My Reports
RGCIRC, Niti Bagh
Testicular Cancer Treatment in Delhi, India
Testicular cancer often affects younger men, so a diagnosis may bring concerns not only about cancer treatment but also about fertility, sexual health, hormone levels and life after treatment. The good news is that testicular cancer is highly treatable, including many cases in which the cancer has spread beyond the testicle.
At Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC), Delhi, testicular cancer is managed by a specialised Uro-Oncology team, with treatment planned according to the type of cancer, tumour markers, stage, lymph-node or distant spread, and the patient’s overall health.
Treatment usually begins with surgery to remove the affected testicle and, depending on the diagnosis and stage, may be followed by active surveillance, chemotherapy, radiation therapy or surgery to remove affected lymph nodes. At RGCIRC, our focus is on achieving effective cancer control while also considering the longer-term impact of treatment on fertility, hormonal health and quality of life.
Understanding Testicular Cancer and Its Main Types
Testicular cancer develops when abnormal cells begin to grow in a testicle. The testicles are part of the male reproductive system and produce sperm and the hormone testosterone. Most testicular cancers begin in germ cells, the cells involved in sperm production.
For treatment planning, testicular germ-cell cancers are mainly divided into seminoma and nonseminoma. This distinction is important because the two types tend to grow and spread differently and may require different treatment approaches.
Seminoma
Seminomas generally grow and spread more slowly than nonseminomas. They are highly sensitive to chemotherapy and are also sensitive to radiation therapy. The treatment approach depends on the stage of the cancer and whether it has spread beyond the testicle.
Nonseminoma
Nonseminomas tend to grow and spread more quickly and often affect younger men. This group includes several tumour types, such as embryonal carcinoma, yolk sac tumour, choriocarcinoma and teratoma. A tumour may contain more than one of these cell types.
Some testicular tumours contain both seminoma and nonseminoma cells. These mixed germ-cell tumours are treated as nonseminomas because their behaviour and treatment approach are closer to this group.
Knowing whether the cancer is a seminoma or nonseminoma, along with its stage and tumour-marker levels, helps the treatment team decide what care is required after the initial surgery.
Early Signs and Symptoms of Testicular Cancer
Testicular cancer often begins with a change in one testicle. In many cases, the first sign is a painless lump or swelling, which is why even a change that does not hurt deserves attention. Pain may occur in some patients, but it is not always present.
Possible signs and symptoms include:
- A painless lump or swelling in one testicle
- A change in the size, shape or firmness of a testicle
- A feeling of heaviness in the scrotum
- A dull ache in the lower abdomen or groin
- Pain or discomfort in a testicle or the scrotum
- A sudden build-up of fluid or swelling in the scrotum
- Back or abdominal pain in some patients when the disease has spread
- Breast tenderness or enlargement in a small number of patients
When Should a Testicular Change Be Checked?
Not every testicular lump or swelling is cancer. Infections, cysts and other non-cancerous conditions may cause similar changes. Still, a new lump, persistent swelling, change in firmness or unexplained discomfort should be examined by a doctor rather than monitored at home for a long time.
A prompt evaluation helps identify the cause and, if testicular cancer is present, allows diagnosis and treatment to begin without unnecessary delay.
Who is at Higher Risk of Testicular Cancer?
The exact reason testicular cancer develops is often unknown. Unlike some other cancers, it does not have a strong established link with lifestyle factors such as diet or tobacco use. Certain medical and family-history factors are, however, associated with a higher risk.
The risk may be higher in:
- Men born with an undescended testicle: Also called cryptorchidism, this occurs when one or both testicles do not move into the scrotum before birth. It is one of the most established risk factors for testicular cancer. Having surgery to correct an undescended testicle, particularly at an early age, reduces the risk but does not remove it completely.
- Men who have previously had testicular cancer: A previous tumour in one testicle increases the risk of developing cancer in the other testicle.
- Those with a close family history: The risk is higher when a father or brother has had testicular cancer.
- Men with certain abnormalities in testicular development or function: Conditions associated with abnormal testicular development, reduced sperm production or impaired fertility are linked with a higher risk of testicular germ-cell tumours.
Testicular cancer is also more commonly diagnosed in younger and middle-aged men than in older adults. Having one or more risk factors does not mean that cancer will develop, and many patients have no known risk factor at the time of diagnosis.
