Answered by SecondMedic Expert
Urologist · Urology
Yes, in rare cases untreated testicular cancer can spread to the other testicle. This is known as metachronous contralateral testicular cancer and it typically occurs after a long latency period of several years or even decades following removal of the first tumor.
The risk factors for metachronous contralateral testicular cancer include age at diagnosis, race and ethnicity, degree of histological differentiation (the grade) of the primary tumor at diagnosis, stage at diagnosis, type of treatment received for the original germ cell tumor (GCT), extent and local dissemination pattern of GCT before treatment began - including palpable lymphadenopathy or non-palpable retroperitoneal nodal occurrence on imaging - as well as its clinical behavior once treated.
Men who had metastatic disease (disease that has spread beyond the original site) prior to treatment are more likely to develop metachronous contralateral GCT than those who did not have detectable metastases before initial therapy begins. The most common route through which cancer cells travel from one side to another is via blood vessels; if an individual has multiple tumors with sites that are connected through their blood supply pathways then this could be a route for cells from one side to travel over to another area.
When considering risk for developing this condition patients should discuss any personal history with their healthcare provider so they can get personalized advice about how best to monitor their health going forward and reduce their chances for developing new cancers in either scrotum/testicle region.
