What Scott Hamilton's Story Can Teach Us About Testicular Cancer

The part of the story that is on the record

Scott Hamilton, the Olympic gold medalist in figure skating, was diagnosed with testicular cancer in 1997. His own foundation, the Scott Hamilton CARES Foundation, states that he was later found to have brain tumors in 2004, 2010, and 2016. His mother, Dorothy, was diagnosed with breast cancer when he was a teenager and died in 1977.

He built things out of all of that. He created Chemocare.com and the 4th Angel Mentoring Program, and in 2014 he founded the CARES Foundation, whose stated mission is funding research that "treats the cancer while sparing the patient."

Those are the disclosed facts, and this article does not go past them. What follows is about the disease, because that is the part a reader can actually use.

A cancer that finds men young

Testicular cancer usually starts in germ cells, the cells that make sperm. It is uncommon. The American Cancer Society projects 9,810 new cases and 630 deaths in the United States in 2026, a pair of figures SEER carries on its page. That is about 0.5 percent of all new cancer diagnoses, and it ranks 25th among cancer types.

What sets it apart is age. The median age at diagnosis is 33, and just over half of new cases occur in men between 20 and 34. It tends to arrive at a point in life when almost nobody is expecting it.

Doctors sort these tumors into two families, seminoma and nonseminoma, and the National Cancer Institute says the split matters because the two groups "have different prognostic and treatment algorithms." In plain terms, the label changes the plan.

What it feels like

The classic first sign is a lump that does not hurt. NCI lists these findings:

• A painless lump or swelling in either testicle.
• A change in how the testicle feels.
• A dull ache in the lower abdomen or the groin.
• A sudden build-up of fluid in the scrotum.
• Pain or discomfort in a testicle or in the scrotum.

Britain's NHS adds a few more to that list, including a testicle that is getting bigger, a scrotum that feels heavy, firm, or hard, and back pain. Most men with these findings turn out not to have cancer, since infections, cysts, and fluid collections cause the same things.

When to get checked

Make an appointment, rather than waiting to see what happens, for any of these:

• Any firm lump on a testicle, even a small one, and even if it does not hurt.
• One testicle that has grown noticeably larger or harder than it was.
• A dull ache in the groin or lower belly that has lasted more than two weeks.
• New heaviness in the scrotum, or fluid that built up suddenly.
• Any change in a testicle that is simply not normal for you.

There is no routine screening test for testicular cancer, and NCI does not recommend one for men without symptoms. That makes noticing changes the whole strategy. A lump that is still there after two weeks needs an examination, not another two weeks of watching.

How the diagnosis is made

The workup starts with a physical exam and an ultrasound of the scrotum, which uses sound waves and causes no pain. Blood is drawn at the same time for three tumor markers, meaning substances a tumor releases into the blood.

Alpha-fetoprotein, or AFP, is raised in 40 to 60 percent of nonseminomas. Seminomas do not make it at all, so a raised AFP tells the team to treat the tumor as a nonseminoma whatever the slide shows. Beta-hCG is raised in about 14 percent of stage I pure seminomas, about half of seminomas that have spread, and 40 to 60 percent of nonseminomas. Lactate dehydrogenase, or LDH, is the least specific of the three, because many conditions unrelated to cancer push it up.

Confirmation comes from surgery rather than a needle. The standard step is an inguinal orchiectomy, which removes the whole testicle through an incision in the groin. Doctors avoid a needle biopsy through the scrotum because of concern that it could seed tumor cells along a new path.

Staging then follows the AJCC TNM system, running from stage 0, called germ cell neoplasia in situ, through stages I to III, based on how far the tumor has reached.

What treatment involves

Options depend on the type and the stage. NCI describes surgery to remove the testicle and, in some cases, nearby lymph nodes. Radiation therapy and chemotherapy are used at various stages, and high-dose chemotherapy followed by a stem cell transplant is an option in some situations.

Surveillance is also a real plan, not a passive one. It means skipping further treatment after surgery and instead following a fixed schedule of exams, blood markers, and scans, so that anything that returns is caught early.

One conversation belongs before treatment starts, not after. NCI warns that "certain treatments for testicular cancer can cause infertility that may be permanent," and it advises men who may want children to ask about sperm banking first.

The numbers, and what they do not say

Five-year relative survival for testicular cancer is 94.6 percent for men diagnosed from 2016 to 2022, as measured by NCI's SEER program. NCI reports that seminomas have a cure rate above 90 percent across all stages, and that low-stage seminomas and nonseminomas approach 100 percent.

These are group figures drawn from thousands of men, and they describe that group rather than any individual. Type, stage, and marker levels all shift the picture for one person.

Survivorship has its own agenda. Men treated for testicular cancer face a higher chance of cancer in the remaining testicle, so NCI advises regular self-checks and prompt reporting of anything unusual. Long-term follow-up has also shown cardiac events roughly 2.5 times higher in treated men than in men managed with surveillance over ten years, which is a reason for lasting attention to blood pressure, lipids, and heart health.

Sources

• https://www.cancer.gov/types/testicular/hp/testicular-treatment-pdq
• https://www.cancer.gov/types/testicular/patient/testicular-treatment-pdq
• https://www.cancer.gov/types/testicular/symptoms
• https://seer.cancer.gov/statfacts/html/testis.html
• https://medlineplus.gov/testicularcancer.html
• https://www.nhs.uk/conditions/testicular-cancer/symptoms/
• https://www.scottcares.org/about/scott-hamilton