10 Testicular Cancer Symptoms Every Man Should Know

Testicular cancer is one of the most common cancers affecting men between the ages of 15 and 35, though it can occur at any age. While it represents only about 1% of all male cancers, early detection is crucial for successful treatment outcomes. Understanding the symptoms and warning signs of testicular cancer can be lifesaving, as this type of cancer is highly treatable when caught early.

The testicles are part of the male reproductive system, responsible for producing sperm and testosterone. When abnormal cells begin to grow uncontrollably in one or both testicles, testicular cancer develops. Most testicular cancers begin in the germ cells, which produce sperm. Being aware of what’s normal for your body and recognizing changes early can make a significant difference in treatment success.

In this comprehensive guide, we’ll explore the most common symptoms of testicular cancer, helping you understand what to look for and when to seek medical attention. Remember, experiencing one or more of these symptoms doesn’t necessarily mean you have cancer, but it’s essential to get checked by a healthcare professional for proper evaluation.

1. A Painless Lump or Swelling in the Testicle

The most common symptom of testicular cancer is a painless lump or swelling in one of the testicles. This is often the first sign that men notice, typically discovered during self-examination or by accident.

The lump may feel like a small, hard mass about the size of a pea or it could be larger. It’s usually found on the front or side of the testicle. What makes this particularly concerning is that it’s typically painless, which can lead some men to ignore it. The lump may feel different from the rest of the testicular tissue and is usually firm to the touch.

Key characteristics include:

• Firm or hard texture, different from surrounding tissue
• Usually painless, though some discomfort may be present
• Can be any size, from very small to notably large
• Doesn’t go away and may gradually increase in size
• Most commonly appears in only one testicle

If you discover any unusual lump or mass in your testicle, it’s essential to schedule an appointment with your doctor immediately, even if it doesn’t cause pain.

2. Enlargement or Swelling of a Testicle

Beyond a discrete lump, you may notice that one testicle has become noticeably larger than the other or has changed in size. While it’s normal for one testicle to be slightly larger than the other, a sudden or significant change in size warrants medical attention.

This enlargement may occur gradually over weeks or months, or it can happen more rapidly. The affected testicle may feel heavier than usual or appear visibly larger when you look in the mirror. Some men describe a feeling of fullness or heaviness in the scrotum.

The swelling associated with testicular cancer is different from temporary swelling that might occur due to injury or infection. Cancer-related swelling:

• Persists over time rather than resolving quickly
• Doesn’t respond to typical treatments for infection or inflammation
• May be accompanied by a change in the testicle’s firmness
• Typically affects only one testicle

3. Dull Ache or Pain in the Scrotum or Lower Abdomen

While testicular cancer lumps are often painless, some men experience a dull, persistent ache in the affected testicle, scrotum, or lower abdomen. This discomfort is different from the sharp, intense pain associated with conditions like testicular torsion.

The pain or ache may be described as:

• A constant, dull discomfort rather than sharp or stabbing
• A heavy or dragging sensation in the groin or scrotum
• Mild to moderate in intensity, often tolerable but persistent
• Sometimes radiating to the lower back or abdomen
• Not severe enough to prevent daily activities but noticeable

Some men report that the discomfort comes and goes, while others experience continuous mild pain. This type of ache can be easily dismissed or attributed to other causes like muscle strain or minor injury, which is why it’s important to pay attention to any persistent discomfort in the testicular area, especially when accompanied by other symptoms.

4. Heaviness or Pressure in the Scrotum

Many men with testicular cancer describe an unusual feeling of heaviness or pressure in the scrotum. This sensation can be one of the earlier symptoms and is often described as feeling like you’re carrying extra weight in that area.

This heaviness is different from normal testicular weight and may be noticeable when:

• Walking or moving around
• Standing for extended periods
• During physical activity or exercise
• When wearing tighter clothing

The feeling of pressure or heaviness occurs because the growing tumor adds mass to the testicle, creating a weighted sensation. Some men compare it to the feeling of carrying a small stone or having something “pulling down” in the scrotal area. This symptom may be subtle at first but often becomes more noticeable as time progresses.

It’s important to note that this heaviness doesn’t typically come and go quickly – it tends to be persistent and may gradually worsen over time.

5. Changes in Testicle Texture or Firmness

Regular self-examination can help you become familiar with the normal texture and consistency of your testicles, making it easier to detect changes. Testicular cancer can cause noticeable changes in how the testicle feels.