How is Testicular Cancer Diagnosed at RGCIRC?
A testicular lump does not always mean cancer. Diagnosis begins with a careful examination and tests that help doctors understand whether the lump is suspicious, what type of tumour may be present and whether the disease has spread beyond the testicle.
Clinical Examination
A uro-oncologist examines both testicles to check for a lump, swelling or change in size, firmness or texture. The abdomen and relevant lymph-node areas may also be examined for signs that require further investigation.
Testicular Ultrasound
An ultrasound is usually the first imaging test when testicular cancer is suspected. It uses sound waves to show the inside of the testicle and helps doctors determine whether a lump lies within the testicle and whether it has features that raise concern for cancer. Current guidelines recommend ultrasound assessment of both testicles when a testicular tumour is suspected.
Blood Tests for Testicular Tumour Markers
Blood tests are used to measure substances known as tumour markers. The main markers checked in testicular cancer are:
- Alpha-fetoprotein (AFP)
- Beta-human chorionic gonadotropin (beta-hCG)
- Lactate dehydrogenase (LDH)
These markers are measured before and after surgery and may help with staging, risk assessment, monitoring treatment response and detecting recurrence.
A normal tumour-marker result does not rule out testicular cancer because some testicular tumours do not produce raised markers.
Radical Inguinal Orchidectomy to Confirm the Diagnosis
Unlike many cancers, a suspicious testicular tumour is generally not diagnosed through a routine needle biopsy of the testicle. When ultrasound and other findings strongly suggest cancer, the usual approach is a radical inguinal orchidectomy, in which the affected testicle is removed through an incision in the groin. The removed tissue is examined by a pathologist to confirm whether cancer is present and determine whether it is a seminoma, nonseminoma or another tumour type.
The procedure therefore serves two purposes: it establishes the diagnosis and removes the primary tumour.
Imaging to Check Whether Cancer Has Spread
If testicular cancer is confirmed, doctors may recommend CT scans of the chest, abdomen and pelvis to check for involvement of lymph nodes or other organs. Additional imaging is considered only when clinically required. FDG-PET is not routinely recommended for the initial staging of testicular cancer.
Once the pathology report, tumour-marker results and imaging findings are available, the team determines the stage of the cancer and plans the next steps.
Understanding Testicular Cancer Stages
After testicular cancer is confirmed, doctors determine whether it is limited to the testicle or has spread elsewhere. This process is called staging. Unlike many cancers, testicular cancer staging also takes blood levels of the tumour markers AFP, beta-hCG and LDH into account.
In simple terms:
- Stage I: Cancer remains limited to the testicle and nearby structures and has not spread to lymph nodes or distant organs. Some Stage I cancers may have persistently raised tumour markers after surgery, which affects their classification.
- Stage II: Cancer has spread to nearby lymph nodes, usually those at the back of the abdomen. The size and number of affected lymph nodes help determine whether the cancer is Stage IIA, IIB or IIC.
- Stage III: Cancer has spread more widely, such as to distant lymph nodes, the lungs or other organs. Significantly raised tumour-marker levels may also contribute to Stage III classification.
There is also a Stage 0, known as germ cell neoplasia in situ, where abnormal germ cells remain within the tiny tubules of the testicle and have not developed into invasive cancer.
The stage, whether the tumour is a seminoma or nonseminoma, and the tumour-marker levels after orchidectomy help doctors determine what treatment or surveillance is required next.
Testicular Cancer Treatment Options at RGCIRC
Testicular cancer treatment depends mainly on whether the tumour is a seminoma or nonseminoma, its stage, tumour-marker levels after surgery and whether the disease has spread beyond the testicle. The team also considers overall health, previous treatment and fertility plans before recommending the next step.
Radical Inguinal Orchidectomy
For most testicular cancers, treatment begins with a radical inguinal orchidectomy, in which the affected testicle is removed through an incision in the groin. The procedure removes the primary tumour and provides tissue for the pathologist to confirm the exact cancer type.
Removal of one testicle does not automatically affect sexual function or testosterone levels when the remaining testicle is healthy. Fertility is discussed before treatment because testicular cancer itself and later treatments may affect sperm production.
In selected situations, testis-sparing surgery may be considered, such as for certain small tumours, cancer affecting both testicles or a tumour in a solitary testicle. It is not the standard approach for most testicular germ-cell cancers.
