Testicular Cancer: Signs, Diagnosis, and Key Risk Factors
Know all about the testicular cancer, signs, diagnosis, risk factors, significance of early detection and more.
Written by Dr. Rohinipriyanka Pondugula
Reviewed by Dr. M L Ezhilarasan MBBS
Last updated on 17th Sep, 2025
Introduction
Testicular cancer, though relatively rare, is the most common cancer in young men aged 15 to 35. The thought of a cancer diagnosis can be daunting, but there's profoundly good news: when detected early, testicular cancer is one of the most treatable and curable forms of cancer, with a survival rate exceeding 95%. The key to this success lies in awareness, knowing your body, recognising the early warning signs, and understanding your personal risk factors. This guide will walk you through everything you need to know about the symptoms of testicular cancer, the modern diagnosis process, and the factors that might increase your risk.
Recognising the Early Signs and Symptoms
Early detection of testicular cancer dramatically improves treatment outcomes. The symptoms can be subtle, so it's crucial to pay attention to any changes in your testicles. Most often, men discover testicular cancer themselves, either by chance or during a self-exam.
The Most Common Symptom: A Lump or Swelling
The hallmark sign of testicular cancer is a painless lump or nodule on either testicle. You might also notice a general enlargement or swelling of a testicle without a distinct lump. The lump is typically hard and can be as small as a pea. It's important to remember that not every lump is cancerous, but every lump requires a prompt professional evaluation. This is the single most important early sign of testicular cancer to be aware of.
Consult an Oncologist for Personalised Advice
Pain, Discomfort, and Heaviness
While often painless, some men experience a dull ache or a feeling of heaviness in the lower abdomen, groin, or scrotum. You might feel a general discomfort or a sensation of "dragging" in the scrotum. Sharp pain is less common but can occur, especially if there is bleeding inside the tumour. Any persistent testicle pain or unusual sensation warrants a check-up.
Less Common but Important Symptoms
In some cases, symptoms may appear that seem unrelated to the testicles. These can include:
- Breast tenderness or growth (gynecomastia): Certain types of testicular tumours secrete hormones that can cause breast tissue to swell or become tender.
- Lower back pain: This can be a sign that the cancer may have spread to lymph nodes in the back of the abdomen.
- Shortness of breath or chest pain: In advanced stages, if the cancer has spread to the lungs, these respiratory symptoms may occur.
Any sudden change in how your testicles feel or look should be discussed with a doctor. If you notice a persistent lump, swelling, or pain, consult a doctor online with Apollo24|7 for further evaluation. A quick virtual consultation can guide the necessary next steps.
Who is at Risk? Key Testicular Cancer Risk Factors
Understanding the risk factors for testicular cancer helps individuals be more vigilant. However, it's critical to know that many men who develop testicular cancer have no known risk factors. Having a risk factor doesn't mean you will get cancer, and not having any doesn't mean you are immune.
The Primary Risk Factor: Cryptorchidism (Undescended Testicle)
This is the most significant and well-established risk factor. Cryptorchidism is a condition where one or both testicles fail to move down into the scrotum before birth. Men with a history of an undescended testicle have a significantly higher risk of developing cancer, even if surgery (orchiopexy) was performed to correct it. The risk applies to both testicles.
Age, Race, and Family History
- Age: While it can occur at any age, testicular cancer in young men between 15 and 35 is most common.
- Race and Ethnicity: White men have a much higher risk than Black, Asian, or Hispanic men. The reasons for this disparity are not fully understood.
- Family History: Having a close relative (especially a father or brother) who has had testicular cancer increases your risk, suggesting a possible genetic component.
Other Potential Risk Factors and Myths
- Personal History: A man who has had cancer in one testicle has an increased risk of developing it in the other testicle.
- HIV Infection: Some evidence suggests a link between HIV infection and a slightly elevated risk.
- Body Size: Some studies have indicated a correlation between taller height and a higher risk, though the connection is not definitive.
- Myths Debunked: There is no proven link between testicular cancer and vasectomy, athletic activity, or specific types of underwear.
How is Testicular Cancer Diagnosed? A Step-by-Step Guide
If a doctor suspects testicular cancer based on symptoms or a physical exam, they will follow a standard testicular cancer diagnosis process to confirm it.
Step 1: Physical Examination and Medical History
The doctor will carefully feel (palpate) your testicles, abdomen, and lymph nodes to check for lumps, swelling, or tenderness. They will ask about your symptoms, duration, and any personal or family history of cancer.
Step 2: Scrotal Ultrasound – The Key Diagnostic Tool
This is the most important test for diagnosing testicular cancer. A scrotal ultrasound for cancer uses sound waves to create a detailed image of your scrotum and testicles. It is painless and non-invasive. The ultrasound can definitively determine whether a lump is solid (a potential tumour) or fluid-filled (a benign cyst), and it helps rule out other conditions like infection or injury.
Step 3: Serum Tumour Marker Tests
A blood draw will be performed to check for certain proteins that are often elevated in men with testicular cancer. These testicular cancer tumour markers are:
- Alpha-fetoprotein (AFP)
- Human chorionic gonadotropin (HCG)
- Lactate dehydrogenase (LDH)
Not all tumours secrete these markers, but when they are elevated, they are powerful tools for diagnosis, determining the type of cancer, and monitoring the response to treatment. Apollo24|7 offers convenient home collection for tests like these tumour markers, making the diagnostic process smoother.
