Testicular cancer is a type of cancer that occurs in the testicles, or testes. While lumps and swelling are common symptoms, people should be aware of other potential signs. These include changes in the size and weight of the testicles, as well as a sharp pain in the scrotum.
Research suggests that about 1 in 250 males in the United States will develop testicular cancer during their lifetime. The average age at diagnosis is 33 years, and it is the most common solid cancer type among males aged 15–34 years in the U.S.
Although a lump in the testicle can indicate testicular cancer, there are many potential causes of testicular lumps. It is important for people to be knowledgeable about other possible symptoms and to see a doctor if they have any concerns.
In this article, we will describe some other possible symptoms of testicular cancer and explain when a person should see a doctor.
In some people, testicular cancer symptoms may appear at an early stage, but in others, symptoms do not appear until much later. To catch any symptoms early, it is important to conduct regular testicular self-exams.
Although a lump does not always mean cancer, if anyone notices a change in their testicles, they should see a doctor.
Other than lumps, people should also be mindful of the following potential symptoms:
Some people with testicular cancer may report experiencing pressure in one or both testicles. This pressure may be more pronounced when urinating or ejaculating.
Testicular cancer can cause changes to how the scrotum (the skin that contains the testicles) feels. For instance, the testicles may start to feel “heavier” or have a feeling of fullness.
Leg or scrotal swelling
A testicular tumor can affect blood and fluid flow in the body, leading to swelling. This swelling may occur in the testicle or groin, or even in the leg.
Sometimes, testicular cancers are due to tumors in the germ cells of the body. These cells secrete hormones, including human chorionic gonadotropin (hCG). When hCG levels build up in the body, this can cause male breasts to grow, known as gynecomastia. Breast soreness may accompany this growth.
Difference in appearance
While a person’s testicles are not always identical, testicular cancer can cause one testicle to appear noticeably different in shape or size.
Testicular tumors can cause pain and discomfort in the affected testicle. However, pain is not usually the first symptom that a person experiences when they have testicular cancer, according to the American Urological Association.
Cancer metastasis symptoms
Sometimes, testicular cancer can metastasize (spread) to other parts of the body. Metastasis may result in other symptoms that do not seem related to testicular cancer, despite being so. Examples of testicular cancer metastasis symptoms include:
- lower back pain
- a neck mass
- an upset stomach
- unexplained respiratory symptoms, such as a cough or shortness of breath
In some cases, a person may cough up blood, which indicates that the cancer has spread to the lungs.
A person may not link these symptoms to testicular cancer until their cancer is more advanced.
The symptoms of several medical conditions can closely resemble those of testicular cancer. A doctor may try to rule these out before proceeding to diagnose testicular cancer.
- Epididymitis: Epididymitis is an inflammation of the epididymis, which is a duct through which sperm passes. The condition causes symptoms that include inflammation, pain, and swelling. Often, the condition is due to the effects of a sexually transmitted infection (STI), such as gonorrhea or chlamydia.
- Hydrocele: A hydrocele occurs when fluid fills the scrotum. This fluid can cause testicular swelling, heaviness, and discomfort.
- Inguinal hernia: An inguinal hernia occurs when an area of the intestine moves through the abdominal wall. It can cause pain, swelling, and a palpable mass or lump in the groin.
- Orchitis: Orchitis is the swelling of one or both testicles. A person can have epididymitis and orchitis at the same time. Orchitis symptoms may include testicular pain, blood in the semen, pain with urination or ejaculation, or groin tenderness on one side. Conditions that cause STIs can lead to orchitis, as can a history of the mumps or damage to the urinary tract.
- Testicular injury: A blow or other injury to the testicle can cause symptoms that closely resemble those of testicular cancer. Injury can cause blood to leak from the testicle and into the scrotum, which may lead to infection.
- Testicular torsion: Testicular torsion can occur due to injury or unknown factors that lead to the testicle becoming twisted. The resulting impaired testicular blood flow can cause pain and swelling, and surgery is often necessary.
Sometimes, while a doctor is evaluating one of these conditions, they may discover that the person also has testicular cancer.
The American Cancer Society state that some doctors recommend self-examining the testicles monthly. Doing this is particularly important if a person has certain risk factors, such as a family history of cancer. These individuals should also talk with their doctor for further advice.
There is some debate regarding the benefit of testicular self-exams. The Preventive Services Task Force have not recommended routine self-exams to screen for testicular cancer because there is insufficient evidence to prove that they improve outcomes.
However, some recent research advocates for testicular self-exams and suggests their use for monitoring testicular health, beyond cancer detection. People may wish to discuss the pros and cons of routine testicular self-exams with a doctor.
A testicular self-exam involves the following steps:
- Perform the self-exam after a shower or bath, as this is when the scrotal skin is most “relaxed.”
- Move the penis to one side and feel each testicle separately.
- Hold the testicle between the thumb and fingers, gently rolling it between the fingers.
- Look and feel for any lumps, masses, or changes in size, shape, or consistency.
A person’s first testicular self-exam provides a baseline against which they can compare future exams. If they notice changes in the shape, appearance, or feeling of the testicle, they should talk to a doctor.
It is normal for testicles not to feel completely smooth or be symmetrical. One may also seem to hang lower than the other. However, anyone who is unsure whether the differences are due to normal anatomy or related to a testicular problem should talk to a doctor, if possible.
It is important to see a doctor about any potential testicular cancer symptoms. In addition to a lump on the testicles, these may include:
- aching or a feeling of firmness in the testicle or scrotum
- heaviness in the scrotum
- swelling in the scrotum
- unexplained pain in the testicle or scrotum
Often, a doctor may first prescribe antibiotics to treat a potential infection, such as epididymitis. If symptoms persist after antibiotic treatment, a doctor may recommend diagnostic or imaging tests to identify abnormalities or potentially cancerous lesions.
Testicular cancer is a highly treatable cancer, with up to 97% of people surviving at least another 5 years after treatment.
Performing regular self-exams and reporting any testicle-related abnormalities or discomforts to a doctor are important. Taking these steps can aid testicular cancer detection and lead to a person receiving early, effective treatments.