You might notice:

• One testicle feeling significantly harder or firmer than the other
• Areas of unusual firmness or hard spots within the testicle
• Changes in the smooth texture of the testicular surface
• An irregular or bumpy feeling instead of the normal smooth surface
• Differences in consistency between the two testicles

Healthy testicles typically feel smooth, slightly firm, and oval-shaped. They should feel similar to a hard-boiled egg without the shell – firm but with some give. If one testicle feels noticeably different from the other, particularly if it’s harder or has irregular areas, this warrants medical evaluation.

The texture changes associated with testicular cancer are usually persistent and don’t fluctuate. Unlike temporary swelling from infection or injury, these changes remain constant or gradually worsen.

6. Accumulation of Fluid in the Scrotum (Hydrocele)

A hydrocele is a collection of fluid around the testicle that causes swelling in the scrotum. While hydroceles are common and often benign, they can sometimes be associated with testicular cancer, particularly when they develop suddenly in an adult male.

Characteristics of a hydrocele include:

• A smooth, fluid-filled swelling around the testicle
• The scrotum may appear enlarged and feel like a water balloon
• Usually painless, though there may be discomfort from the size
• May make the testicle difficult to feel due to the surrounding fluid
• Can occur on one or both sides, but cancer-related hydroceles typically affect one side

When a hydrocele develops suddenly in an adult without obvious cause, or when it’s accompanied by a testicular mass, it’s important to have it evaluated by a doctor. Your physician can use a simple test called transillumination (shining a light through the scrotum) to help determine if the swelling is fluid-filled and may recommend an ultrasound to examine the testicle beneath the fluid.

7. Breast Tenderness or Growth (Gynecomastia)

Though it may seem unrelated to testicular issues, some types of testicular cancer produce hormones that can cause breast tissue changes. This symptom, called gynecomastia, occurs when testicular tumors secrete hormones such as human chorionic gonadotropin (hCG) or produce estrogen.

Signs of gynecomastia related to testicular cancer include:

• Swelling or enlargement of one or both breasts
• Tenderness or sensitivity in the breast tissue
• Development of a lump or mass under the nipple area
• Changes in the nipple appearance

This symptom is more common with certain types of testicular cancer, particularly choriocarcinoma and some germ cell tumors. While gynecomastia can have many causes unrelated to cancer, when it occurs in conjunction with testicular symptoms or appears suddenly in a young man, it should be investigated.

It’s worth noting that gynecomastia affects roughly 10-20% of men with testicular cancer, so while it’s not the most common symptom, it’s an important warning sign that shouldn’t be ignored.

8. Lower Back Pain

Lower back pain can be a symptom of testicular cancer, particularly in more advanced cases where the cancer has spread to lymph nodes in the back of the abdomen (retroperitoneal lymph nodes). These lymph nodes are located along the back wall of the abdomen, near the spine.

Cancer-related lower back pain characteristics:

• Persistent ache in the lower back, particularly in the middle of the back
• Pain that doesn’t improve with typical remedies like rest or pain relievers
• May be accompanied by other testicular cancer symptoms
• Can range from dull and constant to more severe
• Doesn’t necessarily correlate with physical activity or movement

While lower back pain is an extremely common complaint with many possible causes, when it occurs alongside testicular symptoms or in young men without obvious explanation, it deserves medical attention. The pain occurs because enlarged lymph nodes can press on nerves and surrounding structures in the back area.

This symptom typically indicates that cancer may have spread beyond the testicle, making early detection and treatment even more critical.

9. Shortness of Breath or Chest Pain

In cases where testicular cancer has spread to the lungs, men may experience respiratory symptoms. While this represents more advanced disease, it’s important to be aware of these potential symptoms, especially if testicular cancer hasn’t been diagnosed yet.

Respiratory symptoms may include:

• Shortness of breath, particularly during physical activity or even at rest
• Persistent cough that doesn’t resolve
• Coughing up blood or blood-tinged sputum
• Chest pain or discomfort
• Feeling winded more easily than usual

Testicular cancer can spread to the lungs through the bloodstream. When tumors develop in the lungs, they can interfere with normal breathing function. The symptoms may develop gradually and might be initially dismissed as being related to respiratory infections or other lung conditions.