Step 4: Radical Inguinal Orchiectomy and Pathology
If the ultrasound suggests cancer, the next step is almost always a surgical procedure called a radical inguinal orchiectomy. This involves removing the entire affected testicle through an incision in the groin (not the scrotum). This approach prevents the potential spread of cancer cells. The removed testicle is then sent to a lab for pathological analysis, which confirms the diagnosis and identifies the specific type of germ cell tumour (seminoma or non-seminoma), which is crucial for planning further treatment.
The Critical Importance of Early Detection
The high cure rate for testicular cancer is directly tied to early detection. A tumour found at an early stage, before it has spread beyond the testicle, is highly treatable, often with surgery alone. Knowing how to perform a self-exam is a simple yet powerful tool for taking control of your health.
H3: How to Perform a Testicular Self-Exam (TSE)
The best time to do a TSE is during or after a warm shower or bath, when the scrotal skin is relaxed.
1. Examine one testicle at a time. Use both hands.
2. Place your index and middle fingers underneath the testicle and your thumbs on top.
3. Gently roll the testicle between your thumbs and fingers. Feel for any hard lumps, smooth rounded masses, or changes in the size, shape, or consistency of the testicle.
4. Find the epididymis, a soft, rope-like structure on the back of each testicle. This is a normal part of the anatomy, not a lump.
5. Repeat with the other testicle.
Perform this testicular self-examination monthly to become familiar with what is normal for you, making it easier to spot any changes.
Conclusion
Facing the possibility of a cancer diagnosis is intimidating, but knowledge is your greatest ally. Understanding the signs and symptoms of testicular cancer, along with the risk factors, transforms you from a passive observer into an active participant in your health. Remember, most lumps are not cancer, but everyone deserves medical attention. The diagnostic process is straightforward and highly effective, and treatment success rates are outstanding. By incorporating a simple monthly self-exam into your routine, you are taking a powerful step toward early detection and peace of mind. Don't let fear or embarrassment prevent you from seeking help. Your health is paramount. If you have any concerns or notice any changes, book a physical visit to a doctor with Apollo24|7 for a confidential and professional evaluation.
Consult an Oncologist for Personalised Advice
Consult an Oncologist for Personalised Advice
Dr Sunita Samleti
Oncologist
18 Years • M.D. (Pathology)- TN Medical College, Mumbai University, Mumbai, Mar 2005 M.B.B.S. Grant Medical College, Mumbai University, Mumbai, Oct 1999
Chinagadila
Apollo Hospitals Health City Unit, Chinagadila
Dr.sanchayan Mandal
Oncologist
17 Years • MBBS, DrNB( MEDICAL ONCOLOGY), DNB (RADIOTHERAPY),ECMO. PDCR. ASCO
Kolkata
Dr. Sanchayan Mandal Oncology Clinic, Kolkata
Dr. Sanchayan Mandal
Oncologist
17 Years • MBBS, DNB Raditherapy, DrNB Medical Oncology
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
Dr Gowshikk Rajkumar
Oncologist
10 Years • MBBS, DMRT, DNB in Radiation oncology
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Raja T
Oncologist
20 Years • MBBS; MD; DM
Chennai
Apollo Hospitals Greams Road, Chennai
(175+ Patients)
Consult an Oncologist for Personalised Advice
Dr Sunita Samleti
Oncologist
18 Years • M.D. (Pathology)- TN Medical College, Mumbai University, Mumbai, Mar 2005 M.B.B.S. Grant Medical College, Mumbai University, Mumbai, Oct 1999
Chinagadila
Apollo Hospitals Health City Unit, Chinagadila
Dr.sanchayan Mandal
Oncologist
17 Years • MBBS, DrNB( MEDICAL ONCOLOGY), DNB (RADIOTHERAPY),ECMO. PDCR. ASCO
Kolkata
Dr. Sanchayan Mandal Oncology Clinic, Kolkata
Dr. Sanchayan Mandal
Oncologist
17 Years • MBBS, DNB Raditherapy, DrNB Medical Oncology
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
Dr Gowshikk Rajkumar
Oncologist
10 Years • MBBS, DMRT, DNB in Radiation oncology
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Raja T
Oncologist
20 Years • MBBS; MD; DM
Chennai
Apollo Hospitals Greams Road, Chennai
(175+ Patients)
More articles from Testicular Cancer
Frequently Asked Questions
What does a testicular cancer lump actually feel like?
It typically feels like a hard, pea-sized or larger lump attached to the front or side of the testicle itself. It's often painless to the touch. Remember, the epididymis feels like a soft rope and is normal.
I have testicle pain but no lump. Could it still be cancer?
While cancer is often painless, it can sometimes cause a dull ache or heaviness. However, testicular pain is more commonly caused by other issues like infections, injuries, or varicoceles. It's still important to get any persistent pain checked out by a doctor to rule out serious causes.
Can I still have children after testicular cancer treatment?
Yes, many men can still father children after treatment. Surgery to remove one testicle usually does not affect fertility, as the remaining testicle produces enough sperm. However, some treatments like chemotherapy or radiation can temporarily or permanently impact sperm production. Doctors strongly recommend sperm banking before starting any treatment to preserve fertility options.
Is there any way to prevent testicular cancer?
There is no known way to prevent testicular cancer. Therefore, the focus is on early detection through awareness of symptoms and regular self-exams to find it at its most treatable stage.
Will I need to have regular check-ups after treatment?
Yes, follow-up care is a critical part of the process. After treatment, you will have a schedule of regular appointments for several years. These will include physical exams, blood tests (tumor markers), and imaging scans (like CT scans) to ensure the cancer has not returned and to manage any potential long-term side effects of treatment.