas — and they do not respond to radiation. For Stage I non-seminoma, active surveillance is offered to low-risk patients; those with high-risk microscopic features receive 1 to 2 cycles of BEP as a precaution. For Stage II and III non-seminoma, full BEP chemotherapy is given. After chemotherapy, if a residual lymph node mass remains in the abdomen, surgical removal (RPLND) is often recommended.
Testicular cancer is staged using the AJCC system. Unlike most cancers, even Stage III testicular cancer carries high cure rates — a result of its exceptional sensitivity to chemotherapy.
| Stage | Extent of disease | Marker status | 5-Year Survival* | Primary treatment |
|---|---|---|---|---|
| Stage I | Cancer confined to the testicle; no spread on CT | Normal / normalising after orchidectomy | ~99% | Orchidectomy + active surveillance, OR 1–2 cycles BEP (non-seminoma high-risk) |
| Stage IIA–IIB | Spread to abdominal lymph nodes ≤5cm | Normal or slightly elevated | 95–99% | Seminoma: radiation; Non-seminoma: 3 cycles BEP |
| Stage IIC | Spread to abdominal lymph nodes >5cm | May be elevated | 90–95% | 3–4 cycles BEP; RPLND if residual mass remains |
| Stage III (Good Risk) | Spread to lungs or distant lymph nodes | AFP <1000, hCG <5000, normal LDH | 90–95% | 3 cycles BEP chemotherapy |
| Stage III (Intermediate Risk) | Non-pulmonary metastases or moderate markers | Moderate elevation | 75–85% | 4 cycles BEP chemotherapy |
| Stage III (Poor Risk) | Non-pulmonary metastases + high markers | AFP >10000 or hCG >50000 | 50–70% | 4 cycles BEP; high-dose chemotherapy considered |
*5-year overall survival per AJCC / NCCN testicular cancer outcomes data. CION outcomes monitored against national NCRP data. Individual outcomes depend on response to chemotherapy and completeness of surgical resection.
For Stage I testicular cancer, orchidectomy alone cures approximately 80 to 85% of patients without any further treatment. Active surveillance monitors for the 15 to 20% who relapse and cures them with chemotherapy at that point. This means the majority of Stage I patients avoid chemotherapy entirely. Ask your oncologist whether active surveillance is appropriate for your situation before accepting automatic chemotherapy or radiation after orchidectomy.
For every stage and type of testicular cancer, the first treatment is the same: surgical removal of the affected testicle. This operation is called a radical inguinal orchidectomy — the testicle is removed through a small cut in the groin (not the scrotum) to prevent any risk of cancer cells spreading through the scrotal lymph channels.
The operation takes approximately 30 to 60 minutes under general anaesthesia. Most patients go home the same day or the following morning. The removal of one testicle does not affect testosterone production (the remaining testicle compensates) and does not typically affect sexual function or fertility.
A silicone testicular prosthesis — a replacement implant placed in the scrotum during or after the operation — is available for patients who wish to restore the natural appearance of the scrotum. This is a cosmetic option and has no impact on function or cancer outcomes.
One of the most important advances in testicular cancer management over the past 30 years is the recognition that many Stage I patients — those whose cancer is confirmed to be confined to the testicle and has not spread anywhere — are already cured by orchidectomy alone and do not need any additional treatment.
Active surveillance is a carefully structured monitoring programme. Instead of automatically giving chemotherapy or radiation after orchidectomy, the patient is followed with regular CT scans and blood tests. If the cancer comes back during surveillance (approximately 15 to 20% of Stage I patients), chemotherapy is given at that point and is still highly curative. The 80 to 85% who do not relapse are spared any additional treatment and its associated side effects.
Active surveillance requires commitment: regular clinic visits, blood tests, and CT scans every few months for the first 2 to 3 years, then less frequently thereafter. It also requires that the patient and their family understand the plan — if any symptoms develop between scheduled visits, they must be reported promptly. CION's oncology team structures surveillance schedules individually and supports patients through each review appointment.
Active surveillance is not a passive or lesser treatment — it is an evidence-based choice that protects the majority of Stage I patients from unnecessary chemotherapy while curing those who do relapse just as effectively as if they had received preventive treatment.
