Testicular Cancer: Signs, Diagnosis, and Who's at Risk
Learn the signs, diagnosis steps, and risk factors of testicular cancer. Discover the importance of self-exams, early detection, and when to see a doctor.
Written by Dr. Dhankecha Mayank Dineshbhai
Reviewed by Dr. D Bhanu Prakash MBBS, AFIH, Advanced certificate in critical care medicine, Fellowship in critical care medicine
Last updated on 11th Sep, 2025
Introduction
Testicular cancer is a highly treatable form of cancer, especially when caught early. While it is relatively rare compared to other cancers, it is the most common cancer in young and middle-aged men, making awareness crucial. This guide will walk you through everything you need to know about the signs of testicular cancer, the diagnosis process, and the key risk factors. Knowing what to look for can empower you to take charge of your health. We will demystify the symptoms, explain what happens during a medical evaluation, and address common concerns. Early detection is the cornerstone of successful treatment, and understanding your body is the first step.
Understanding Testicular Cancer
Testicular cancer occurs when malignant cells develop in the tissues of one or, less commonly, both testicles. The testicles are part of the male reproductive system responsible for producing sperm and the hormone testosterone. Most testicular cancers begin in the germ cells, which are the cells that make sperm. The two main types of germ cell tumours are seminomas and non-seminomas, which grow and spread differently and are treated in distinct ways. Understanding that testicular cancer is highly curable, with a survival rate of over 95% when detected early, is vital for reducing fear and encouraging prompt action.
What is Testicular Cancer?
At its core, testicular cancer is an uncontrolled growth of abnormal cells within a testicle. This growth often forms a tumour, which may be felt as a lump. Unlike many other cancers, testicular cancer has a very clear and effective standard treatment path, leading to excellent outcomes for the vast majority of patients.
How Common is Testicular Cancer?
The American Cancer Society estimates about 1 in 250 men will develop testicular cancer in their lifetime. While this makes it rare overall, its impact is significant because it primarily affects younger men. It is the most common cancer diagnosed in men between the ages of 15 and 35, though it can occur at any age. The rate of diagnosed cases has been increasing for several decades, which makes awareness even more important.
The Most Common Signs and Symptoms of Testicular Cancer
Recognising the symptoms is the first line of defence. Most often, men discover testicular cancer themselves, either by chance or through a self-exam.
The Primary Symptom: A Lump or Swelling
The most common early sign of testicular cancer is a painless lump or swelling in either testicle. Men may also notice a noticeable increase in the firmness of the testicle or a change in size where one testicle becomes larger than the other. It's crucial to understand that not every lump is cancerous, but any new lump requires immediate medical evaluation.
- Other Physical Symptoms to Watch For
- Beyond a lump, other symptoms can include:
- A feeling of heaviness or aching in the scrotum or lower abdomen.
- A sudden buildup of fluid in the scrotum.
- Pain or a dull ache in the testicle or scrotum (though pain is not always present).
- Changes in how the testicle feels.
Symptoms if Cancer Has Spread (Metastasised)
In some cases, the first symptoms may be related to the cancer having spread to other parts of the body. This can include:
- Lower back pain (a common sign of spread to lymph nodes).
- Shortness of breath or chest pain (indicating spread to the lungs).
- Swollen lymph nodes in the neck.
- Unusual fatigue or unexplained weight loss.
Many men report a specific sensation of "heaviness" or "dragging" in the scrotum, which is different from general pain. This subtle feeling is often overlooked but can be a significant early indicator.
The Critical Importance of Testicular Self-Exams
Performing a monthly testicular self-exam is a simple, 2-minute habit that can save your life. The goal is to become familiar with the normal size, shape, and weight of your testicles so you can more easily detect any changes.
How to Perform a Testicular Self-Exam (Step-by-Step)
1. Best Time: Perform the exam during or after a warm shower or bath. The heat relaxes the scrotal skin, making it easier to examine.
2. Examine One at a Time: Gently roll each testicle between your thumb and fingers of both hands.
3. Feel for Normality: The testicle itself should feel smooth, firm, and egg-shaped. It's normal for one to be slightly larger.
4. Know the Anatomy: Behind each testicle, you will feel the epididymis, a soft, tube-like structure. This is a normal part of the anatomy and not a lump.
5. Look and Feel: Check for any hard lumps, smooth rounded masses, or any change in size, shape, or consistency.
Consult Top Uro Oncologists
When is the Best Time to Do a Self-Check?
Aim for once a month. Consistency is key. If you find anything unusual, don't panic—but do schedule an appointment with a doctor promptly. If you notice a painless lump or any concerning changes, consult a doctor online with Apollo24|7 for further evaluation and to determine if an in-person visit is needed.
How is Testicular Cancer Diagnosed? A Step-by-Step Guide
If a symptom or self-exam raises concern, a doctor will follow a standard testicular cancer diagnosis pathway to confirm or rule out cancer.
Step 1: Clinical Examination and Medical History
A doctor, often a urologist, will discuss your symptoms and medical history (including any history of cryptorchidism) and perform a physical exam of the testicles, abdomen, and lymph nodes to assess for swelling or tenderness.