If you experience respiratory symptoms along with any testicular symptoms, or if you have persistent breathing difficulties without clear cause, seek medical evaluation promptly.

10. Abdominal Pain or Swelling

Abdominal discomfort or swelling can occur when testicular cancer spreads to the lymph nodes in the abdomen or when it causes other complications. This symptom typically appears in more advanced stages but is important to recognize.

Abdominal symptoms may present as:

• A dull ache or feeling of fullness in the lower abdomen
• Visible swelling or a mass that can be felt in the abdomen
• Discomfort that persists and may worsen over time
• Loss of appetite or early feeling of fullness when eating
• Nausea or digestive discomfort

When testicular cancer spreads to the retroperitoneal lymph nodes (located in the back of the abdomen), these nodes can become significantly enlarged. Large masses of cancer in the abdomen can cause a noticeable swelling, create pressure on other organs, or be felt as a firm mass during examination.

Abdominal symptoms combined with testicular changes should prompt immediate medical evaluation, as this combination suggests the cancer may have spread and requires urgent treatment.

Main Causes and Risk Factors of Testicular Cancer

While the exact cause of testicular cancer isn’t always clear, researchers have identified several risk factors that increase the likelihood of developing this disease. Understanding these factors can help men be more vigilant about monitoring their testicular health.

Cryptorchidism (Undescended Testicle): Men who were born with one or both testicles that didn’t descend properly into the scrotum have a significantly increased risk of testicular cancer. This is one of the strongest known risk factors, and the risk remains elevated even if the condition was surgically corrected in childhood.

Family History: Having a father or brother with testicular cancer increases your risk. There appears to be a genetic component to the disease, with men who have a first-degree relative with testicular cancer being 4-8 times more likely to develop it themselves.

Personal History of Testicular Cancer: Men who have had cancer in one testicle have an increased risk of developing cancer in the other testicle. Approximately 3-4% of men who’ve had testicular cancer will develop it in the remaining testicle.

Age: Testicular cancer most commonly affects younger men, with the highest incidence occurring between ages 15 and 35. However, it can develop at any age, including in infants and elderly men.

Race and Ethnicity: White men have a 4-5 times higher risk of developing testicular cancer compared to African American men. The disease is also more common in European and North American populations than in Asian or African populations.

Abnormal Testicular Development: Conditions that cause abnormal testicular development, such as Klinefelter syndrome, can increase the risk of testicular cancer.

HIV Infection: Men with HIV, particularly those with AIDS, have an elevated risk of testicular cancer.

Body Size: Some research suggests that tall men and those with higher body mass may have a slightly increased risk, though the connection isn’t fully understood.

It’s important to note that having one or more risk factors doesn’t mean you’ll definitely develop testicular cancer. Many men with risk factors never develop the disease, while some men with no known risk factors do develop it. This underscores the importance of regular self-examination and awareness of symptoms for all men, regardless of risk level.

Prevention and Early Detection

Unlike many other cancers, testicular cancer doesn’t have clearly established prevention methods since many risk factors (such as cryptorchidism and family history) cannot be changed. However, early detection dramatically improves treatment outcomes, and there are important steps men can take to catch the disease early.

Regular Self-Examination: Monthly testicular self-exams are the most effective way to detect testicular cancer early. The best time to perform a self-exam is during or after a warm shower when the scrotal skin is relaxed.

To perform a self-exam:

• Examine each testicle separately using both hands
• Roll the testicle gently between your thumbs and fingers
• Feel for any hard lumps, smooth rounded bumps, or changes in size, shape, or consistency
• It’s normal to feel the epididymis (the soft, tube-like structure behind the testicle)
• Know what’s normal for you so you can detect changes

Prompt Medical Evaluation: If you notice any changes, lumps, swelling, or other symptoms, see your doctor immediately. Don’t wait to see if symptoms go away on their own. Early-stage testicular cancer is highly treatable with cure rates exceeding 95%.

Treatment of Cryptorchidism: If a boy is born with an undescended testicle, having it surgically corrected before age 2 may reduce (though not eliminate) the risk of testicular cancer. Parents should work with their child’s pediatrician to address this condition early.

Regular Physical Exams: Annual physical examinations with your healthcare provider should include a testicular exam, especially for men with risk factors.