For patients who require chemotherapy — Stage II disease beyond small lymph nodes, Stage III disease, or Stage I high-risk non-seminoma — the standard regimen is BEP: bleomycin, etoposide, and cisplatin. Three medicines given together as intravenous infusions over 5 days, repeated every 3 weeks for 3 to 4 cycles.
The three medicines work together to destroy cancer cells. Side effects — nausea (well-controlled with modern anti-nausea medicines), fatigue, temporary hair loss, and a period of reduced blood counts requiring infection precautions — are monitored closely throughout. Most patients complete treatment as outpatients or day-care patients, returning home between cycles. The cumulative duration of BEP treatment is typically 9 to 12 weeks.
The results of BEP for testicular cancer are remarkable compared to other solid tumour chemotherapy: the majority of patients with good-risk advanced disease are cured — including those with cancer spread to the lungs. This is why testicular cancer carries such a different prognosis from most other adult cancers.
Testicular cancer typically spreads first to the lymph nodes at the back of the abdomen — the retroperitoneal nodes. In two situations, surgical removal of these nodes is recommended:
RPLND is a major abdominal operation requiring specialist surgical oncology expertise. It is performed as an open procedure for most cases, or laparoscopically at specialist centres. Recovery takes 2 to 4 weeks. CION's surgical oncology team coordinates RPLND for patients whose post-chemotherapy assessment identifies a residual abdominal mass requiring removal.
Testicular cancer management requires surgical and medical oncology to work closely together at every decision point. At CION, every case is reviewed by our multidisciplinary team before treatment begins.
When you're choosing where to be treated for testicular cancer, what you're really looking for is a team that handles every stage — from active surveillance for Stage I to BEP for advanced disease and RPLND for residual masses — with the protocols to do it correctly.
Costs are indicative ranges in INR. A personalised cost estimate is provided following your initial oncology consultation at CION. EMI options are available; CION works with all major TPAs for cashless hospitalisation.
| Treatment | Approximate Cost (INR) | Notes |
|---|---|---|
| Radical Inguinal Orchidectomy | ₹60,000 – ₹1,80,000 | Day or overnight procedure; includes anaesthesia and pathology |
| Orchidectomy + Testicular Prosthesis | ₹1,00,000 – ₹2,50,000 | Cosmetic implant placed at same operation |
| BEP Chemotherapy (per 21-day cycle) | ₹50,000 – ₹1,50,000 | 3–4 cycles for advanced disease |
| BEP Chemotherapy Full Course (3 cycles) | ₹1,50,000 – ₹4,50,000 | Good-risk Stage III; includes blood count monitoring |
| EP Chemotherapy (Etoposide + Cisplatin, per cycle) | ₹40,000 – ₹1,20,000 | Alternative to BEP for selected patients |
| RPLND (Retroperitoneal Lymph Node Surgery) | ₹2,00,000 – ₹5,00,000 | Major abdominal surgery; 3–5 day hospital stay |
| Radiation Therapy — Abdominal (Stage II Seminoma) | ₹1,20,000 – ₹2,50,000 | For seminoma with abdominal lymph node involvement |
| Active Surveillance (annual monitoring) | ₹20,000 – ₹60,000 | Per year; no treatment cost if no relapse |
Financial support: EMI facility available for all patients · CION works with all major TPAs for cashless hospitalisation · Aarogyasri / CGHS / ECHS / ESI accepted where applicable.
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Start Your Story. Book Free Consultation.Yes — testicular cancer is one of the most curable cancers in medicine. Stage I disease, treated with orchidectomy and surveillance, has cure rates approaching 99%. Advanced Stage III disease — with cancer spread to lymph nodes or lungs — still achieves 5-year survival of 70 to 95% with BEP chemotherapy. This remarkable curability exists because testicular cancer cells are uniquely sensitive to chemotherapy. A diagnosis of testicular cancer, even at an advanced stage, carries a very different prognosis from most other adult cancers.
The most common first sign is a painless lump or swelling in one testicle — often noticed during bathing or exercise. Other symptoms include a feeling of heaviness or dull ache in the scrotum or lower abdomen, a sudden collection of fluid in the scrotum, breast tenderness or unusual breast tissue growth (from tumour hormones), and back or abdominal pain when cancer has spread to abdominal lymph nodes. Because the lump is typically painless, many men delay seeking help. Any new lump or change in a testicle that persists for 2 or more weeks should be evaluated with a scrotal ultrasound.
