Listing 13.25 Male Genital Tract Cancer in 2026

By Anthony Albert, Benefits Research Director at Disability Exchange · Published 2026-08-04 · 12-minute read

Male genital tract cancers get lumped together in SSA's Blue Book, but the diseases underneath the listing look nothing alike. Penile cancer is rare and often devastating. Testicular cancer is highly curable even when metastatic, which creates a strange dynamic at DDS. Prostate cancer is by far the most common of the three, with a whole set of listings and cross-references. If you're reading this, you already know your diagnosis. This article walks through how Listing 13.25 actually plays out for each cancer, what SSA reads carefully, and where cases get denied.

The Listing 13.25 rule

Listing 13.25 covers cancers of the male genital tract other than prostate. Prostate cancer has its own listing at 13.24. Here's the exact 13.25 rule:

Cancers of the male genital tract that are inoperable or unresectable, or that have recurred after initial anticancer therapy, or that have metastasized beyond the regional lymph nodes.

Four qualifying conditions. Any one meets the listing. No RFC analysis if the medical piece is documented. The listing covers penile, testicular, and rare urethral cancers. Prostate cancer routes to Listing 13.24, but I'll cover it here too because the questions overlap.

Testicular cancer under 13.25

About 10,090 new US testicular cancer cases are projected for 2026, per American Cancer Society, with roughly 490 deaths. The disease is common in men aged 15-45 and rare after 55. Two big subtypes matter:

Seminoma

Slower-growing, radiosensitive. Stage I seminoma has 5-year survival near 99%. Standard treatment for early-stage disease is orchiectomy (surgical removal of the testicle) plus surveillance, adjuvant carboplatin AUC 7, or radiation to the retroperitoneum. Advanced seminoma gets platinum-based chemo, usually BEP (bleomycin, etoposide, cisplatin) x 3 cycles or EP x 4 cycles.

Non-seminoma

Includes embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma. More aggressive than seminoma. Stage I non-seminoma still has 5-year survival above 95% with orchiectomy plus surveillance or RPLND (retroperitoneal lymph node dissection) or one cycle of BEP. Advanced non-seminoma is treated by IGCCCG risk group: good risk gets BEP x 3, intermediate gets BEP x 4, poor risk gets BEP x 4 or VIP x 4.

The testicular cancer paradox at DDS

Testicular cancer is one of the most curable solid tumors. Even Stage III non-seminoma has 5-year survival around 70-80%. So DDS examiners sometimes deny testicular cancer applications on the theory that treatment is likely to work within 12 months. The listing doesn't require permanence, but the durational rule in SSA regs does require expected duration of 12+ months or death.

Where testicular cancer cases clear the listing:

• Metastasized beyond regional nodes at diagnosis: Stage III or Stage IV disease with pulmonary, hepatic, brain, or bone metastases. Retroperitoneal nodes are regional. Mediastinal, supraclavicular, or lung mets are distant.
• Recurred after initial anticancer therapy: post-orchiectomy relapse, post-chemo relapse, or platinum-refractory disease. Salvage regimens like TIP (paclitaxel, ifosfamide, cisplatin), VeIP (vinblastine, ifosfamide, cisplatin), or high-dose chemo with autologous stem cell rescue apply.
• Cisplatin-refractory disease: disease that progresses during or shortly after platinum therapy. Poor prognosis. Meets the recurrent prong.

Where testicular cancer cases get harder at DDS:

• Stage I resected disease on surveillance: not disabling by itself, though ongoing surveillance schedule (CT every 3-6 months, tumor markers every 1-2 months) can create absences and mental health strain that support a Medical-Vocational finding.
• Stage IIA seminoma treated with radiation alone: the disease is likely resolved. RFC path only.

Penile cancer under 13.25

Penile cancer is rare. About 2,240 new US cases projected for 2026 and around 500 deaths. Squamous cell carcinoma is the dominant histology (over 95%), with HPV-related and non-HPV-related pathways. Verrucous carcinoma, melanoma, and sarcoma are rare variants.

Treatment

Early-stage disease (Tis, Ta, T1a) can be treated with topical therapy (5-FU or imiquimod), laser ablation, glansectomy, or partial penectomy. Higher-stage disease gets partial or total penectomy, often with inguinal lymphadenectomy. Advanced or metastatic disease is treated with cisplatin-based chemotherapy (TIP: paclitaxel, ifosfamide, cisplatin, or 5-FU plus cisplatin). Immunotherapy (pembrolizumab) has activity in select cases, particularly HPV-driven or high-TMB disease.

Five-year survival by stage

• Localized: about 82%.
• Regional (positive inguinal nodes): about 48%.
• Distant metastases: about 12%.

