More generally, if a young adult or adolescent has a single enlarged testicle, which may or may not be painful, this should give doctors reason to suspect testicular cancer.

The differential diagnosis of testicular cancer requires examining the histology of tissue obtained from an inguinal orchiectomy—that is, surgical excision of the entire testis along with attached structures (epididymis and spermatic cord).

[citation needed] Blood tests are also used to identify and measure tumor markers (usually proteins present in the bloodstream) that are specific to testicular cancer.

[citation needed] A pregnancy test may be used to detect high levels of chorionic gonadotropin; however, the first sign of testicular cancer is usually a painless lump.

To some extent, this can be done via blood tests for tumor markers, but definitive diagnosis requires examination of the histology of a specimen by a pathologist.

[38] Most pathologists use the World Health Organization classification system for testicular tumors:[39] The three basic types of treatment are surgery, radiation therapy, and chemotherapy.

However, this approach, while standard in many places, especially in the United States, is out of favor due to costs and the high level of expertise required to perform successful surgery.

If the cancer is not particularly advanced, patients may be offered careful surveillance by periodic CT scans and blood tests, in place of adjuvant treatment.

[48] The landmark trial published in 1987 which established BEP as the optimum treatment was conducted by Dr. Lawrence Einhorn at Indiana University.

[50] Lymph node surgery may also be performed after chemotherapy to remove masses left behind (stage 2B or more advanced), particularly in the cases of large non-seminomas.

The concept of carboplatin as a single-dose therapy was developed by Tim Oliver, Professor of Medical Oncology at Barts and The London School of Medicine and Dentistry.

[citation needed] Since seminoma can recur decades after the primary tumor is removed, patients receiving adjuvant chemotherapy should remain vigilant and not assume they are cured 5 years after treatment.

[53] In 2011 overall cure rates of more than 95% were reported, and 80% for metastatic disease—the best response by any solid tumor, with improved survival being attributed primarily to effective chemotherapy.

[4] By 2013 more than 96 percent of the 2,300 men diagnosed each year in the U.K. were deemed cured, a rise by almost a third since the 1970s, the improvement attributed substantially to the chemotherapy drug cisplatin.

[56] The form this surveillance takes, e.g. the type and frequency of investigations and the length time it should continue, will depend on the type of cancer (non-seminoma or seminoma), but the aim is to avoid unnecessary treatments in the many patients who are cured by their surgery, and ensure that any relapses with metastases (secondary cancers) are detected early and cured.

For patients treated for stage I seminoma who choose surveillance rather than undergoing adjuvant therapy, there have been no randomized trials to determine the optimum frequency of scans and visits, and the schedules vary very widely across the world, and within individual countries.

MRI is being investigated because it does not expose the patient to radiation and so, if it is shown to be as good at detecting relapses, it may be preferable to CT.[citation needed] For more advanced stages of testicular cancer, and for those cases in which radiation therapy or chemotherapy was administered, the extent of monitoring (tests) after treatment will vary based on the circumstances but normally should be done for five years in uncomplicated cases and for longer in those with higher risks of relapse.

[63] Castration or partial removal is associated with fantasies, beliefs, myths, and cultural norms surrounding the testes, which can lead to severe psychological trauma and consequences for the individual.

[64] Since testicles have long been seen as symbols of strength, bravery, and masculinity, having surgery to remove them can change how men with testicular cancer view themselves and what it means to be a man.

[64] Males aged 18–24 encounter distinct gender-specific social factors that are linked to a decrease in mental health outcomes.

[64] These social factors include limited access to health services and engagement, stigma related to masculinity, and cultural expectations.

[64] Single or unemployed men are at a higher risk of poorer psychological outcomes that are correlated with an impairment of sexual functions and masculinity.

[65] These concerns are important for teenage boys going through puberty or recently experiencing physical changes, which can shape their developing understanding of their sexual identity.

[65] This involves feeling disconnected from those who haven't been through a similar intense experience, questioning the purpose of their existence, and becoming more aware of life's fragility and the certainty of death.

[63] Difficulties in physiological aspects such as achieving erection and ejaculation are correlated with the severity of the disease and the methods of treatment employed such as surgery, radiotherapy, or chemotherapy.

[63] Nonetheless, treatment approaches for testicular cancer can induce physiological alterations while simultaneously eliciting emotional responses.

[63]  Therefore, diminished sexual function (such as decreased libido or inhibition) may result from treatment-related physical factors like fatigue, overall discomfort, hair loss, and significant weight fluctuations, as well as emotional factors including concerns about sexual performance, fear of losing control, and ambiguity regarding what lies ahead.

[65] Many cancer survivors, both young and older adults, have reported benefits and personal growth in the months and even years following their diagnosis.

[65] Furthermore, researchers have discovered that while the journey of testicular cancer initially brings physical and emotional challenges, it also leads many survivors to develop a newfound gratitude for life.

[65] Besides improving mental outlook, going through testicular cancer might also motivate men to adopt healthier behaviors such as: These positive changes in lifestyle could contribute to better psychological well-being, which can offset any initial difficulties they face.