Though relatively rare compared with other types of cancer, testicular cancer is the most common cancer affecting American men between the ages of 20 and 34, according to the American Cancer Society (ACS). Testicular cancer tends to have a positive prognosis because it can usually be treated successfully. Knowing the signs and symptoms of the disease can help ensure you receive early diagnosis and treatment, which improves your chances of survival.
Signs and Symptoms
A painless lump on (or embedded in) a testicle is the most common sign of testicular cancer, according to the ACS. Other testicular symptoms are also possible, including:
Pain or discomfort in the testicle, sometimes described as a feeling of heaviness in the scrotumA change in how the testicle feelsA swollen or enlarged testicle (without a defining lump)A dull ache in the groin or lower abdomenBuildup of fluid in the scrotum
Early-stage testicular cancer may also cause other kinds of symptoms, such as enlarged breast growth (gynecomastia), loss of sexual desire, and abnormally early signs of puberty in boys. If the cancer has spread to other parts of the body, it can also cause various additional symptoms, including:
Lower back painBelly painHeadaches and confusion (due to brain involvement)Numbness, tingling, or weakness in the extremities (due to spinal cord involvement)Respiratory issues, such as shortness of breath, chest pain, and cough
Testicular Self-Examination
Regularly conducting testicular self-exams can help you catch physical signs of testicular cancer early. Some doctors recommend conducting a self-exam once a month after puberty, particularly if you have a risk factor for testicular cancer, according to the ACS. When conducting the exam, make sure to hold your penis out of the way and check one testicle at a time. Also keep in mind that it’s normal to have differently sized testicles, testicles that hang at different lengths, and small bumps on the upper or middle outer side of the testicles (these may be a testicular structure called the epididymis). To conduct the exam, gently roll each testicle between your thumbs and fingers of both hands while you look and feel for:
Hard lumpsSmooth, rounded lumpsChanges in the size, shape, or consistency of the testicles
It’s best to conduct a testicular self-exam when the scrotum is relaxed, such as after a warm bath or shower.
Diagnosis
If you feel something abnormal in your testicles, see your doctor right away. Diagnosis of testicular cancer begins with your doctor asking you about your medical history and any symptoms you may be experiencing. Your doctor will then conduct a physical exam, looking for swelling and tenderness and noting the size and location of any lumps you may have. If your doctor finds a hard lump, he or she may hold a flashlight up to your scrotum to see if light doesn’t pass through it (a sign of a tumor). It’s also possible that your doctor will physically examine your groin, abdomen, and other areas of your body to see if the suspected cancer has spread. Your doctor will then order one or more tests to diagnose testicular cancer, particularly a scrotal ultrasound or a blood test that detects testicular tumor markers (substances linked to the disease), which includes alpha fetoprotein, human chorionic gonadotropin, and lactic dehydrogenase. In rare cases, doctors conduct a biopsy — cut off and inspect a small piece of testicular tissue — to diagnose testicular cancer, if the results of ultrasound or blood tests are unclear. Various imaging techniques, such as computed tomography (CT) scans of the abdomen and pelvis, chest X-rays, and magnetic resonance imaging (MRI) scans, may also be used if your doctor suspects the cancer has spread.