The first treatment for all testicular cancers is orchidectomy — surgical removal of the affected testicle through a small groin incision. The pathology result then determines what comes next. For Stage I, active surveillance (careful monitoring without additional treatment) is the preferred option for most patients. For more advanced stages, BEP chemotherapy (3 medicines given every 3 weeks) is the standard treatment and achieves cure in the large majority of patients. Radiation therapy is used for Stage II seminoma. Surgical removal of abdominal lymph nodes (RPLND) may be needed after chemotherapy for non-seminoma patients with a residual mass.
Both are germ cell tumours — the most common type of testicular cancer — but they behave differently and are treated differently. Seminomas are slow-growing and highly sensitive to both radiation and chemotherapy; they tend to remain localised for longer. Non-seminomas grow and spread faster and do not respond to radiation, but are equally curable with chemotherapy. The distinction is confirmed by the pathologist after orchidectomy and is one of the most important results in guiding what happens next — which is why the pathology report after orchidectomy is so central to the treatment plan.
Active surveillance is a monitoring approach for Stage I testicular cancer where no additional treatment is given after orchidectomy. Instead, the patient has regular blood tests and CT scans over 2 to 3 years. Most Stage I patients (80 to 85%) are already cured by orchidectomy alone and will never need further treatment. The 15 to 20% who relapse during surveillance are treated with chemotherapy at that point and are cured just as effectively as if they had received preventive treatment earlier. Active surveillance avoids unnecessary chemotherapy side effects for the majority of patients while remaining fully curative.
Orchidectomy (or orchiectomy) is the surgical removal of the affected testicle. For testicular cancer, it is performed as a radical inguinal orchidectomy — through a small cut in the groin rather than through the scrotum. This approach is important because it prevents cancer cells from spreading to the inguinal (groin) lymph channels. The procedure takes 30 to 60 minutes under general anaesthesia; most patients go home the same day. A testicular prosthesis (a silicone implant placed in the scrotum) can be inserted at the same time for patients who wish to restore the normal appearance of the scrotum.
Testicular cancer survival rates are among the highest of any cancer. Stage I: ~99% 5-year survival. Stage IIA–IIB (small abdominal lymph node involvement): 95 to 99%. Stage IIC (larger abdominal lymph nodes): 90 to 95%. Stage III good-risk (spread to lungs, good marker profile): 90 to 95%. Stage III intermediate-risk: 75 to 85%. Stage III poor-risk (non-pulmonary spread, very high markers): 50 to 70%. Even poor-risk Stage III — which in many other cancers would carry a very unfavourable outlook — retains a meaningful cure rate, reflecting the unique chemosensitivity of testicular cancer cells.
In most cases, yes. One healthy testicle produces sufficient testosterone and sperm to support normal fertility. Most men who have had one testicle removed retain normal hormone levels and can father children naturally. Testosterone levels are rarely affected because the remaining testicle compensates. However, some chemotherapy regimens can temporarily reduce sperm production, and it takes 1 to 2 years for counts to recover fully after treatment. Men who are concerned about fertility should discuss this with their oncologist before chemotherapy begins, as sperm banking and other options are available to protect future fertility.
Orchidectomy: ₹60,000 to ₹1,80,000. For Stage I patients on active surveillance, annual monitoring (CT scans + blood tests) is ₹20,000 to ₹60,000 per year, with no treatment cost unless relapse occurs. BEP chemotherapy: ₹50,000 to ₹1,50,000 per cycle; a standard 3-cycle course costs ₹1,50,000 to ₹4,50,000. RPLND (abdominal lymph node surgery): ₹2,00,000 to ₹5,00,000. Radiation therapy for Stage II seminoma: ₹1,20,000 to ₹2,50,000. A personalised estimate is provided after your CION consultation. EMI options are available for all patients.
Absolutely — and for testicular cancer, a second opinion is particularly valuable in three situations: if chemotherapy or radiation has been recommended for Stage I disease without a discussion of active surveillance (surveillance avoids unnecessary treatment in the majority who are already cured); if you are a non-seminoma patient after chemotherapy with a residual abdominal mass and have not been offered RPLND assessment; and if you have been told your cancer is not responding to treatment — second-line options exist and should be reviewed by a specialist centre. CION offers a dedicated Second Opinion service with a free written second opinion.