Active Surveillance After Surgery
Some patients with Stage I testicular cancer may not require chemotherapy or radiation therapy immediately after orchidectomy. Instead, doctors may recommend active surveillance when the risk of recurrence and individual circumstances make this an appropriate option.
Surveillance involves scheduled clinical reviews, tumour-marker blood tests and imaging at defined intervals. It allows doctors to avoid unnecessary additional treatment while monitoring closely for recurrence. If the cancer returns, further treatment is started promptly. Current EAU guidance recommends surveillance as a preferred option for many patients with Stage I seminoma and appropriate Stage I nonseminoma who can follow a structured surveillance programme.
Chemotherapy for Testicular Cancer
Chemotherapy plays an important role when testicular cancer has spread beyond the testicle and in selected patients at higher risk of recurrence.
Cisplatin-based chemotherapy forms the basis of treatment for many metastatic seminomas and nonseminomas. The combination of medicines and number of treatment cycles depend on the cancer type, stage, tumour-marker levels and prognostic risk group.
During treatment, the care team monitors blood counts, kidney function and other possible side effects. Fertility preservation is also discussed before chemotherapy begins whenever appropriate.
Radiation Therapy for Selected Seminomas
Radiation therapy has a role in selected seminomas, particularly in certain limited Stage II cases. It is not routinely used to treat nonseminoma.
For Stage I seminoma, current treatment has increasingly moved towards surveillance rather than routine radiation because many patients are cured by surgery alone and unnecessary radiation may cause long-term effects.
Retroperitoneal Lymph-Node Dissection (RPLND)
Testicular cancer may spread to lymph nodes at the back of the abdomen, known as the retroperitoneal lymph nodes. Retroperitoneal lymph-node dissection (RPLND) removes these nodes and may be recommended for selected patients with nonseminoma or for residual masses that remain after chemotherapy.
RGCIRC’s Uro-Oncology programme offers robot-assisted retroperitoneal lymph-node dissection for testicular tumours. The team has also published long-term institutional experience with robot-assisted RPLND for post-chemotherapy residual masses in testicular cancer.
Treatment for Recurrent or Advanced Testicular Cancer
If testicular cancer returns after initial treatment, the next approach depends on the cancer type, where it has returned and the treatment already received. Options may include further chemotherapy and surgery to remove residual disease. More intensive treatment strategies may be considered for selected patients with relapsed or difficult-to-treat disease.
Clinical Trials at RGCIRC
RGCIRC has a dedicated clinical research programme evaluating newer cancer treatments and treatment approaches. Patients with testicular cancer may be considered for a suitable clinical trial when one is available and matches the diagnosis, stage, previous treatment and overall health.
Participation is voluntary. Before enrolment, the treating and research teams explain the purpose of the trial, possible benefits and risks, and the standard treatment options available.
Fertility, Sexual Health and Follow-Up After Testicular Cancer Treatment
Testicular cancer often affects men at an age when fertility and future family planning may be important concerns. For this reason, discussions about fertility, hormonal health and long-term follow-up form an important part of care before and after treatment.
Fertility and Sperm Banking
Testicular cancer itself may affect sperm production in some patients, and treatments such as chemotherapy, radiation therapy or certain lymph-node surgeries may further affect fertility. Current EAU guidelines recommend discussing sperm banking before starting testicular cancer treatment.
Sperm banking involves collecting and freezing sperm for possible future use. The treating team may recommend fertility counselling before treatment, particularly for patients who may wish to have children in the future.
Hormonal and Sexual Health
Removing one testicle does not usually mean a loss of sexual function. When the remaining testicle is healthy, it generally continues to produce testosterone required for sexual function and other body processes.
Some patients may still experience changes related to treatment, body image or emotional well-being. If symptoms suggest a hormonal problem, the care team may recommend further evaluation and appropriate management.
Testicular Prosthesis
Patients undergoing removal of a testicle may also choose to have a testicular prosthesis, an artificial implant placed in the scrotum to restore its appearance. This is a personal choice and does not affect cancer treatment. Current EAU guidance recommends that the option of a prosthesis be offered to patients undergoing removal of one or both testicles.