Awareness and Education: Understanding your risk factors and being aware of the symptoms can lead to earlier detection. Young men, in particular, should be educated about testicular cancer and the importance of self-examination.

While there’s no guaranteed way to prevent testicular cancer, these measures can significantly increase the chances of early detection, which is the most powerful tool we have against this disease. Remember, testicular cancer is one of the most curable cancers when detected early, with excellent long-term survival rates.

Frequently Asked Questions About Testicular Cancer Symptoms

What does testicular cancer feel like?

Testicular cancer most commonly feels like a hard, painless lump or a firm mass in the testicle. Some men describe it as feeling like a pea or marble embedded in the testicle. The affected testicle may also feel heavier than normal or have a dull ache. Unlike the sharp pain associated with injury or infection, testicular cancer typically causes mild discomfort at most, though the lump itself is usually painless to touch.

Can testicular cancer develop quickly?

Testicular cancer can develop relatively quickly compared to other cancers. Some types, particularly non-seminomas, can grow and spread rapidly over weeks to months. However, the rate of growth varies depending on the specific type of testicular cancer. This is why prompt medical attention is crucial if you notice any symptoms – waiting even a few weeks can make a difference in treatment outcomes.

Are testicular cancer symptoms always painless?

No, while the most common symptom (a testicular lump) is usually painless, not all testicular cancer symptoms are pain-free. Some men experience a dull ache in the testicle, scrotum, or lower abdomen. Others may feel discomfort, heaviness, or pressure. However, severe or sharp pain is less common and more often associated with other conditions like testicular torsion or infection.

Can testicular cancer affect both testicles at once?

Testicular cancer almost always affects only one testicle initially. Cancer in both testicles at the same time is extremely rare, occurring in less than 2% of cases. However, men who have had cancer in one testicle have a slightly increased risk (3-4%) of developing cancer in the other testicle later, which is why ongoing monitoring is important after treatment.

How do I know if a lump is cancer or something else?

You cannot definitively determine whether a testicular lump is cancer without medical evaluation. However, lumps that are hard, painless, attached to the testicle, and don’t go away are more concerning for cancer. Other conditions like cysts, varicoceles, or hydroceles can also cause lumps or swelling. The only way to know for certain is to see a doctor who can perform a physical exam, ultrasound, and possibly blood tests.

At what age should men start checking for testicular cancer?

Men should begin performing monthly testicular self-exams starting in their teenage years, around age 15. While testicular cancer can occur at any age, it’s most common in men between 15 and 35 years old. Establishing the habit of self-examination early helps young men become familiar with what’s normal for them, making it easier to detect changes.

Should I see a doctor if I have just one symptom?

Yes, you should see a doctor if you notice any persistent testicular symptom, even if it’s just one. A painless lump, persistent swelling, or any change in your testicle that lasts more than two weeks warrants medical evaluation. Don’t wait for multiple symptoms to appear or for symptoms to worsen. Early detection is key to successful treatment.

Can testicular cancer be felt from the outside?

Yes, most testicular cancers can be felt during a physical examination or self-exam. The cancer typically presents as a hard lump or area of firmness within the testicle itself that can be detected by gently rolling the testicle between your fingers. However, in some cases, particularly when there’s significant swelling or fluid accumulation, the tumor may be harder to feel, which is why imaging tests like ultrasound are important for diagnosis.

Is testicular cancer painful?

Testicular cancer itself is usually not painful, which is why many men delay seeking treatment. The characteristic lump is typically painless, though about 20% of men report some discomfort, heaviness, or a dull ache in the testicle or lower abdomen. If you experience sudden, severe testicular pain, this is more likely to be a different condition such as testicular torsion or infection, but still requires immediate medical attention.

What should I do if I find a lump during self-examination?

If you discover a lump or any abnormality during self-examination, schedule an appointment with your doctor as soon as possible, ideally within a few days. Don’t panic, as not all lumps are cancerous, but don’t delay seeking evaluation either. Your doctor will perform a physical exam and likely order an ultrasound to determine the nature of the lump. Avoid searching endlessly online for answers – professional medical evaluation is the only way to get an accurate diagnosis.

References:

• American Cancer Society – Testicular Cancer Signs and Symptoms
• National Cancer Institute – Testicular Cancer Treatment
• Mayo Clinic – Testicular Cancer
• NHS – Testicular Cancer
• Cancer Research UK – Testicular Cancer Symptoms