Step 2: Scrotal Ultrasound - The Key Diagnostic Tool
A scrotal ultrasound is the most important test for diagnosing testicular masses. It uses sound waves to create an image of the testicles. It can confirm the presence of a solid mass, which is likely a tumour, versus a fluid-filled cyst, which is usually benign.
Step 3: Blood Tests for Tumour Markers
Many testicular cancers produce specific proteins and hormones called tumour markers. A blood test can measure the levels of these markers.
Understanding Tumour Markers:
- Alpha-fetoprotein (AFP): Elevated in non-seminoma tumours.
- Human chorionic gonadotropin (HCG): Elevated in some seminomas and non-seminomas.
- Lactate dehydrogenase (LDH): A less specific marker that can be elevated with bulky disease.
These markers are crucial not only for diagnosis but also for monitoring the effectiveness of treatment. Apollo24|7 offers convenient home collection for these crucial blood tests, making the diagnostic process smoother.
Step 4: Radical Inguinal Orchiectomy and Biopsy
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 a biopsy to confirm the type of cancer. This procedure is both diagnostic and therapeutic.
Known Risk Factors for Testicular Cancer
A risk factor is anything that increases your chance of getting a disease. Having a risk factor doesn't mean you will get cancer, and many men with testicular cancer have no known risk factors.
- Unchangeable Risk Factors (Age, Race, Genetics)
- Age: Young and middle-aged men are at the highest risk.
- Race and Ethnicity: The risk is significantly higher in white men compared to Black or Asian men.
- Body Size: Some studies suggest taller men may have a slightly increased risk.
Medical History Factors (Cryptorchidism)
This is the most significant known risk factor. Cryptorchidism, or an undescended testicle, is a condition where one or both testicles fail to move into the scrotum before birth. Even if surgically corrected, the risk remains elevated.
Family History and Genetic Conditions
Having a close relative (father or brother) with testicular cancer increases your risk. Certain genetic conditions, such as Klinefelter syndrome, are also associated with a higher risk.
Debunking Myths: What Does NOT Cause Testicular Cancer
It's equally important to address common misconceptions. There is no proven link between testicular cancer and:
- Vasectomy: Multiple large studies have found no connection.
- Physical Trauma: While an injury might lead to the discovery of an existing lump, it does not cause cancer.
- Sexual Activity: There is no evidence that masturbation, frequency of sex, or sexually transmitted infections cause testicular cancer.
- Tight Clothing: Myths about underwear choice affecting cancer risk are unfounded.
Conclusion: Early Detection is Your Best Defence
Understanding the signs of testicular cancer and the diagnosis process empowers you to be proactive about your health. While the thought of cancer can be frightening, the outlook for testicular cancer is overwhelmingly positive. The key is early action. Knowing your body through regular self-exams and seeking prompt medical attention for any changes can make all the difference. Most lumps are not cancer, but only a doctor can provide a definitive diagnosis. Do not let fear or embarrassment delay you. If you have concerns or notice symptoms, book a physical visit to a urologist with Apollo24|7 for professional evaluation.
Consult Top Uro Oncologists
Consult Top Uro Oncologists
Dr. K Ramesh
Urologist
23 Years • M.S., FRCS(Glasgow)., IntlFRCS (Glasgow)(Urology), DNB(Urology), FEBU (Fellow of European Board Of Urology)
Chennai
Apollo Hospitals Greams Road, Chennai
(625+ Patients)
Dr. Rupam Manna
Radiation Specialist Oncologist
4 Years • MBBS MD(RADIO THERAPY)
Barasat
Diab-Eat-Ease, Barasat
Dr. Swati Shah
Surgical Oncologist
15 Years • DNB Surgical Oncology, certified Robotic Cancer Surgeon
Ahmedabad
Apollo Hospitals Gandhinagar, Ahmedabad
(25+ Patients)
Dr Ved Bhaskar
Urologist
11 Years • MBBS, MS (Gen Surgery), MCh (Urology), Fellowship in Robotic Surgery
Lucknow
Apollomedics Super Speciality Hospital, Lucknow
Dr. Priyanka Srivastava
Medical Oncologist
15 Years • MBBS, MD, DrNB Medical Oncology, Fellowship (Medical Oncology) , PMCC, UOT Canada.
Ahmedabad
Apollo Hospitals Gandhinagar, Ahmedabad
More articles from Testicular Cancer
Frequently Asked Questions
Does testicular cancer hurt?
Not always. A common warning sign is actually a painless lump in the testicle. However, some men may experience aching, heaviness, or sudden pain. Any persistent change warrants a doctor's visit.
Can you 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. Treatments like chemotherapy can affect fertility, so sperm banking before treatment is often recommended.
Is testicular cancer deadly?
Thanks to modern treatments, testicular cancer survival rates are very high. The overall 5-year survival rate is over 95%. Even when cancer has spread, cure rates remain excellent.
How long can you have testicular cancer without knowing?
It's variable. Some aggressive types can grow quickly in a matter of weeks, while others may grow slowly over months. This is why monthly self-exams are crucial to detect changes early.
Will I need to have both testicles removed?
No. The standard surgery (orchiectomy) involves removing only the testicle with the tumor. The remaining healthy testicle is usually sufficient to maintain normal testosterone levels and appearance.