Follow-Up After Testicular Cancer Treatment
Regular follow-up helps doctors monitor for recurrence and manage any long-term effects of treatment. The schedule depends on the cancer type, stage and treatment received rather than following one identical plan for every patient.
Follow-up may include:
- Clinical examination
- Blood tests for AFP, beta-hCG and LDH where appropriate
- CT or MRI at recommended intervals
- Monitoring for treatment-related side effects
- Assessment of fertility, hormonal health and general well-being when required
Patients on active surveillance generally require particularly careful adherence to scheduled appointments because follow-up is what allows recurrence to be detected and treated promptly. Patients with more complex or higher-risk disease may require an individualised follow-up plan at a specialised cancer centre.
Why Choose RGCIRC for Testicular Cancer Treatment in Delhi?
At RGCIRC, we understand that testicular cancer treatment may raise questions not only about controlling the disease, but also about fertility, hormonal health and life after treatment. Our Uro-Oncology team works with specialists across cancer care to plan treatment according to the tumour type, stage and individual needs, while considering long-term health from the beginning.
Here’s why patients and families trust RGCIRC for testicular cancer treatment in Delhi:
Dedicated Uro-Oncology Expertise
Our Department of Uro-Oncology has been providing specialised cancer care since 1996 and manages testicular tumours along with other cancers of the urinary and male reproductive systems. The department combines open, laparoscopic and robotic surgical expertise with access to medical and radiation oncology when additional treatment is required.
Multidisciplinary Cancer Care
Testicular cancer care may involve surgery, chemotherapy, specialised pathology, tumour-marker assessment, imaging and, in selected cases, radiation therapy. Our specialists work together to review these findings and decide whether a patient requires surveillance, additional treatment or surgery for residual disease. RGCIRC follows an organ-specific multidisciplinary approach, with tumour-board review available for complex cases.
Expertise in Retroperitoneal Lymph-Node Surgery
RGCIRC offers robot-assisted retroperitoneal lymph-node dissection (RPLND) for selected testicular tumours. Our Uro-Oncology team has also published its experience with robot-assisted RPLND for residual masses that remain after chemotherapy, reflecting specialised expertise in a complex area of testicular cancer surgery.
RGCIRC’s work in this field was further recognised with Special Recognition for Clinical Leadership in Uro-Oncology at the 7th Cancer Summit & Awards in 2026.
Accreditation, Recognition and Accessible Cancer Care
RGCIRC holds NABH and NABL accreditations, along with Green OT and Nursing Excellence certifications. The Institute was recognised among Newsweek’s World’s Best Specialised Hospitals in 2024 and 2025, ranked No. 1 in North India among single-specialty hospitals in The Times of India’s 2025 critical-care hospital survey, and received the Best Oncology Hospital of the Year award at the Cancer Summit & Awards 2026.
Established in 1996 as a not-for-profit cancer centre, RGCIRC also works to make specialist cancer care more accessible. Its Philanthropy Department supports eligible patients through financial assistance and subsidised care. Over the years, RGCIRC has cared for more than 3.5 lakh patients from India and neighbouring regions.
Consult a Testicular Cancer Specialist at RGCIRC
If you or a loved one has been diagnosed with testicular cancer, has a new or persistent testicular lump, or needs a second opinion on the recommended treatment, our Uro-Oncology team can review the diagnosis, explain the available options and guide the next steps based on the tumour type and stage.
To book a consultation, schedule an appointment online or download the RGCI Care app on iOS or Android.
For appointments:
Rohini: +91-11-4702 2222
Niti Bagh, South Delhi: +91-11-4582 2222
OPD Hours: Monday to Saturday, 9:00 AM to 5:00 PM
Emergency Services: Available 24×7 at both campuses
Frequently Asked Questions About Testicular Cancer
Doctors commonly measure three serum tumour markers:
- AFP (alpha-fetoprotein)
- beta-hCG (beta-human chorionic gonadotropin)
- LDH (lactate dehydrogenase)
These markers help with staging, risk assessment, monitoring treatment and detecting recurrence. They are usually checked before and after orchidectomy and during follow-up when appropriate.
Testicular cancer is highly treatable and usually curable, including many cases where the disease has spread beyond the testicle. The outlook depends on whether the tumour is a seminoma or nonseminoma, its stage, tumour-marker levels and response to treatment. NCI reports particularly high cure rates for low-stage testicular germ-cell tumours.