Where penile cancer meets 13.25

• Inoperable or unresectable: tumor invading femoral vessels or extending to pelvic bones. Rare but does happen with delayed presentation.
• Recurrent: local recurrence at surgical margin, regional inguinal recurrence, or distant recurrence. Penile cancer local recurrence rates run 15-30% after conservative surgery, less after penectomy.
• Metastatic beyond regional nodes: lung, liver, bone. Median survival with distant mets is under 12 months even with chemo.

Prostate cancer routes to Listing 13.24

Prostate cancer sits in a separate listing at 13.24, not 13.25, but you'll see it discussed alongside because DDS examiners handle both under the male reproductive umbrella. The 13.24 rule:

Prostate cancer that has metastasized beyond regional lymph nodes with progressive disease despite anticancer therapy, or that is small cell (oat cell) carcinoma.

Two paths. Small cell prostate cancer (rare, aggressive) qualifies automatically. All other prostate cancers need metastatic disease beyond regional nodes AND progression despite treatment. This is stricter than 13.25's four-condition rule and it's why metastatic prostate cancer is not automatically a listing win when hormone therapy is still working.

When prostate cancer meets 13.24

• Castration-resistant prostate cancer with bone metastases progressing on ADT.
• Metastatic hormone-sensitive prostate cancer that progresses despite triplet therapy (ADT + docetaxel + abiraterone or darolutamide).
• Neuroendocrine or small cell differentiation on repeat biopsy of previously typical prostate cancer.

When prostate cancer doesn't meet 13.24

• Newly diagnosed metastatic prostate cancer responding well to ADT plus abiraterone.
• PSA-only recurrence with no imaging evidence of metastases.
• Localized high-risk disease post-prostatectomy or post-radiation with no metastases.

These don't-meet cases often still win at ALJ under the Medical-Vocational path with documented functional limitations from ADT side effects (fatigue, cognitive changes, muscle weakness, cardiovascular disease, osteoporosis, hot flashes, mood changes).

Evidence checklist for a strong 13.25 or 13.24 application

1. Pathology report naming tumor type. For testicular: seminoma vs non-seminoma with mixed germ cell components broken out. For penile: SCC with grade and depth of invasion. For prostate: Gleason score, ISUP grade group, and any small cell or neuroendocrine differentiation.
2. Tumor markers where applicable. Testicular: AFP, beta-hCG, LDH pre-orchiectomy and post-orchiectomy. Prostate: PSA baseline and follow-up.
3. Staging imaging. CT chest, abdomen, pelvis. MRI pelvis for prostate. Brain MRI if indicated (choriocarcinoma, small cell). Bone scan or PSMA PET for prostate cancer.
4. Operative report if surgery was performed. Orchiectomy path, RPLND findings, penectomy specimen.
5. Oncology treatment plan and response documentation. Cycles, response by imaging, tumor marker trends.
6. Late toxicity documentation if applicable: pulmonary function tests for bleomycin, audiometry for cisplatin, nerve conduction studies for peripheral neuropathy, DEXA for prostate ADT bone loss.

Timeline from filing to payment

Common denial reasons and fixes

1. Testicular cancer denial because "cure rates are high"

Fix: The listing does not require permanence. If your disease is metastatic beyond regional nodes at diagnosis, or if you've had recurrence, the listing is met. Push back on any denial that leans on statistical cure rates without addressing the actual prong criteria.

2. Regional retroperitoneal nodes counted as metastasis

Fix: Retroperitoneal nodes are regional for testicular cancer. If your only "metastasis" is retroperitoneal nodes, look to the recurrent prong (post-orchiectomy relapse) or inoperable/unresectable prong. Straightforward Stage II with retroperitoneal disease usually isn't a metastatic-prong case.

3. Prostate cancer denial when metastatic but responding to ADT

Fix: Listing 13.24 requires progression despite therapy. If you're newly on ADT and responding, 13.24 isn't met yet. Wait for progression, or build the RFC case around ADT side effects, or look for small cell differentiation on any repeat biopsy.

4. Path report inconclusive on small cell vs adenocarcinoma prostate

Fix: Push for immunohistochemistry (synaptophysin, chromogranin, CD56) to confirm neuroendocrine differentiation. Small cell prostate cancer meets 13.24 automatically.

5. Late effects of BEP chemo not documented

Fix: If your listing prong is a stretch but you have documented bleomycin lung, cisplatin neuropathy, or hearing loss, get PFTs, nerve conduction studies, and audiometry into the file. These build the RFC case.

State considerations

DDS wait times vary. Applicants in California see initial decisions averaging 105 days. Texas at 92 days. Florida at 118 days. New York at 96 days. Clear listing cases move faster. Testicular cancer cases with distant metastases often clear DDS in under 45 days when documentation is clean.

Related reading

• Why was my disability denied in 2026
• Denial Notice Anatomy 2026
• Listing 13.11 Skeletal System Sarcoma
• Listing 13.17 Small Intestine Cancer

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