Testicular cancer is considered rare in older men but remains possible because of the nature of how this cancer develops and the biological changes that can occur in the testicles over a lifetime. While testicular cancer is most commonly diagnosed in younger men, particularly those between 15 and 40 years old, it does not completely disappear as a risk in older age. The reasons for this involve the types of cells involved, the biology of the testicles, and the way cancer can arise from genetic changes in cells.
Testicular cancer primarily originates from germ cells, which are the cells responsible for producing sperm. These germ cell tumors are the most common form of testicular cancer and are divided mainly into two types: seminomas and non-seminomas. Seminomas tend to develop more slowly and usually affect men between 25 and 45 years old but can occur in older men as well. Non-seminomas tend to develop more quickly and are more common in younger men, especially in their late teens and early twenties. Sometimes, tumors can be a mix of both types, called mixed germ cell tumors. Besides germ cell tumors, there are also stromal tumors, which arise from the supportive and hormone-producing cells of the testicles, but these are much less common and often benign.
The reason testicular cancer is rare in older men is partly because the peak incidence is in younger men when germ cells are more active and undergoing more frequent division, which increases the chance of DNA errors that can lead to cancer. As men age, the activity of germ cells decreases, reducing the likelihood of these cancers developing. However, older men can still develop testicular cancer because abnormal changes in DNA can happen at any age. These changes cause cells to grow uncontrollably, forming tumors. Some germ cell tumors, especially seminomas, can appear later in life, even beyond 50 years old.
Another factor is that some testicular cancers begin as a condition called germ cell neoplasia in situ (GCNIS), where abnormal cells exist but have not yet spread. GCNIS can remain dormant or undetected for years before developing into cancer, which means cancer can appear later in life even if the initial abnormality started earlier. This latent potential contributes to the possibility of testicular cancer in older men.
Risk factors such as a history of undescended testicles, family history of testicular cancer, or previous testicular cancer can increase the chance of developing the disease at any age. However, these risk factors are more often linked to younger men. In older men, testicular cancer is less common but still possible because the underlying genetic mutations or environmental exposures that cause cancer can accumulate over time.
Symptoms of testicular cancer in older men are similar to those in younger men and include a lump or swelling in the testicle, a feeling of heaviness in the scrotum, or a dull ache in the groin or lower abdomen. Pain is not usually a symptom, which can sometimes delay diagnosis. Because testicular cancer is less expected in older men, there can be a lack of awareness, leading to later detection.
Despite its rarity in older men, testicular cancer remains highly treatable, especially when caught early. Treatments include surgery, radiation, and chemotherapy, and the prognosis is generally good. Regular self-exams and medical check-ups can help detect any unusual changes early, regardless of age.
In summary, testicular cancer is rare but possible in older men because the biological processes that cause it—genetic mutations in germ cells—can occur at any age, though they are more common in younger men. The presence of conditions like GCNIS, the potential for dormant abnormal cells to become cancerous later, and accumulated genetic damage over time all contribute to the possibility of testicular cancer in older age, even though it is much less frequent than in younger men.